osteonecrosis

Aetiology and pathogenesis

Sites which are peculiarly vulnerable to ischaemic

necrosis are the 

• femoral head, 
• the femoral condyles,
• the head of the humerus, 
• the capitulum and the 
• proximal
• parts of the scaphoid and talus.

MAIN CONDITIONS ASSOCIATED WITH

NON-TRAUMATIC OSTEONECROSIS

Infections

• Osteomyelitis

• Septic arthritis

Haemoglobinopathy

• Sickle cell disease

Storage disorders

• Gaucher’s disease

Caisson disease

• Dysbaric osteonecrosis

Coagulation disorders

• Familial thrombophilia

• Hypofibrinolysis

• Hypolipoproteinaemia

• Thrombocytopenic purpura

Other

• Perthes’ disease

• Cortisone administration

• Alcohol abuse

• SLE (? increase in antiphospholipid antibodies)

• Pregnancy (? decreased fibrinolysis; ? fatty liver)

• Anaphylactic shock

• Ionizing radiation

SLE, systemic lupus erythematosus.