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Avascular necrosis (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. [1] Early on, there may be no symptoms. [1] Gradually joint pain may develop, which may limit the person's ability to move. [1] Complications may include collapse of the bone or nearby joint surface. [1]
Pain in the affected area [1] [2] Muscle spasm in the affected area [1] Numbness and tingling in an arm or leg [1] [2] Paleness [1] [2] of the skin of the arm or leg; Muscle weakness of an arm or leg, [1] [2] possibly to the grade of paralysis [2] Later symptoms are closely related to infarction of the tissue supplied by the occluded artery:
A major presentation is painful thigh or leg swelling. [12] Bone: Infarction of bone results in avascular necrosis. Without blood, the bone tissue dies and the bone collapses. [13] If avascular necrosis involves the bones of a joint, it often leads to destruction of the joint articular surfaces (see osteochondritis dissecans).
Cancellous bone, with its mesh like structure and spaces filled with marrow tissue is more susceptible to damage by bone infarcts, leading to hypoxia and premature cell apoptosis. [ 15 ] [ 16 ] [ 27 ] [ 28 ] The mean life-span of osteocytes has been estimated to be 15 years in cancellous bone, [ 29 ] and 25 years in cortical bone.
A number of diseases can cause bone pain, including the following: Endocrine, such as hyperparathyroidism, osteoporosis, kidney failure. [7]Gastrointestinal or systemic, such as celiac disease and non-celiac gluten sensitivity (both often occur without obvious digestive symptoms), inflammatory bowel disease (including Crohn's disease and ulcerative colitis).
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[1] [5] Abrupt onset of pain at the back or neck marks the location of ischaemia or hemorrhage at the beginning, which radiates as the damage intensifies. [ 9 ] [ 10 ] Temporary paresis in limbs may occur days before the onset of spinal ischaemic stroke, though the relationship remains unclear.
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