Avascular necrosis: radiological findings and main sites of involvement - pictorial essay.

Dair Jocely Enge Junior,Adham Do Amaral E Castro,Durval Do Carmo Barros Santos,Eduardo Baptista,Eduardo Kaiser Ururahy Nunes Fonseca,Laercio Alberto Rosemberg

doi:10.1590/0100-3984.2017.0151

Dair Jocely Enge Junior, Adham Do Amaral E Castro + Show 4 more

Open Access

https://doi.org/10.1590/0100-3984.2017.0151

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Abstract

The term avascular necrosis describes any one of a number of bone diseases that have a common mechanism: the death of bone components due to lack of blood supply. Avascular necrosis can occur in diverse parts of the skeleton, each location-specific form not only receiving a distinct designation but also presenting unique epidemiologic characteristics. However, the imaging findings are similar in all of the forms, which pass through well-described radiological phases, regardless of the site of involvement. Because avascular necrosis can cause considerable morbidity if not properly detected and managed, the radiologist plays a fundamental role. The present study provides a brief review of the main radiological aspects of the various forms of avascular necrosis, illustrated on the basis of a collection of cases from our institution.

Highlights

Avascular necrosis, known as osteonecrosis or aseptic necrosis, is a pathological process associated with a number of conditions and therapeutic interventions
The imaging findings are similar in all of the forms, which pass through well-described radiological phases, regardless of the site of involvement
The present study provides a brief review of the main radiological aspects of the various forms of avascular necrosis, illustrated on the basis of a collection of cases from our institution

Summary

INTRODUCTION

Known as osteonecrosis or aseptic necrosis, is a pathological process associated with a number of conditions and therapeutic interventions. In patients with direct damage to the bone vasculature (such as a femoral neck fracture) or direct lesion of bone components (such as radiation-induced damage), the cause can be clearly identified. Blood flow impairment leading to bone cell death seems to be common to most of the proposed etiologies of avascular necrosis. The process is usually progressive, resulting in ischemia and gradual bone destruction within a few months to two years in most patients(1–3). A number of traumatic and nontraumatic factors can contribute to the etiology of avascular necrosis. Preeminent among the traumatic factors are femoral neck fractures, whereas nontraumatic factors include the use of steroids, hemoglobinopathies, human immunodeficiency virus infection, alcoholism, smoking, and idiopathic, among other causes(2)

DISCUSSION

Köhler disease

Findings

Dias disease

CONCLUSION