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Question: Avascular Necrosis
| pt_i_am
- Wed Jun 28, 2006 4:50 pm |
I am a 40 yr old female who has been on prednisone for the past year due to pulmonary problems. The average dosage is about 40 mg/day. I began having hip pain about 2 weeks ago and had an MRI which showed Stage I AVN of the femoral head. I have read quite a bit on AVN and want to make sure I am understanding what I read.
Is it true that since I am on prednisone and there is no end in site right now, that the AVN will not get better but get worse? The doctor has started me on Fosomax, which may help somewhat. I am currently full weight bearing. Should I be using crutches? Is it true that more than likely, my other hip will become affected?
FYI... I was started on Immuran to help assist with decreasing the steroid use, however my liver enzymes have increased, so I am on hold right now from taking that medication.
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| Theresa Jones, RN
- Fri Aug 11, 2006 11:00 am |
 Hi pt_i_am,
If you have researched Avascular Necrosis then you are probably aware that it is also known as Osteonecrosis. Avascular Necrosis is essentially a disease that causes death of the femoral head due to interruption of blood flow. Avascular Necrosis in the earliest stages are typically not detected on xray, and usually found during a MRI. Very small lesions may resolve but larger lesions, generally speaking, progress until there is collapse of the femoral head. There are four stages of Avascular Necrosis. Careful attention and monitoring should also be done of the unaffected hip as there of course is a risk that it may become affected as well. There are a variety of causative factors increasing the risk of this condition, one of which is long term corticosteroid use. Nonsurgical intervention may include partial weight bearing for a period of approximately six weeks and then re-evaluation but in many cases progression of the disease, noted with larger lesion, may ultimately result in total hip replacement (Total Hip Arthroplasty). Discuss with your physician regarding available treatment options as mentioned above including, for example, core decompression, etc. so that you will be making informed decisions regarding treatment.
Sincerely,
Theresa Jones, RN
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