• For osteonecrosis of the femoral head, MRI has become the imaging modality of choice because of its high sensitivity and specificity. (medscape.com)
  • After the femoral head, osteonecrosis of the humeral head is the most common site for nontraumatic osteonecrosis. (medscape.com)
  • Management of early stages of osteonecrosis aims to prevent the collapse of the femoral head by attempts at restoring the vascularity of femoral head. (nih.gov)
  • Forty patients (60 hips) with stage I, II or III (ARCO system) osteonecrosis of femoral head were treated by either core decompression and isolated mononuclear cells (group A) or core decompression and unprocessed bone marrow injection (group B). The patients were followed up clinically and radiologically for a minimum of 2 years. (nih.gov)
  • [ 16 ] A study analyzed the clinical, functional and radiological outcome of core decompression and bone grafting in 20 patients with 28 cases of osteonecrosis of the femoral head (ONFH) up to stage IIB (Ficat & Arlet). (medscape.com)
  • What Is Femoral Head Osteonecrosis and What Are the Treatment Options? (eorthopod.com)
  • Osteonecrosis of the femoral head most frequently affects 30 to 50 years old, with 20,000-30,000 new cases diagnosed annually. (eorthopod.com)
  • Although the actual pathology behind femoral osteonecrosis is not yet understood, the disease typically follows a progression to eventual femoral collapse, which results in the need for a total hip replacement. (eorthopod.com)
  • Osteonecrosis of the femoral head (ONFH) is a disabling disease. (biomedcentral.com)
  • osteonecrosis is uncommon after intertrochanteric fractures. (msdmanuals.com)
  • Common manifestations include lytic lesions in bones that cause pain and/or fractures, renal insufficiency, hypercalcemia, anemia, and recurrent infections. (merckmanuals.com)
  • OCL may be genetic or may be caused due to trauma, stress fractures in sports, severe sprain, local osteonecrosis, etc. (michaelclaremd.com)
  • The potential, albeit rare, adverse events of using denosumab in arthroplasty patients include osteonecrosis of the jaw and atypical femur fractures, even in the periprosthetic region. (sense-studios.com)
  • Background: The ideal treatment for osteochondral lesions of the talus (OLTs) is still controversial, especially in older patients. (researchgate.net)
  • OATS of the ankle is a surgical procedure to treat Osteochondral Lesions of the Talus (OCL) or Osteochondritis Dissecans (OCD). (michaelclaremd.com)
  • This systematic review was performed to assess the potential influence of medication-induced salivary changes on the development of medication-related osteonecrosis of the jaw (MRONJ). (frontiersin.org)
  • Medication-related osteonecrosis of the jaw (MRONJ) is an adverse drug reaction, described as an exposed necrotic bone or a bone that can be probed through an intraoral or extraoral fistula in the maxillofacial region, that persists for more than 8 weeks in patients without a history of radiotherapy or disease metastasis to the jaws ( 1 , 2 ). (frontiersin.org)
  • Mucosal lesions in these individuals may be reflective of underlying medication-related osteonecrosis of the jaws (MRONJ), a condition that may be exacerbated by any manipulation. (medscape.com)
  • Factors Influencing Severity of Medication-Related Osteonecrosis of the Jaw: A Retrospective Study. (bvsalud.org)
  • The progression of medication-related osteonecrosis of the jaw (MRONJ) is influenced by many factors. (bvsalud.org)
  • Medication-related osteonecrosis of the jaw (MRONJ) is a clinical risk for patients on bisphosphonate therapy. (medicalindependent.ie)
  • Lesions in the epiphysis are called avascular necrosis (AVN). (medscape.com)
  • Dysbaric osteonecrosis or DON is a form of avascular necrosis where there is death of a portion of the bone that is thought to be caused by nitrogen (N2) embolism (blockage of the blood vessels by a bubble of nitrogen coming out of solution) in divers. (wikipedia.org)
  • Lateral view of the knee in a deep-sea diver shows dysbaric osteonecrosis in the diaphysis of the femur and tibia. (medscape.com)
  • Dysbaric osteonecrosis lesions are typically bilateral and usually occur at both ends of the femur and at the proximal end of the humerus. (wikipedia.org)
  • Dysbaric osteonecrosis is a significant occupational hazard, occurring in 50% of commercial Japanese divers, 65% of Hawaiian diving fishermen and 16% of commercial and caisson divers in the UK. (wikipedia.org)
