Osteonecrosis involves death of bone tissue due to an adequate lack of blood supply. It can lead to bone cracks and collapse over months and years. Osteonecrosis is associated with broken bones and dislocated joints as well as overuse of alcohol and too much use of steroid medications. It’s most common in people between the ages of 30 and 50.
When an individual has osteonecrosis, the symptoms start as mild or non-existent and gradually worsen over time. Pain will worsen over time in the affected area. People commonly experience osteonecrosis in the groin, thigh, hip, buttock, hand, foot, knee, and shoulder. Osteonecrosis can occur on both sides of the body. It’s important to seek medical attention for ongoing pain in any joint or bone and to seek medical attention for a dislocated joint or broken bone.
Osteonecrosis is caused by a lack of blood supply to bone tissue. A lack of blood supply to a bone can be caused by joint or bone injuries that damage blood vessels in close proximity, radiation therapy, fat buildup in blood vessels, and medical conditions like sickle cell disease or Gaucher’s disease.
Sometimes, the cause is not fully understood. Genetics may combine with lifestyle factors like overuse of alcohol or use of certain medications to contribute to osteonecrosis.
Risk factors for osteonecrosis include injury to a bone or joint, long-term use of steroid medications, drinking a lot of alcohol, long-term use of medications used to increase bone density, and certain medical treatments like radiation therapy and organ transplants, particularly kidney transplants. Other medical conditions that are associated with a higher incidence of osteonecrosis include HIV/AIDS, pancreatitis, decompression sickness, and lupus.
If your doctor suspects you have osteonecrosis, they will take a full medical history and seek to understand your current symptoms. Additionally, they will do a physical exam, checking to see if you’re in pain anywhere and if your range of motion has changed.
To confirm a diagnosis of osteonecrosis, your doctor will probably perform imaging tests like an X-ray or computerised tomography (CT) scan. There are several types of bone diseases, and getting a good visualisation of the bones can give your doctor a clear picture of if you have osteonecrosis or are dealing with something else.
Complications of osteonecrosis include bone collapse and severe arthritis. These complications usually arise if osteonecrosis is left untreated.
There are different ways to treat osteonecrosis depending on how advanced it is. In early osteonecrosis, medications can be used to treat and prevent symptoms. Common medications include over the counter pain relievers, like Ibuprofen and medications your doctor prescribes, like cholesterol medication, medications that widen the blood vessels, blood thinners, and bone-strengthening drugs.
Rest and physical therapy exercises may also be recommended. Depending on how advanced the osteonecrosis is, surgery may be required to help strengthen the bone with osteonecrosis, replace collapsed joints, and reshape bones.
While osteonecrosis cannot always be entirely prevented, eating a heart-healthy diet, limiting alcohol intake, and making sure you get enough Vitamin D and calcium in your diet are good ways to prevent osteonecrosis as much as possible.