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Osteonecrosis, osteochondrosis, and osteochondritis dissecans 

Osteonecrosis, osteochondrosis, and osteochondritis dissecans
Osteonecrosis, osteochondrosis, and osteochondritis dissecans

Gavin Clunie

, Donncha O’Gradaigh

, and Adrian Crisp


August 28, 2014: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.


Chapter reviewed and heavily updated throughout.

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date: 16 October 2021

Osteonecrosis (‘bone death’) can be caused by a range of conditions including trauma, drugs (e.g. glucocorticoids), metabolic or endocrine conditions (e.g. Cushing’s syndrome, Gaucher disease), and haematological disease (e.g. sickle cell disease, antiphospholipid syndrome [APLS]). There are no specific features on history or examination but the condition may present with pain or localised skeletal failure. Diagnosis is made by Magnetic Resonance (MR) imaging. Treatment involves approaches designed to improve blood supply (vasodilators, low-molecular-weight heparin), promote bone repair (bisphosphonates), revascularize bone (e.g. surgical core decompression), or remove or replace tissue (e.g. osteotomy, arthroplasty)....

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