  • Clinical manifestations of DCS include (but are not limited to) joint pain ("bends"), lytic lesions of bones (dysbaric osteonecrosis), cutaneous disorders (cutis marmorata), spinal cord and brain disorders (stroke, paralysis, paresthesias, bladder dysfunction, etc.), and cardiopulmonary disorders (shortness of breath ["chokes"]), arterial gas embolism). (cdc.gov)
  • Dysbarism-related osteonecrosis: proceedings of a symposium on dysbaric osteonecrosis. (cdc.gov)
  • Treatment of nontraumatic (for example, dysbaric) osteonecrosis is correlated with clinical, radiological and pathological stages of progressive involvement of the shoulder and hip joints. (cdc.gov)
  • A strong link has recently been identified between chronic use of these drugs and the development of osteonecrosis in the jawbone, clinically characterized by bone exposure on these places. (bvsalud.org)
  • Common manifestations include lytic lesions in bones that cause. (merckmanuals.com)
  • Arthrodesis of the shoulder and complete hip replacement are indicated when severe Stage III lesions and arthritis are present. (cdc.gov)
  • In looking for better options, the surgeons of this paper suggest "a (surgical) technique for patients with end-stage ankle arthritis associated to extensive talar osteonecrosis, and patients with prior total ankle replacement and talar component collapse due to AVN. (jointrehab.com)
  • Chronic bone marrow lesions (BML) in the weight-bearing portions of the knee are often associated with symptomatic degenerative arthritis resulting in pain and dysfunction. (biomedcentral.com)
  • Denosumab is already a well-established licensed drug for the indications of osteoporosis and metastatic bone lesions in cancer, and has been shown to be effective in reducing erosions in inflammatory arthritis," Dr. Mark JM Wilkinson of the University of Sheffield, UK, told Reuters Health by email. (sense-studios.com)
  • As an ideal target," he added, "denosumab could control osteolytic lesions in patients with age-related low bone mineral density and in patients with advanced rheumatoid arthritis, who poorly tolerate revision surgery due to inherent skeletal fragility. (sense-studios.com)
  • Recently, mesenchymal stem cells (MSCs) have been suggested for use in the cell-based treatment of cartilage lesions. (researchgate.net)
  • MRI is the best imaging modality, which helps to visualize the cartilage and bone lesions as well as bone edema. (michaelclaremd.com)
  • MRONJ has characteristics that differ from osteonecrosis at other sites. (msdmanuals.com)
  • Demographic and clinical factors were the independent variables, and the clinical stage of MRONJ lesions was the dependent variable. (bvsalud.org)
  • A total of 79 patients (with 93 MRONJ lesions) were included. (bvsalud.org)
  • Symptomatic lesions usually involve joint surfaces, and fracture where attempted healing occurs. (wikipedia.org)
  • citation needed] Divers who have suffered from DON are at increased risk of future fracture of a juxta-articular lesion during a dive, and may face complications with future joint replacements. (wikipedia.org)
  • An aggressive looking bone lesion in the right mandible suggests a pathological fracture. (bmj.com)
  • Fracture or dislocation may cause osteonecrosis by grossly disrupting or compressing nearby blood vessels. (msdmanuals.com)
  • 20 years of age with a pathological fracture through the lesion. (orthobullets.com)
  • Treatment is usually immobilization for proximal humerus lesions with pathologic fracture. (orthobullets.com)
  • These lesions are usually symptomatic and difficult to treat. (scielo.org)
  • Calcium phosphate injection of symptomatic bone marrow lesions of the knee: what is the current clinical evidence? (biomedcentral.com)
  • Dr Joyce's presentation was based on a case involving multiple presentations and investigations, which were non-diagnostic until angiosarcoma was eventually diagnosed from a cutaneous lesion. (medicalindependent.ie)
  • This patient's diagnosis was reached by punch biopsy of cutaneous lesions identified on full skin examination during his medical workup. (medicalindependent.ie)
  • Vascular lesions in the hand may be secondary to local pathology, a proximal source of emboli, or systemic diseases with vascular compromise. (springer.com)
