Avascular (Aseptic) Necrosis of the Femoral Head (Hip)
Basics
DESCRIPTION
- Avascular (aseptic) necrosis results from the interruption of the blood supply to bone (either traumatic or nontraumatic occlusion).
- The femoral head is the most common site.
- A self-limiting idiopathic avascular necrosis of the hip that occurs in children is known as Perthes disease (see “Perthes Disease” chapter).
RISK-FACTORS
GENETICS
- Variable, depending on cause
- Steroid-induced avascular necrosis may have an underlying genetic predisposition.
PATHOPHYSIOLOGY
- Death and necrosis of bone with gradual return of blood supply
- Necrotic bone gradually resorbed and replaced by new bone
- During bone resorption, structural integrity of femoral head may be reduced, leading to collapse.
ETIOLOGY
- Traumatic
- Slipped capital femoral epiphysis
- Hip fracture
- Hip dislocation
- Complication of casting, bracing, surgery
- Nontraumatic
- Steroids or chemotherapy
- Malignancy (leukemia)
- Idiopathic (older, after physeal closure); similar to adult avascular necrosis
- Idiopathic (younger, before physeal closure, Perthes disease)
- Caisson disease
- Sickle cell disease
- Septic arthritis
- Gaucher disease
- Viral infection (HIV, CMV)
- Radiation therapy
- Hypercoagulable states
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Cabana, Michael D., editor. "Avascular (Aseptic) Necrosis of the Femoral Head (Hip)." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14070/all/Avascular__Aseptic__Necrosis_of_the_Femoral_Head__Hip_.
Avascular (Aseptic) Necrosis of the Femoral Head (Hip). In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14070/all/Avascular__Aseptic__Necrosis_of_the_Femoral_Head__Hip_. Accessed December 3, 2024.
Avascular (Aseptic) Necrosis of the Femoral Head (Hip). (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14070/all/Avascular__Aseptic__Necrosis_of_the_Femoral_Head__Hip_
Avascular (Aseptic) Necrosis of the Femoral Head (Hip) [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14070/all/Avascular__Aseptic__Necrosis_of_the_Femoral_Head__Hip_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Avascular (Aseptic) Necrosis of the Femoral Head (Hip)
ID - 14070
ED - Cabana,Michael D,
BT - Select 5-Minute Pediatrics Topics
UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14070/all/Avascular__Aseptic__Necrosis_of_the_Femoral_Head__Hip_
PB - Wolters Kluwer Health
ET - 7
DB - Medicine Central
DP - Unbound Medicine
ER -