Oszteonekrózis

Oszteonekrózis, also known as avascular necrosis or aseptic necrosis, is a medical condition characterized by the death of bone tissue due to a lack of blood supply. This deprivation of blood can lead to bone collapse, pain, and eventual joint destruction if it occurs near a joint. The most commonly affected bones include the femoral head, humeral head, and the bones of the wrists and ankles.

The causes of osteonecrosis are varied and can include trauma, such as fractures or dislocations, which can disrupt blood flow to the bone. Other risk factors include the long-term use of corticosteroid medications, excessive alcohol consumption, and certain medical conditions like sickle cell disease, lupus, and Gaucher disease. Idiopathic osteonecrosis, where no specific cause can be identified, also occurs.

Symptoms of osteonecrosis can range from mild to severe and often depend on the location and extent of the affected bone. Early stages may be asymptomatic, but as the condition progresses, pain becomes a prominent symptom, often worsening with weight-bearing activities. The pain can be deep and throbbing. Swelling and limited range of motion in the affected joint may also develop.

Diagnosis typically involves a combination of medical history, physical examination, and imaging studies. X-rays are often the first step, but they may not detect early changes. Magnetic resonance imaging (MRI) is highly effective in identifying osteonecrosis in its early stages, as it can visualize changes in bone marrow edema and the extent of bone death. Bone scans may also be used.

Treatment approaches for osteonecrosis depend on the stage of the disease, the location of the affected bone, and the patient's overall health. Conservative treatments include pain management with medication, limiting weight-bearing on the affected limb, and the use of crutches or canes. Surgical interventions may be necessary for more advanced cases and can include core decompression, osteotomy, or joint replacement surgery, such as hip or shoulder replacement. Early diagnosis and intervention are crucial to preserve bone function and prevent long-term complications.