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Diagnosis of Aseptic Osteonecrosis of the Femoral Head (AONTH)

Received: 25 March 2022     Accepted: 19 April 2022     Published: 13 January 2023
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Abstract

Aseptic osteonecrosis is a frequent pathology. It corresponds to epiphyseal bone necrosis, secondary to ischemic and/or cytotoxic mechanisms. It is not a specific disease, but rather the final outcome of various pathological situations in which there is a disturbance of the intraosseous circulation of the femoral head. This explains the usual names of avascular necrosis or aseptic necrosis. It may be unilateral, bilateral or multifocal. More than 75% of aseptic osteonecrosis involve the femoral head. Many risk factors must be considered, such as corticosteroid therapy, alcoholism, dyslipidemia or sickle cell disease. It is important to diagnose osteonecrosis in the potentially reversible stages of the disease. It is a condition that is all the more disabling because it affects the young adult, in the middle of an active life, in the presence of pain in the groin crease of a young man who tends to take steroids, when the femoral head is still spherical on standard radiography. Magnetic resonance imaging has profoundly changed our diagnostic possibilities, showing pathognomonic signs while the radiograph may still be normal. Aseptic osteonecrosis of the femoral head (AONTH) often poses a problem of differential diagnosis with other coxopathies, which is a source of diagnostic delay in medical practice.

Published in International Journal of Clinical and Experimental Medical Sciences (Volume 9, Issue 1)
DOI 10.11648/j.ijcems.20230901.11
Page(s) 1-6
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Osteonecrosis, Aseptic Osteonecrosis, Etiologies, Diagnosis

