Ischemic or avascular necrosis of the hip occurs in young patients and usually affects both hips. Coursing with dull pain in buttock, groin and / or knee. Although it relates to steroid intake and alcoholism, the origin is unknown disease itself. Diagnosis is difficult, so it is important to detect the disease early and make appropriate treatment.
Ischemic or avascular necrosis of the femoral head (hip) is a disease that occurs in young patients (aged 35 to 50 years), male and usually bilaterally in both hips.
Causes of avascular necrosis or ischemic
The etiology or cause is more frequent intake of corticosteroids and alcoholism. Although there are described many other causes, traumatic and non-traumatic (arteriosclerosis, Cushing's disease, diabetes mellitus, hyperlipidemia, dysplasias, etc.). Also, more than one third of patients is idiopathic, meaning that the origin of the disease is not known.The reason that happens (their pathogenic) is not yet clear; in fact there are many theories on the subject. There are theories that argue that the reason is a progressive intraosseous infarct, a fatty embolism, increased cell stress or ischemia (lack of blood supply). But what they all agree is that, for whatever reason, appears an area of weakness bone of the femoral head (hip) that can collapse and cause osteoarthritis.
Symptoms of hip avascular necrosis
Clinical symptoms usually begin as a dull or intermittent pain of gradual onset, based on buttock, groin and / or knee. In some cases a sudden, intense pain appears, sometimes nocturnal apparition, then followed by the dull ache. Usually bilateral, but not simultaneously (in 60% of patients). Mobility is usually well preserved, which the difference of osteoarthritis.
Diagnosis of avascular necrosis of the hip
The diagnosis should be as early as possible. To do this we must have the clinical suspicion, and then confirm the diagnosis with tests such as plain radiography, scintigraphy, the TAC and, above all, nuclear resonance.
How to treat avascular necrosis of the hip
Treatment varies greatly depending on the patient and the degree of injury present. It may be an expectant and conservative treatment, based on the discharge of the joint, or surgical and in this field options in Traumatology are varied: drilling, grafts, osteotomies and finally hip.In conclusion, as the disease is difficult initial diagnosis is very important to diagnose it as early as possible, before a young patient begins with pain in one or both hips, the most important thing is to see a specialist in pathology hip to be diagnosed and treated as soon as possible.
Edited by Patricia Crespo Pujante