Avascular necrosis is a disease affecting joints, most commonly the hips, where insufficient blood flow to the bone causes death to the bone. Causes of this disease would be trauma to the joint or restriction in blood vessels within the bone. Alcoholism can also cause this disease. Over use of cortisone can be also be a cause. Avascualar necrosis can go undetected for months. MRI is the best type of imaging to diagnose avascular necrosis early. X-rays and bone scans can also be used to diagnose. There is no reversal for avascular necrosis. If caught in early stages, treatment with pain medication and steroid can help treat the pain and prevent further deterioration of the bone. If deterioration is severe, surgery would be the best treatment. There are different types of surgeries depending on the level of deterioration. These surgeries include decompression of the femoral head, bone grafts, and hip replacements. Decompression surgery would drill holes into the femoral head in hope that blood vessels would enter through the new openings and begin bone regeneration. Bone grafts would be placed in the femur and blood vessels attached to create a new path for blood in the hip. Joint replacement is the last treatment, and would be used in severe cases. Included is a MRI image of a hip with avascular necrosis. I have imaged a patient in his late 20's with this disease. To view this type of a disease in someone so young, and appearing to be healthy is scary.