References
[1] Maillefert JF, Tavernier C, Toubeau M, Brunotte F. Non-traumatic avascular necrosis of the femoral head. J Bone Joint Surg Am. 1996 Mar; 78 (3): 473–4.
[2] Aldridge JM, Urbaniak JR. Avascular necrosis of the femoral head: etiology, pathophysiology, classification, and current treatment guidelines. Am J Orthop Belle Mead NJ. 2004 Jul; 33 (7): 327–32.
[3] Cooper C, Steinbuch M, Stevenson R, Miday R, Watts NB. The epidemiology of osteonecrosis: findings from the GPRD and THIN databases in the UK. Osteoporos Int 2010; 21: 569–77.
[4] Dudkiewicz I, Covo A, Salai M, Israeli A, Amit Y, Chechik A. Total hip arthroplasty after avascular necrosis of the femoral head: does etiology affect the results? Arch Orthop Trauma Surg. 2004 Mar; 124 (2): 82–5.
[5] Assouline-Dayan Y, Chang C, Greenspan A, Shoenfeld Y, Gershwin ME. Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum. 2002; 32 (2): 94–124.
[6] Source: d'après Xie XH, Wang XL, Yang HL et al. Steroid-associated osteonecrosis: epidemiology, pathophysiology, animal model, prevention and potential treatments (an overview). J Orthop Trans, 2015, 3: 58–70.
[7] Papakostidis C, Tosounidis TH, Jones E, Giannoudis PV. The role of «cell therapy» in osteonecrosis of the femoral head. Acta Orthop 2016; 87: 72-8.
[8] Barotraumatisme/Larousse medical. Cause.
[9] DynaMed Plus [Internet]. Ipswich (MA): EBSCO Information Services. 1995. Record No. 114844, "Gaucher disease"; [updated 2015 Apr 15, cited 2017 Apr 4]; [about 8 screens]. Available from.
[10] Lee JY, et al. Clinical and genetic characteristics of Gaucher disease according to phenotypic subgroups. Korean J Pediatr. 2012. 55 (2): 48-53.
[11] Cappellini MD. Gaucher Disease Precetorship. A call to action for hematologists. 2017. Milan, Italy.
[12] Wenstrup RJ, et al. Skeletal aspects of Gaucher disease: a review. Br J Radiol. 2002; 75 (suppl. 1): A2-A12.
[13] Bembi B, et al. Bone complications in children with Gaucher disease. Br J Radiol. 2002; 75 (suppl. 1): A37-A44.
[14] Hernigou P, Bachir D, Galacteros F. The natural history of symptomatic osteonecrosis in adults with sickle-cell disease. J Bone Joint Surg Am 2003; 85: 500-4.
[15] Matsuo K, Hirohata T, Sugioka Y, et al. Influence of alcohol intake, cigarette smoking and occupational status on idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res, 1988, 234: 115–23.
[16] Glesby MJ, Hoover DR, Vaamonde CM. Osteonecrosis in patients infected with human immunodeficiency virus: a case-control study. J Infect Dis 2001; 184: 519–23.
[17] Borges AH, Hoy J, Florence E, et al. Antiretrovirals, fractures, and osteonecrosis in a large international HIV cohort. Clin Infect Dis 2017; 64: 1413–21.
[18] Wen Z, Lin Z, Yan W, et al. Influence of cigarette smoking on osteonecrosis of the femoral head (ONFH): a systematic review and metaanalysis. Hip Int 2017; 27: 425–35.
[19] Wood TJ, Hoppe DJ, Winemaker M, et al. Bilateral osteonecrosis of the femoral head during pregnancy following two corticosteroid injections: a case report and review of the literature. Cureus 2016; 8: e556.
[20] Nakamura J, Konno K, Orita S, et al. Distribution of hip pain in patients with idiopathic osteonecrosis of the femoral head. Mod Rheumatol 2017; 27: 503–7.
[21] Paolaggi JB, Le Parc JM, Arfi S. Severe arthralgia after pulse corticoids therapy in transplant patients. J Rhumatol 1987; 14: 1077-8.
[22] J. AMAT Le 04/06/2016Réunion inter-régional de Médecine Nucléaire, Ostéonécrose aseptique de la tête fémorale/Apport de la radiographie.
[23] Mitchell DG, Rao VM, Dalinka MK, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 1987; 162: 709-15.
[24] Hu LB, Huang ZG, Wei HY, Wang W, Ren A, Xu YY. Osteonecrosis of the femoral head: using CT, MRI and gross specimen to characterize the location, shape and size of the lesion. Br J Radiol 2015; 88: 20140508.
[25] Cofer, diapothèque, ostéonécrose de la tête fémorale au scanner.
[26] Mont MA, Ulrich SD, Seyler TM, Smith JM, Marker DR, McGrath MS, et al. Bone scanning of limited value for diagnosis of symptomatic oligofocal and multifocal osteonecrosis. J Rheumatol 2008; 35: 1629–34.
[27] Cofer, diapothèque, ostéonécrose de la tête fémorale au la scintigraphie osseuse.
[28] Guerra JJ, Steinberg ME. Distinguishing transient osteoporosis from avascular necrosis of the hip. J Bone Joint Surg 1995; 77A: 616–24.
[29] Yamamoto T. Subchondral insufficiency fractures of the femoral head. Clinics Orthop Surg 2012; 4: 173–80.
[30] Weatherall PT, Maale GE, Mendelsohn DB, et al. Chondroblastoma: classic and confusing appearance at MR imaging. Radiology 1994; 190: 467–74.
[31] Lafforgue P. Pathophysiology and natural history of avascular necrosis of bone. Jt Bone Spine Rev Rhum 2006; 73: 500–7.
[32] Lafforgue P, Dahan E, Chagnaud C, Schiano A, Kasbarian M, Acquaviva PC. Earlystage avascular necrosis of the femoral head: MR imaging for prognosis in 31 cases with at least 2 years of follow-up. Radiology 1993; 187: 199–204.
[33] Pr Pierre Lafforgue* et Pr Xavier Flecher/Rhumatos Novembre 2014 vol. 11 numéro 101, page 228.
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  • APA Style

    Halidou Idrissa Abdoul-Rahamane, Kawtar Nassar, Saadia Janani. (2023). Diagnosis of Aseptic Osteonecrosis of the Femoral Head (AONTH). International Journal of Clinical and Experimental Medical Sciences, 9(1), 1-6. https://doi.org/10.11648/j.ijcems.20230901.11

