Osteonecrosis is a medical condition in which parts of the bones die because they do not get enough blood. The condition is most common in the hips and shoulders; however, it can affect other bones including those in the wrists, elbows, knees, and ankles.
Sometimes, osteonecrosis occurs without any apparent cause, which is called idiopathic osteonecrosis. In other cases, it is caused by a break or a dislocation in a bone that can affect blood flow to the area. Other potential causes of the condition include sickle cell disease, Gaucher disease (a rare genetic disorder involving a deficiency of enzyme glucocerebrosidase), exposure to radiation therapy or steroids, decompression sickness from deep sea diving, and heavy alcohol use.
In the early stages of osteonecrosis, there are often no apparent symptoms. However, as the bone continues to deteriorate, you may begin to experience pain that increases in severity, to have restricted range of motion, and to limp if the osteonecrosis occurs in the hips or legs.
A physical exam and a medical history can help a doctor diagnose the condition. Your doctor will ask you questions about the origin and extent of the pain, whether or not it gets better at certain times of the day, and if medications help relieve the pain. Additionally, he or she may ask you about alcohol or steroid usage. Your doctor may also conduct a bone or CT scan, MRI, or x-rays to check for the condition.
Treatments are aimed at helping to reduce pain and treat the underlying cause of the osteonecrosis. The use of crutches may help you keep pressure off the affected bone, and range-of-motion exercises may be useful in allowing you to regain mobility in your joints.
Though non-surgical options can limit the extent of disease progression, many people will require surgery to help treat their osteonecrosis.
National Center for Biotechnology Information, National Institutes of Health. (2011 Jun 4). Osteonecrosis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004519/
National Center for Biotechnology Information, National Institutes of Health. (2010 Nov 12). Gaucher disease. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001590/
By Nicole Stewart
Reviewed by Karen Schmidt, RN