Editor’s Note: The following article is for educational and informational use and cannot be considered as medical advice. Please consult your doctor or healthcare practitioner for the proper diagnosis.
Popular actress and first-time mom Angelica Panganiban recently made headlines when she published a vlog documenting how she’s dealing with her Avascular necrosis diagnosis. In it, she gave a brief overview of the illness and the treatment options she has had so far. However, what exactly is this disease?
What is avascular necrosis?
Avascular necrosis (AVN) is a disease that results from the temporary or permanent loss of blood supply to the bone. When the blood supply is cut off, the bone tissue dies and the bone collapses. If it happens near a joint, the joint surface may collapse.
The condition may affect any bone but most commonly happens in the ends of a long bone. It may also affect one bone or several bones at one time, or different bones at different times.
What causes avascular necrosis?
It is primarily caused by bone fractures or disease that prevent blood flow to bone tissue. Around 20% of AVN cases happen without an obvious cause.
Known causes of AVN are:
Traumatic avascular necrosis: This happens after you break a bone or dislocate a joint. This includes hip fractures and dislocations. Around 20% of people who dislocate their hips develop AVN.
Nontraumatic avascular necrosis: This happens if you have an illness or medical condition that prevents the blood from flowing to your bone tissue. In this instance, AVN can affect the same bones on both sides of your body, such as both right and left shoulders for example.
Medical conditions that can cause nontraumatic AVN include:
- Osteoporosis, especially in elderly women and men
- Blood disorders such as sickle cell anemia
- Cancer treatments, such as radiation therapy
- Decompression sickness
- Organ transplants
What are the other causes and risk factors for avascular necrosis?
While injuries that slow or stop blood flow to the bone are considered the primary cause of AVN, other common risks and causes include:
- Drinking too much alcohol
- Use of high doses of corticosteroids for long periods of time, such as prednisone or cortisone
- Childhood diseases including Legg-Calve-Perthes disease
Studies show that men develop AVN more than women unless the cause is injury or lupus. And it most often affects people ages 30 to 60.
Which bones are most commonly affected by avascular necrosis?
- Hip bone
- Although less likely, but it can also affect bones in the following areas:
What are the symptoms of avascular necrosis?
Avascular necrosis has no early symptoms but as the bone damage worsens, you might feel the following symptoms:
- Joint pain that may increase over time, becoming severe if the bone collapses
- Pain that occurs even at rest
- Limited range of motion
- Groin pain, if the hip joint is affected
- Limping, if the condition occurs in the leg
- Difficulty with overhead movement, if the shoulder joint is affected
- Worsening arthritic symptoms in the joint when the condition deteriorates
How is avascular necrosis diagnosed?
Aside from a physical assessment from a healthcare practitioner, the following tests are needed to diagnose AVN:
- MRI (Magnetic resonance imaging)
What is the treatment for avascular necrosis?
Treatment for AVN will depend on the amount of damage to the bones. Possible treatments for AVN that’s limited to smaller, non-weight bearing bones include:
- Cold packs
- Heat treatment
- Nonsteroidal anti-inflammatory drugs or NSAIDs
- Physical therapy to ease joint tenderness and increase range of motion
- Walking aids such as canes and crutches
Surgery might be recommended for more advanced cases of AVN. Surgical options can include:
- Core decompression: This involves the surgeon drilling small holes or cores in the affected bone to improve blood flow. It can be combined with injections or bone grafts to promote healing.
- Joint replacement: This involves replacing the damaged joint with an artificial one. Hip replacements and knee replacements are 95% effective in relieving pain and restoring mobility in people with AVN.
How to prevent avascular necrosis?
There is no surefire way to prevent avascular necrosis, but here are a few simple steps to take to reduce your risk:
- Quit smoking
- Reduce alcohol intake
- Monitor cholesterol levels
- If you are taking corticosteroids for a chronic medical condition, talk to your healthcare provider about reducing your dosage