osteonekroos

Osteonekros, also known as avaskulär nekros eller aseptisk nekros, is a medical condition resulting from a temporary or permanent loss of blood supply to a bone. When bone tissue does not receive adequate blood, it can die and subsequently collapse. This death of bone tissue can lead to significant pain and can eventually cause the bone to break or the joint surface to collapse.

The most common sites for osteonekros are the hip, knee, and shoulder, but it can affect any bone. Risk factors for developing osteonekros include trauma, such as fractures or dislocations, which can disrupt blood flow. Long-term use of corticosteroid medications is another significant risk factor. Other associated conditions include excessive alcohol consumption, sickle cell disease, Gaucher disease, and certain blood clotting disorders.

Symptoms of osteonekros typically include pain in the affected joint, which may worsen with activity and improve with rest. As the condition progresses, pain can become constant and severe, leading to limitations in movement and function. In later stages, the collapse of the bone can cause the joint to become irregular, leading to arthritis and further pain and disability.

Diagnosis often involves a combination of medical history, physical examination, and imaging studies. X-rays can detect changes in bone density and shape, while MRI scans are more sensitive and can identify osteonekros in its earlier stages by showing changes in the bone marrow.

Treatment for osteonekros depends on the stage of the disease, the location, and the number of bones affected. Early stages may be managed with medication to relieve pain and reduce inflammation, as well as avoiding weight-bearing activities. In more advanced cases, surgical interventions may be necessary. These can include procedures to preserve the bone, such as core decompression, or more extensive surgeries like osteotomy or joint replacement (arthroplasty) to restore function and alleviate pain.