  • Vascular lesions in the hand may be secondary to local pathology (e.g. tumour, malformation, trauma, iatrogenic cause, or drug injection), a proximal source of emboli (e.g. dissections or aneurysms), or systemic diseases with vascular compromise (e.g. rheumatic and vaso-occlusive diseases). (springer.com)
  • Although the etiology of secondary osteonecrosis is unknown, several risk factors are associated with the disease. (medscape.com)
  • Microscopic cysts form, fill with necrotic material and there is massive necrosis with replacement by cancellous bone with collapse of the lesions. (wikipedia.org)
  • Osteonecrosis is a disease characterized by a derangement of osseous circulation that leads to necrosis of osseous tissue. (medscape.com)
  • The radiographic hallmark of cherubism is bilateral, symmetrical, multiloculated radiolucent lesions in the mandible extending from the region of the molar teeth towards the midline, 5 resulting in a soap-bubble appearance of the jaw. (sajr.org.za)
  • 2011. Bisphosphonates and osteonecrosis of the jaw. (medsafe.govt.nz)
  • 2006. Osteonecrosis of the jaw and bisphosphonates-putting the risk in perspective. (medsafe.govt.nz)
  • 2009. Bisphosphonates and time to osteonecrosis development. (medsafe.govt.nz)
  • Besides stopping the use of bisphosphonates, the treatment established was: antibiotic therapy, surgical debridement and topical measures of oral hygiene, thus there was no regression of the lesion. (bvsalud.org)
  • Bisphosphonates are drugs used in the treatment of malignant metastatic diseases and in other bone lesions such as osteoporosis and Paget´s disease. (scielo.org)
  • Bisphosphonate related osteonecrosis of the jaw (BRONJ) is a recently described adverse side effect of bisphosphonate therapy, with an estimated 94% of cases reported in the oncologic patients receiving intravenous nitrogen-containing bisphosphonates (BP). (ca.gov)
  • Diagnosis is made with radiographs showing a central, lytic, well-demarcated metaphyseal lesions with cystic expansion and a characteristic "fallen leaf" sign. (orthobullets.com)
  • Unicameral Bone Cysts are non-neoplastic, serous fluid-filled bone lesions most commonly found in the proximal humerus. (orthobullets.com)
  • The most benign and common form of Langerhans-cell histiocytosis which involves localized nodular lesions predominantly of the bones but also of the gastric mucosa, small intestine, lungs, or skin, with infiltration by EOSINOPHILS. (bvsalud.org)
  • We demonstrate the biological concept that the drug is 90% effective in reducing osteoclast numbers within these osteolytic lesions," he said. (sense-studios.com)
  • lesions that are related to infection, inflammation, or local trauma may resolve during this time. (medscape.com)
  • Oral infection is considered to play a critical role in the pathogenesis of bisphosphonate-related osteonecrosis of the jaw (BRONJ), and antibiotic therapy has become a mainstay of BRONJ therapy. (nih.gov)
  • The jaws are particularly sensitive to osteonecrosis due to high bone turnover resulting from daily activity and the presence of teeth 1 . (medsafe.govt.nz)
  • The incidence of osteonecrosis after hip dislocation is related primarily to the severity of the initial injury but may be higher if the dislocation is not promptly reduced. (msdmanuals.com)
  • Large lesion size (≥109 mm(2)) and the existence of subchondral cysts were significant predictors of unsatisfactory clinical outcomes in group A (P = .04 and .03, respectively). (researchgate.net)
  • These correlations were not observed in group B. Conclusion: Injection of MSCs with marrow stimulation treatment was encouraging in patients older than 50 years compared with patients treated with marrow stimulation treatment alone, especially when the lesion size was larger than 109 mm(2) or a subchondral cyst existed. (researchgate.net)
  • In osteonecrosis, the lesion can extend to the subchondral plate and result in collapse of the necrotic segment. (medscape.com)
  • Oral tissue biopsy may be necessary for lesions that cannot be diagnosed on the basis of the history and clinical findings alone. (medscape.com)
  • Biopsy is strongly recommended for the evaluation of most lesions that persist for 2 weeks or longer after the potential irritants are removed. (medscape.com)
  • Therefore, the decision to forego biopsy in an apparently benign lesion should be made with great care and only when the patient understands the need for close follow-up and agrees to comply. (medscape.com)