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    ACS Style

    Halidou Idrissa Abdoul-Rahamane; Kawtar Nassar; Saadia Janani. Diagnosis of Aseptic Osteonecrosis of the Femoral Head (AONTH). Int. J. Clin. Exp. Med. Sci. 2023, 9(1), 1-6. doi: 10.11648/j.ijcems.20230901.11

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    AMA Style

    Halidou Idrissa Abdoul-Rahamane, Kawtar Nassar, Saadia Janani. Diagnosis of Aseptic Osteonecrosis of the Femoral Head (AONTH). Int J Clin Exp Med Sci. 2023;9(1):1-6. doi: 10.11648/j.ijcems.20230901.11

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  • @article{10.11648/j.ijcems.20230901.11,
      author = {Halidou Idrissa Abdoul-Rahamane and Kawtar Nassar and Saadia Janani},
      title = {Diagnosis of Aseptic Osteonecrosis of the Femoral Head (AONTH)},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {9},
      number = {1},
      pages = {1-6},
      doi = {10.11648/j.ijcems.20230901.11},
      url = {https://doi.org/10.11648/j.ijcems.20230901.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcems.20230901.11},
      abstract = {Aseptic osteonecrosis is a frequent pathology. It corresponds to epiphyseal bone necrosis, secondary to ischemic and/or cytotoxic mechanisms. It is not a specific disease, but rather the final outcome of various pathological situations in which there is a disturbance of the intraosseous circulation of the femoral head. This explains the usual names of avascular necrosis or aseptic necrosis. It may be unilateral, bilateral or multifocal. More than 75% of aseptic osteonecrosis involve the femoral head. Many risk factors must be considered, such as corticosteroid therapy, alcoholism, dyslipidemia or sickle cell disease. It is important to diagnose osteonecrosis in the potentially reversible stages of the disease. It is a condition that is all the more disabling because it affects the young adult, in the middle of an active life, in the presence of pain in the groin crease of a young man who tends to take steroids, when the femoral head is still spherical on standard radiography. Magnetic resonance imaging has profoundly changed our diagnostic possibilities, showing pathognomonic signs while the radiograph may still be normal. Aseptic osteonecrosis of the femoral head (AONTH) often poses a problem of differential diagnosis with other coxopathies, which is a source of diagnostic delay in medical practice.},
     year = {2023}
    }
    

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    T1  - Diagnosis of Aseptic Osteonecrosis of the Femoral Head (AONTH)
    AU  - Halidou Idrissa Abdoul-Rahamane
    AU  - Kawtar Nassar
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    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
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    PB  - Science Publishing Group
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    UR  - https://doi.org/10.11648/j.ijcems.20230901.11
    AB  - Aseptic osteonecrosis is a frequent pathology. It corresponds to epiphyseal bone necrosis, secondary to ischemic and/or cytotoxic mechanisms. It is not a specific disease, but rather the final outcome of various pathological situations in which there is a disturbance of the intraosseous circulation of the femoral head. This explains the usual names of avascular necrosis or aseptic necrosis. It may be unilateral, bilateral or multifocal. More than 75% of aseptic osteonecrosis involve the femoral head. Many risk factors must be considered, such as corticosteroid therapy, alcoholism, dyslipidemia or sickle cell disease. It is important to diagnose osteonecrosis in the potentially reversible stages of the disease. It is a condition that is all the more disabling because it affects the young adult, in the middle of an active life, in the presence of pain in the groin crease of a young man who tends to take steroids, when the femoral head is still spherical on standard radiography. Magnetic resonance imaging has profoundly changed our diagnostic possibilities, showing pathognomonic signs while the radiograph may still be normal. Aseptic osteonecrosis of the femoral head (AONTH) often poses a problem of differential diagnosis with other coxopathies, which is a source of diagnostic delay in medical practice.
    VL  - 9
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Author Information
  • Rheumatology Department, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco

  • Rheumatology Department, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco

  • Rheumatology Department, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco

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