Clinical Presentation and Evaluation of Glenohumeral Arthritis.
Last updated Thursday, January 27, 2005
Avascular necrosis
Nontraumatic avascular necrosis of the humeral head may be idiopathic
or associated with the systemic use of steroids, dysbaric conditions,
transplantation, or systemic illnesses with vasculitis.Other implicated conditions Other implicated conditions include alcoholism, sickle cell disease,
hyperuricemia, Gaucher's disease, pancreatitis, familial
hyperlipidemia, renal or other organ transplantation, and lymphoma.
(Bradford, Szalapski, Sutherland, et al., 1984; Cruess, 1976; Cruess,
1985; Rossleigh, Smith, Straus, et al., 1986)
The pathology may first be detected by magnetic resonance imaging
before collapse is seen radiographically. Later osteoporosis and/or
osteosclerosis may be seen on plain radiographs. Next there is evidence
of a fracture through the abnormal subchondral bone superior-centrally.
Later, collapse of the subchondral bone occurs, often with a separated
osteocartilaginous flap. In end-stage avascular necrosis, the irregular
humeral head destroys glenoid articular cartilage resulting in
secondary degenerative joint disease. (Cruess, 1976; Rutherford and
Cofield, 1987)
How useful was this page or article?
|
|