Difference between revisions of "Avascular necrosis of the femoral head"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Necrotic bone -- very high mag.jpg | |||
| Width = | |||
| Caption = Necrotic bone in a case of AVN. [[H&E stain]]. | |||
| Micro = bone with empty lacunae (indicative of necrosis) | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[femoral head]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = +/-oral steroids, +/-radiation | |||
| Signs = | |||
| Symptoms = pain | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
'''Avascular necrosis of the femoral head''' is [[necrosis]] of the head of the femur to the vascular compromise. | '''Avascular necrosis of the femoral head''' is [[necrosis]] of the head of the femur to the vascular compromise. | ||
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*[[Cushing syndrome]]. | *[[Cushing syndrome]]. | ||
*Radiation. | *Radiation. | ||
*[[Sickle cell disease]].<ref>{{Cite journal | last1 = Al Omran | first1 = A. | title = Multiple drilling compared with standard core decompression for avascular necrosis of the femoral head in sickle cell disease patients. | journal = Arch Orthop Trauma Surg | volume = 133 | issue = 5 | pages = 609-13 | month = May | year = 2013 | doi = 10.1007/s00402-013-1714-9 | PMID = 23494112 }}</ref> | |||
==Gross== | ==Gross== | ||
Revision as of 02:21, 20 December 2013
| Avascular necrosis of the femoral head | |
|---|---|
| Diagnosis in short | |
 Necrotic bone in a case of AVN. H&E stain. | |
|
| |
| LM | bone with empty lacunae (indicative of necrosis) |
| Site | femoral head |
|
| |
| Clinical history | +/-oral steroids, +/-radiation |
| Symptoms | pain |
| Prevalence | uncommon |
| Prognosis | benign |
Avascular necrosis of the femoral head is necrosis of the head of the femur to the vascular compromise.
It is often just referred to as avascular necrosis, abbreviated AVN.
General
Risk factors:
- Oral steroids, e.g. prednisone.[1]
- Cushing disease.
- Cushing syndrome.
- Radiation.
- Sickle cell disease.[2]
Gross
Features:[3]
- Wedge-shaped pale yellow abnormality below cartilage.
- +/-Cartilage separates from the bone.
- +/-Deformation of femoral head.
Image:
Microscopic
Features:[4]
- Empty lacunae (indicative of necrotic bone).
Images
AVN - intermed. mag. (WC/Nephron)
AVN - high mag. (WC/Nephron)
AVN - very high mag. (WC/Nephron)
Sign out
FEMORAL HEAD, RIGHT, HIP ARTHROPLASTY: - AVASCULAR NECROSIS OF THE FEMORAL HEAD.
AVN and degenerative joint disease
FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY: - AVASCULAR NECROSIS OF THE FEMORAL HEAD. - DEGENERATIVE JOINT DISEASE WITH MILD SYNOVITIS AND VILLOUS HYPERPLASIA. - NEGATIVE FOR MALIGNANCY.
FEMORAL HEAD AND JOINT CAPSULE, RIGHT, HIP ARTHROPLASTY: - AVASCULAR NECROSIS OF THE FEMORAL HEAD. - DEGENERATIVE JOINT DISEASE. - BENIGN JOINT CAPSULE TISSUE. - NEGATIVE FOR MALIGNANCY.
Remote AVN
FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY: - FEMORAL HEAD WITH DEGENERATIVE JOINT DISEASE AND MARKED DEFORMATION CONSISTENT WITH A HISTORY OF AVASCULAR NECROSIS. - JOINT CAPSULE WITH MINIMAL CHRONIC INFLAMMATION.
Micro
The sections show a femoral head with loss of cartilage and focal vertical cleft formation in the remaining thinned cartilage. Subchondral sclerosis is present. The underlying bone is viable. Bone marrow is present. The red blood cells have a sickled morphology.
Joint capsule tissue with focal lymphocytes and plasma cells is present.
See also
References
- ↑ URL: http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html. Accessed on: 30 April 2012.
- ↑ Al Omran, A. (May 2013). "Multiple drilling compared with standard core decompression for avascular necrosis of the femoral head in sickle cell disease patients.". Arch Orthop Trauma Surg 133 (5): 609-13. doi:10.1007/s00402-013-1714-9. PMID 23494112.
- ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 224. ISBN 978-0443066450.
- ↑ Steffen, RT.; Athanasou, NA.; Gill, HS.; Murray, DW. (Jun 2010). "Avascular necrosis associated with fracture of the femoral neck after hip resurfacing: histological assessment of femoral bone from retrieval specimens.". J Bone Joint Surg Br 92 (6): 787-93. doi:10.1302/0301-620X.92B6.23377. PMID 20513874.