Pathology notes

Apr 16th, 2015
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AVASCULAR NECROSIS(OSTEONECROSIS)SAID, IDHA SALIMHP12/70303/11AVASCULAR NECROSIS(OSTEONECROSIS) Avascularnecrosis of the bones(osteonecrosis): it results fromischaemia.Its usually a common disease. Itsoccurs in the medullary cavitymetaphysis or diaphysis and thesubchondral region of the epiphysis.Conditions Associated with OsteonecrosisTraumaCorticosteroid administrationInfectionDysbarism (e.g., the bends)Radiation therapyConnective tissue disordersPregnancyGaucher diseaseSickle cell and other anemiasAlcohol abuseChronic pancreatitisTumorsEpiphyseal disordersETIOLOGY:It may occur from the following causes:Fracture of the bone.Sickle cell disease.Corticosteroid administration.Radiation TherapyChronic alcoholismIdiopathicPATHOGENESIS:Itspathogenetic mechanism isstill unknown, but some suggestthat it is caused by interruption ofblood supply to the bone eithercaused by directtrauma,compression orthromboembolic obstruction.MORPHOLOGIC FEATURES:Pathologicalfractures ofthe involved bones dueto infarcts. The infarctsinvolve the medulla ofthe long bones in thediaphysis.Clinical Course.subchondral infarcts cause chronic pain that isinitially associated only with activity but thenbecomes progressively more constant assecondary changes superveneSubchondral infarcts, however, often collapseand may predispose to severe, secondaryosteoarthritis.

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