Avascular necrosis
Avascular Necrosis

Avascular Necrosis: Definition, Symptoms, Risk Factors, Causes, Diagnosis, and Treatment

Avascular Necrosis Definition

Avascular necrosis is a serious medical condition in which there are areas of bone death. The cause of bone death is impaired blood flow to the bone area for several reasons. One of the most common causes of avascular necrosis at a young age is the consumption of corticosteroids (which are medications used for psoriasis, SLE, or rheumatoid arthritis).

Other people who have this disease can also experience a history of violence due to alco**hol consumption or are receiving treatment with high doses of immunosuppressants (for example, people with cancer). In severe cases, the cartilage lining the bone can collapse, resulting in severe damage and arthritis in the affected joints.

Avascular Necrosis Symptoms

In the early stages of developing aseptic necrosis often causes no symptoms. But over time and the condition gets worse, the symptoms of ischemic bone necrosis then cause signs and symptoms.

A typical symptom of avascular necrosis is mild to severe pain and usually develops gradually.

These symptoms usually appear around the hips, groin, thighs, buttocks, shoulders, knees, and hands or feet.

At first, pain appears when you do activities that place additional weight on the problem bone. If it is severe, the pain also continues to exist when you lie down to sleep.

If the disease spreads to the joints to cause joint pain, then the affected area of the body will feel stiff and limit your body movements.

Avascular Necrosis Risk Factors

Here are some factors that increase a person’s risk of developing avascular necrosis:


Injuries such as a fractured hip bone, can attack surrounding blood vessels and reduce blood flow to the bone.

Steroid use

The exact cause is unknown, but there is a suspicion that corticosteroids cause hyperlipidemia, resulting in avascular necrosis of the bones.

Drinking too much alco**hol

Drinking excessive alco**hol every day for several years accumulates fat in the blood.


This drug increases bone density, which can lead to osteonecrosis of the jaw.


Radiotherapy cancer can weaken bones. Transplantation of organs, especially the kidneys may increase the risk of avascular necrosis.

Certain diseases

Acute pancreatitis, diabetes, Gaucher’s disease, HIV/AIDS, lupus erythematosus, and sickle cell anemia.

Avascular Necrosis Causes

The cause of avascular necrosis is inhibition of blood flow to the bones, thus making the bone lack blood supply and not even get blood at all.

There are several things that can cause the blood supply to the bones to be disrupted, including:

  • Trauma to the joints or bones. Injuries, such as joint dislocations, can damage surrounding blood vessels.
  • Certain treatments. Cancer treatments such as radiotherapy on the bones can weaken bones and damage surrounding blood vessels.
  • Fatty deposits in the blood vessels. Fat can clog small blood vessels, thereby reducing blood flow to the bones.
  • Certain health problems. Blood flow to the bones can be hampered by sickle cell anemia and Gaucher’s disease.

Even so, as many as 25% of cases of death in bone tissue is not known the exact cause.

Avascular Necrosis Diagnosis

Avascular necrosis can be diagnosed and treated by an orthopedic specialist (doctor or orthopedic surgeon). The doctors performed X-rays when patients complained of bone pain. X-rays can show problems and changes in the bones that may explain the origin of symptoms. Then, more sensitive imaging tests are performed to get additional information. Among them are MRI, CT scan, and bone scan.

Avascular Necrosis Treatment

Treatment depends on the severity of the disease. If diagnosed at an early stage, this will be overcome by the consumption of drugs. Medications given to relieve symptoms and prevent the condition from worsening are:

  • Anti-inflammatory drugs
  • Blood thinners
  • Cholesterol-lowering drugs
  • Pain reliever

Your doctor may recommend the following procedures:

  • Physical therapy, to increase the range of motion of the joints
  • Rest – Patients can be advised not to overburden or press on the aching joints or bones until they heal. Patients can do this with total rest or using a wheelchair.

This treatment can slow the progression of the disease. However, most patients will immediately need surgery. Procedures performed to treat avascular necrosis are:

  • Bone grafts – Healthy bones are taken from parts of the patient’s body. Then, the bone is transferred to the disease area to provide support.
  • Osteotomy – Damaged bone is cut and the ligament is replaced. It helps reduce pressure on the sore bones or joints.
  • Core decompression – The inner bone is removed so that new blood vessels can form.


  • Image: Mikael Häggström, M.D. – Author info – Reusing images- Conflicts of interest:  NoneMikael HäggströmConsent note: Consent from the patient or patient’s relatives is regarded as redundant, because of absence of identifiable features (List of HIPAA identifiers) in the media and case information (See also HIPAA case reports guidance)., CC0, via Wikimedia Commons
  • Video: nabil ebraheim

Last Updated on February 17, 2022 Reviewed by Market Health Beauty Team

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