osteonecrosis

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Classification

  • when osteonecrosis occurs at a bone end, it is known as avascular necrosis
  • when it occurs in the diaphysis of a bone, it is referred to as a bone infarct
  • eponyms have been used to designate osteonecrosis at particular sites.

Etiology

Pathology

(sites of occurrence)

Clinical manifestations

* often bilateral, check both hips[14]

Radiology

Differential diagnosis

Management

More general terms

More specific terms

References

  1. Basic Radiology, Chen MYM, Pope TL & Ott DJ (eds), McGraw Hill, NY 1996
  2. 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 17, 18. American College of Physicians, Philadelphia 1998, 2006, 2015, 2018.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. 3.0 3.1 Advisory Task Force on Bisphosphonate-Related Ostenonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2007 Mar;65(3):369-76. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/17307580 <Internet> http://www.aaoms.org/docs/position_papers/osteonecrosis.pdf
    Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, Gagel RF, Gilsanz V, Guise T, Koka S, McCauley LK, McGowan J, McKee MD, Mohla S, Pendrys DG, Raisz LG, Ruggiero SL, Shafer DM, Shum L, Silverman SL, Van Poznak CH, Watts N, Woo SB, Shane E; American Society for Bone and Mineral Research. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007 Oct;22(10):1479-91. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/17663640 <Internet> http://dx.doi.org/10.1359/JBMR.0707ONJ
    Bilezikian JP. Osteonecrosis of the jaw--do bisphosphonates pose a risk? N Engl J Med. 2006 Nov 30;355(22):2278-81. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17135582
    Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalence, risk factors, and clinical characteristics. Clin Ther. 2007 Aug;29(8):1548-58. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17919538
    Mavrokokki T, Cheng A, Stein B, Goss A. Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg. 2007 Mar;65(3):415-23. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17307586
    Grant BT, Amenedo C, Freeman K, Kraut RA. Outcomes of placing dental implants in patients taking oral bisphosphonates: a review of 115 cases. J Oral Maxillofac Surg. 2008 Feb;66(2):223-30. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18201600
    Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, Wehren LE, Lombardi A, Santora AC, Cummings SR; FLEX Research Group. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA. 2006 Dec 27;296(24):2927-38. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17190893
    Cartsos VM, Zhu S, Zavras AI. Bisphosphonate use and the risk of adverse jaw outcomes: a medical claims study of 714,217 people. J Am Dent Assoc. 2008 Jan;139(1):23-30. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18167381
    Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab. 2005 Mar;90(3):1294-301. Epub 2004 Dec 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15598694
  4. Prescriber's Letter 16(3): 2009 Summary of the Latest Guidelines on Bisphosphonate-Induced Osteonecrosis Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=250303&pb=PRL (subscription needed) http://www.prescribersletter.com
  5. 5.0 5.1 Silverman SL, Landesberg R. Osteonecrosis of the jaw and the role of bisphosphonates: a critical review. Am J Med. 2009 Feb;122(2 Suppl):S33-45. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19187811
  6. Hellstein JW, Adler RA, Edwards B et al Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2011 Nov;142(11):1243-51. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22041409
  7. Ruggiero SL, Fantasia J, Carlson E. Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Oct;102(4):433-41. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16997108
  8. Ruggiero S, Gralow J, Marx RE et al Practical guidelines for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in patients with cancer. J Oncol Pract. 2006 Jan;2(1):7-14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20871729
  9. Shannon J, Shannon J, Modelevsky S, Grippo AA. Bisphosphonates and osteonecrosis of the jaw. J Am Geriatr Soc. 2011 Dec;59(12):2350-5. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22091898
  10. 10.0 10.1 10.2 Shigemura T, Nakamura J, Kishida S et al Incidence of osteonecrosis associated with corticosteroid therapy among different underlying diseases: prospective MRI study. Rheumatology (Oxford). 2011 Nov;50(11):2023-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21865285
  11. Kuhl S, Walter C, Acham S, Pfeffer R, Lambrecht JT. Bisphosphonate-related osteonecrosis of the jaws--a review. Oral Oncol. 2012 Oct;48(10):938-47. Epub 2012 Apr 21. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22525606
  12. Weinstein RS. Glucocorticoid-induced osteonecrosis. Endocrine. 2012 Apr;41(2):183-90. d Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22169965 Free PMC Article
  13. Gontero RP, Bedoya ME, Benavente E, Roverano SG, Paira SO. Osteonecrosis in systemic lupus erythematosus. Reumatol Clin. 2015 May-Jun;11(3):151-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25441491 Free Article
  14. 14.0 14.1 14.2 14.3 NEJM Knowledge+ Rheumatology
  15. National Institute of Arthritis and Muscluloskeletal and Skin Diseases (NIAMS) Osteonecrosis https://www.niams.nih.gov/health-topics/osteonecrosis

Patient information

osteonecrosis patient information