Avascular necrosis of hip: Difference between revisions
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**Decompression sickness (Caisson disease) | **Decompression sickness (Caisson disease) | ||
== | ==Clinical Features== | ||
==Differential Diagnosis== | |||
==Evaluation== | |||
*Plain XR is poorly sensitive in early stages, as low as 41% | *Plain XR is poorly sensitive in early stages, as low as 41% | ||
*Radiographic changes may be delayed by years | *Radiographic changes may be delayed by years | ||
Revision as of 10:34, 30 July 2016
Background
- Etiologies
- Steroid use
- Trauma
- Pancreatitis
- EtOH
- Radiation
- Sickle cell disease
- Infiltrative disease
- HIV
- Malignancy
- Decompression sickness (Caisson disease)
Clinical Features
Differential Diagnosis
Evaluation
- Plain XR is poorly sensitive in early stages, as low as 41%
- Radiographic changes may be delayed by years
- MRI ~90% sensitivity and specificity
Disposition
- Initial supportive care until later stages of disease
- Orthopedic consultation for repeat imaging and risk stratification for surgical treatment
References
- Stoica Z et al. Imaging of Avascular Necrosis of Femoral Head: Familiar Methods and Newer Trends. Curr Health Sci J. 2009 Jan-Mar; 35(1): 23–28.
- Kelly JD et al. Femoral head avascular necrosis treatment & management. Aug 16, 2015. http://emedicine.medscape.com/article/86568-treatment#showall.