Avascular Necrosis: Etiology, Diagnosis and Treatment

Iulian Nusem, MD (Editor)
Department of Orthopaedics, Logan Hospital, School of Medicine, Gold Coast Campus, Griffith University and Queensland Bone Bank, Queensland, Australia

Series: New Developments in Medical Research
BISAC: MED022000

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Although the disease called avascular necrosis (AVN) was discovered in Egyptian mummies, there is a lack of information available in understanding and treating this pathology. AVN is a condition where cellular death of bone components occurs due to an interruption of the blood supply. Nusem discusses the morphopathological appearance of AVN. Avascular necrosis tends to affect young adults and often progresses despite appropriate treatment. Although some of the predisposing factors have been recognized, the pathogenesis of AVN remains unclear. Cheung discusses hypotheses and pathophysiologic mechanisms underlying the disease while Lloyd addresses new advances in the field of radiology. Most authors agree that successful treatment directly relates to the stage of the disease, which in most case is reflected by a specific classification system. Each chapter will provide an overview of the specific systems most commonly used for the anatomical region described therein.

Various anatomical locations more commonly involved with AVN are discussed specifically. Nusem discusses a rare spinal disorder characterized as avascular necrosis of a vertebral body occurring in a delayed fashion after minor trauma (Kümmell’s disease). The femoral head is most commonly affected by AVN; the clinical presentation and existing treatment options are discussed by Cowie and coauthors. AVN around the knee is presented by Myers and colleagues while AVN affecting the foot is presented by Nihal and coworkers. In the upper extremity AVN of the capitellum (Panner’s disease) is presented by Shamimudeen while AVN of the lunate (Kienböck’s disease) is discussed by Rhau and colleagues and AVN of the scaphoid (Preiser’s disease) is described by Wong and his coworkers. Although AVN is not common in the paediatric age group, Jabur presents on AVN after slipped femoral capital epiphysis. Bone marrow oedema is a common finding in MRIs done in patients with AVN and Nusem will discuss bone marrow oedema syndrome and its differential diagnosis. (Imprint: Nova Biomedical )

Preface

Chapter 1. Pathogenesis of Avascular Necrosis
(Ian Cheung, Logan Hospital, The University of Queensland, Australia)

Chapter 2. Pathologic Basis of Avascular Necrosis
(Iulian Nusem, Department of Orthopaedics, Logan Hospital, School of Medicine, Gold Coast Campus, Griffith University and Queensland Bone Bank, Queensland, Australia)

Chapter 3. Radiology of Avascular Necrosis
(Thomas Lloyd, Q Scan Radiology Clinics, Princess Alexandra Hospital Brisbane, Australia)

Chapter 4. Kümmell’s Disease
(Iulian Nusem, Department of Orthopaedics, Logan Hospital, School of Medicine, Gold Coast Campus, Griffith University and Queensland Bone Bank, Queensland, Australia)

Chapter 5. Avascular Necrosis of the Hip
(Jonathan Cowie, Haseeb Qureshi and Ross Crawford, Department of Orthopaedics, The Prince Charles Hospital, Brisbane, Australia and others)

Cbapter 6. Osteonecrosis of the Knee
(Peter T. Myers and Nicholas Bottomley, Brisbane Orthopaedic and Sports Medicine Centre, University of Queensland, Australia and others)

Chapter 7. Avascular Necrosis of the Foot Bones
(Aneel Nihal, Angelo Del Buono and Nicola Maffulli, Aneel Nihal,
Pindara Private Hospital, Queensland, Australia and others)

Chapter 8. Avascular Necrosis of the Humeral Capitellum: Pannner’s Disease
(A.N. Shamimudeen, Logan Hospital & Sunnybank Private Hospital, Brisbane, Australia and others)

Chapter 9. Avascular Necrosis of the Lunate (Kienböck’s Disease)
(Joerg U. Rhau and Peter Wong, Logan Hospital, Queensland, Australia)

Chapter 10. Avascular Necrosis of the Scaphoid
(Peter Wong and Iulian Nusem, Department of Orthopaedics, Logan Hospital, Meadowbrook, Australia and others)

Chapter 11. Avascular Necrosis of the Femoral Head after Slipped Capital Femoral Epiphysis
(Majid Jabur, Logan Hospital and Royal Children’s Hospital, Brisbane, Senior Lecturer, School of Medicine, Griffith University, Queensland, Australia)

Chapter 12. Bone Marrow Oedema Syndrome
(Iulian Nusem, Department of Orthopaedics, Logan Hospital, School of Medicine, Gold Coast Campus, Griffith University and Queensland Bone Bank, Queensland, Australia)

Index

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