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• Diagnosis and Tests
• Treatments and Therapies

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Summary

Osteonecrosis is a disease caused by reduced blood flow to bones in the joints. In people with healthy bones, new bone is always replacing old bone. In osteonecrosis, the lack of blood causes the bone to break down faster than the body can make enough new bone. The bone starts to die and may break down.

You can have osteonecrosis in one or several bones. It is most common in the upper leg. Other common sites are your upper arm and your knees, shoulders and ankles. The disease can affect men and women of any age, but it usually strikes in your thirties, forties or fifties.

At first, you might not have any symptoms. As the disease gets worse, you will probably have joint pain that becomes more severe. You may not be able to bend or move the affected joint very well.

No one is sure what causes the disease. Risk factors include :

• Long-term steroid treatment
• Alcohol misuse
• Joint injuries
• Having certain diseases, including arthritis and cancer

Doctors use imaging tests and other tests to diagnose osteonecrosis. Treatments include medicines, using crutches, limiting activities that put weight on the affected joints, electrical stimulation and surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Start Here

• Avascular Necrosis (Mayo Foundation for Medical Education and Research) Also in Spanish
• Osteonecrosis (American College of Rheumatology) Also in Spanish
• Osteonecrosis (National Institute of Arthritis and Musculoskeletal and Skin Diseases) Also in Spanish

Diagnosis and Tests

• Body CT (American College of Radiology; Radiological Society of North America) Also in Spanish
• Bone Scan (Mayo Foundation for Medical Education and Research) Also in Spanish
• Bone X-Ray (American College of Radiology; Radiological Society of North America) Also in Spanish

Treatments and Therapies

• Bone Grafts: MedlinePlus Health Topic (National Library of Medicine) Also in Spanish
• Hip Replacement Surgery (National Institute of Arthritis and Musculoskeletal and Skin Diseases) Also in Spanish

Specifics

• Kienböck's Disease (American Academy of Orthopaedic Surgeons)
• Osteonecrosis of the Jaw (ONJ) (American College of Rheumatology) Also in Spanish

Genetics

• Legg-Calvé-Perthes disease: MedlinePlus Genetics (National Library of Medicine)

Clinical Trials

• ClinicalTrials.gov: Legg-Calve-Perthes Disease (National Institutes of Health)
• ClinicalTrials.gov: Osteonecrosis (National Institutes of Health)

Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)

• Article: The Lachnospiraceae-butyric acid axis and its role in glucocorticoid-associated osteonecrosis.
• Article: High accuracy but limited readability of large language model-generated responses to...
• Article: Avascular Necrosis of the Talus: Diagnosis, Treatment, and Modern Reconstructive Options.
• Osteonecrosis -- see more articles

Find an Expert

• National Institute of Arthritis and Musculoskeletal and Skin Diseases Also in Spanish

Children

• Legg-Calvé-Perthes Disease (For Parents) (Nemours Foundation) Also in Spanish

Patient Handouts

• Osteonecrosis (Medical Encyclopedia) Also in Spanish