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Avascular necrosis of the femoral head (view source)
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'''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.<ref>URL: [http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html]. Accessed on: 30 April 2012.</ref> | |||
*[[Cushing disease]]. | |||
*[[Cushing syndrome]]. | |||
*Radiation. | |||
==Gross== | |||
Features:<ref name=Ref_Lester224>{{Ref Lester|224}}</ref> | |||
*Wedge-shaped pale yellow abnormality below cartilage. | |||
*+/-Cartilage separates from the bone. | |||
*+/-Deformation of femoral head. | |||
Image: | |||
*[http://www.flickr.com/photos/11462589@N05/1126710488/in/photostream AVN (flickr.com)]. | |||
==Microscopic== | |||
Features:<ref name=pmid20513874>{{Cite journal | last1 = Steffen | first1 = RT. | last2 = Athanasou | first2 = NA. | last3 = Gill | first3 = HS. | last4 = Murray | first4 = DW. | title = Avascular necrosis associated with fracture of the femoral neck after hip resurfacing: histological assessment of femoral bone from retrieval specimens. | journal = J Bone Joint Surg Br | volume = 92 | issue = 6 | pages = 787-93 | month = Jun | year = 2010 | doi = 10.1302/0301-620X.92B6.23377 | PMID = 20513874 }} | |||
</ref> | |||
*Empty lacunae (indicative of necrotic bone). | |||
==Sign out== | |||
<pre> | |||
FEMORAL HEAD, RIGHT, HIP ARTHROPLASTY: | |||
- AVASCULAR NECROSIS OF THE FEMORAL HEAD. | |||
</pre> | |||
===AVN and degenerative joint disease=== | |||
<pre> | |||
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. | |||
</pre> | |||
<pre> | |||
FEMORAL HEAD AND JOINT CAPSULE, RIGHT, HIP ARTHROPLASTY: | |||
- AVASCULAR NECROSIS OF THE FEMORAL HEAD. | |||
- DEGENERATIVE JOINT DISEASE. | |||
- BENIGN JOINT CAPSULE TISSUE. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Remote AVN=== | |||
<pre> | |||
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. | |||
</pre> | |||
====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== | |||
*[[Femoral head]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Femoral head]] | |||