Avascular necrosis of hip: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Limp | |||
*Limited range of motion of joint, both active and passive | |||
*Pain: Knee, Thigh, and/or Groin | |||
*Wasting of local musculature | |||
*Asymmetric leg length | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 17:19, 31 July 2016
Background
Etiologies
- Traumatic causes
- Femoral neck fracture/Dislocation
- Non-traumatic causes
- Use of Corticosteriods, Alcohol, Tobacco
- Systemic Lupus Erythematosus
- Chronic Kidney Disease
- Pancreatitis
- Radiation therapy
- HIV
- Caisson Disease aka Dysbarism
- Legg-Calve-Perthes disease
- Idiopathic
Clinical Features
- Limp
- Limited range of motion of joint, both active and passive
- Pain: Knee, Thigh, and/or Groin
- Wasting of local musculature
- Asymmetric leg length
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
- JONES PHD, L. C. AND MONT MD, M. A. Osteonecrosis (avascular necrosis of bone) In-text: (Jones PhD and Mont MD) Your Bibliography: Jones PhD, Lynne C and Michael A Mont MD. "Osteonecrosis (Avascular Necrosis Of Bone)". UpToDate. N.p., 2016. Web. 31 July 2016.
- Kelly JD et al. Femoral head avascular necrosis treatment & management. Aug 16, 2015. http://emedicine.medscape.com/article/86568-treatment#showall.
- 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.