  • Biopsy confirmed the diagnosis of bisphosphonate-induced osteonecrosis of the torus palatinus. (rdhmag.com)
  • In general, bone infarct refers to lesions occurring in the metaphysis and diaphysis of bone. (medscape.com)
  • Osteonecrosis is a focal infarct of bone that may be caused by specific etiologic factors or may be idiopathic. (msdmanuals.com)
  • Ahlback et al first reported on osteonecrosis of the knee in 1968. (medscape.com)
  • The knee is the second most common site for osteonecrosis, but it is affected much less often than the hip. (medscape.com)
  • Osteonecrosis of the knee is commonly mistaken for osteochondritis dissecans, primary osteoarthritis, meniscal tears, bone bruises, transient osteopenia of the knee, and pes anserine bursitis. (medscape.com)
  • Arthrodesis and intertrochanteric osteotomy of the hip are indicated in patients under 50 years old with Stage III lesions and unilateral hip disease. (cdc.gov)
  • In the United States, osteonecrosis affects approximately 20,000 new patients annually. (msdmanuals.com)
  • Osteonecrosis can occur in any bone but most commonly affects the hip. (medscape.com)
  • It is unusual for osteonecrosis to involve the shoulder or other less commonly affected sites without the hip also being involved. (msdmanuals.com)
  • Free vascularized fibular grafting significantly alters disease progression in precollapse lesions and is even useful in modifying disease in mildly collapsed and early arthritic hips. (medscape.com)
  • Radioisotopic bone scan of the right humerus in a patient with pancreatitis shows a hot lesion, the result of revascularization, which is a part of the reparative process. (medscape.com)
  • Revascularization procedures are indicated for certain Stage I lesions. (cdc.gov)
  • Namely, the clinical results of core decompression alone deteriorate with more advanced lesions. (medscape.com)
  • Clinical history and direct observation remain the best approach for diagnosis of vascular lesions in the hand. (springer.com)
  • We have successfully established BRONJ minipig and mouse models treated with oncologic doses of zolendronate (Zometa)/Dexamethasone (Dex) developed BRONJ-like pathological lesions with similar clinical, radiographic, and histological features as described in the human disease. (ca.gov)
  • Lesions are depicted with one or more color photographs that illustrate typical clinical features. (hpcinternationalinc.com)
  • Bisphosphonate induced and radiation induced osteonecrosis can also have an apparently destructive appearance. (bmj.com)
  • For suspected osteonecrosis following normal or inconclusive radiographs, MRI without IV contrast is usually appropriate. (medscape.com)
  • The initial imaging modality for suspected osteonecrosis is radiography. (medscape.com)
  • Early identification of lesions by radiography is not possible, but over time areas of radiographic opacity develop in association with the damaged bone. (wikipedia.org)
  • citation needed] The lesion begins as a localised area of infarction, usually without symptoms. (wikipedia.org)
  • In juxta-articular lesions without symptoms, there is dead bone and marrow separated from living bone by a line of dense collagen. (wikipedia.org)
  • Large lesions are associated with symptoms such as localized ankle pain and discomfort which worsens while walking or running, a clicking or popping sound, swelling, tenderness, weakness of the foot, etc. (michaelclaremd.com)
  • Malignancy is suspected when persistent oral mucosal lesions are red or red and white or when they are ulcerated, indurated, or fixed to deeper tissues. (medscape.com)
  • Unexplained pigmented oral lesions are of concern if they are new or changed. (medscape.com)
  • This study using limited sample size indicated that oral antibiotic therapy may have a limited efficacy on the bacterial population associated with BRONJ lesions. (nih.gov)
  • Vascular lesions of the hand are common and are distinct from vascular lesions elsewhere because of the terminal vascular network in this region, the frequent hand exposure to trauma and microtrauma, and the superficial location of the lesions. (springer.com)
  • Lesions are caused by bone replacement by expanding plasmacytomas or by cytokines that are secreted by malignant plasma cells that activate osteoclasts and suppress osteoblasts, leading to bone loss. (merckmanuals.com)
  • Small asymptomatic lesions do not warrant surgical intervention and are closely monitored with serial examination. (medscape.com)