| Definitions |
Osteonecrosis occurs as a result of compromise to the blood supply to bone. Hip (femoral head) is a common location, but other bones can also be affected. Two main forms: traumatic (more common, due to direct injury and damage of blood supply) and non-traumatic. Non-traumatic form is associated with several risk factors/conditions including corticosteroid use, alcohol abuse, sickle cell anemia, Gaucher disease, systemic lupus erythematosus, coagulopathies, hyperlipidemia, organ transplantation, caisson disease, thyroid disorders and genetic factors; some cases are idiopathic.Symptoms of osteonecrosis of the femoral head: groin pain (occasionally buttock pain; deep, throbbing and worsens upon walking); and "catching" or popping sensation with motion. Physical examination: pain with range of motion and walking; limitation of internal rotation; Trendelenburg gait often present; plain radiographs of hip are often normal. Osteonecrosis of jaw (ONJ): associated with use of biphosphonates; typically occurs in the setting of recent dental surgery; signs and symptoms include pain, tooth mobility, mucosal swelling, erythema and ulceration.
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| definition |
Osteonecrosis occurs as a result of compromise to the blood supply to bone. Hip (femoral head) is a common location, but other bones can also be affected. Two main forms: traumatic (more common, due to direct injury and damage of blood supply) and non-traumatic. Non-traumatic form is associated with several risk factors/conditions including corticosteroid use, alcohol abuse, sickle cell anemia, Gaucher disease, systemic lupus erythematosus, coagulopathies, hyperlipidemia, organ transplantation, caisson disease, thyroid disorders and genetic factors; some cases are idiopathic.Symptoms of osteonecrosis of the femoral head: groin pain (occasionally buttock pain; deep, throbbing and worsens upon walking); and "catching" or popping sensation with motion. Physical examination: pain with range of motion and walking; limitation of internal rotation; Trendelenburg gait often present; plain radiographs of hip are often normal. Osteonecrosis of jaw (ONJ): associated with use of biphosphonates; typically occurs in the setting of recent dental surgery; signs and symptoms include pain, tooth mobility, mucosal swelling, erythema and ulceration.
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| SMQ SOURCE |
Osteonecrosis. Merck Manual Home Edition. http://www.merck.com/mmhe/sec05/ch064/ch064a.html; Levine, M., Rajadhyaksha, A., and Mont, M. Osteonecrosis, hip. eMedicine; http://www.emedicine.com/orthoped/TOPIC430.HTM; Tofferi, J. and Gilliland, W. Avascular necrosis. http://www.emedicine.com/Med/topic2924.htm; Purcell, PM and Boyd, IW. Biophosphonates and osteonecrosis of the jaw. Med J Australia 2005; 182(8): 417 - 418; Grbic, JT et al. Incidence of Osteonecrosis of the Jaw in Women With Postmenopausal Osteoporosis in the Health Outcomes and Reduced Incidence With Zoledronic Acid Once Yearly Pivotal Fracture Trial. J Am Dent Assoc 2008;139;32-40; Ruggiero, SL and Mehrotra, B. Biphosponate-related osteonecrosis of the jaw: diagnosis, prevention, and management. Annu. Rev. Med 2009; 60: 85-96; De Crignis E, Cimatti L, Borderi M, Gibellini D, Re MC. Bone alterations during HIV infection. New Microbiol. 2008 Apr; 31(2):155-64
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