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Avascular Necrosis
These drugs have been linked to
the catastrophic condition(s) If you or a loved one has been taking any of these “Bisphosphonates”
for YOU MAY DESERVE COMPENSATION! Accepting Inquiries from the U.S. and Internationally Every case is different. No specific results are
implied.
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Questions and Answers About Avascular Necrosis
Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse. If the process involves the bones near a joint, it often leads to collapse of the joint surface. This disease also is known as osteonecrosis, aseptic necrosis, and ischemic bone necrosis. Although it can happen in any bone, avascular necrosis most commonly affects the ends (epiphysis) of long bones such as the femur, the bone extending from the knee joint to the hip joint. Other common sites include the upper arm bone, knees, shoulders, and ankles. The disease may affect just one bone, more than one bone at the same time, or more than one bone at different times. Avascular necrosis usually affects people between 30 and 50 years of age; about 10,000 to 20,000 people develop avascular necrosis each year. Orthopaedic doctors most often diagnose the disease. The amount of disability that results from avascular necrosis depends on what part of the bone is affected, how large an area is involved, and how effectively the bone rebuilds itself. The process of bone rebuilding takes place after an injury as well as during normal growth. Normally, bone continuously breaks down and rebuilds--old bone is reabsorbed and replaced with new bone. The process keeps the skeleton strong and helps it to maintain a balance of minerals. In the course of avascular necrosis, however, the healing process is usually ineffective and the bone tissues break down faster than the body can repair them. If left untreated, the disease progresses, the bone collapses, and the joint surface breaks down, leading to pain and arthritis. What Causes Avascular Necrosis? Avascular necrosis has several causes. Loss of blood supply to the bone can be caused by an injury (trauma-related avascular necrosis or joint dislocation) or by certain risk factors (nontraumatic avascular necrosis), such as some medications (steroids), blood coagulation disorders, or excessive alcohol use. Increased pressure within the bone also is associated with avascular necrosis. The pressure within the bone causes the blood vessels to narrow, making it hard for the vessels to deliver enough blood to the bone cells. Injury When a joint is injured, as in a fracture or dislocation, the blood vessels may be damaged. This can interfere with the blood circulation to the bone and lead to trauma-related avascular necrosis. Studies suggest that this type of avascular necrosis may develop in more than 20 percent of people who dislocate their hip joint. Steroid Medications Corticosteroids such as prednisone are commonly used to treat diseases in which there is inflammation, such as systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, and vasculitis. Studies suggest that long-term, systemic (oral or intravenous) corticosteroid use is associated with 35 percent of all cases of nontraumatic avascular necrosis. However, there is no known risk of avascular necrosis associated with the limited use of steroids. Patients should discuss concerns about steroid use with their doctor. Doctors aren't sure exactly why the use of corticosteroids sometimes leads to avascular necrosis. They may interfere with the body's ability to break down fatty substances. These substances then build up in and clog the blood vessels, causing them to narrow. This reduces the amount of blood that gets to the bone. Some studies suggest that corticosteroid-related avascular necrosis is more severe and more likely to affect both hips (when occurring in the hip) than avascular necrosis resulting from other causes. Alcohol Use Excessive alcohol use and corticosteroid use are two of the most common causes of nontraumatic avascular necrosis. In people who drink an excessive amount of alcohol, fatty substances may block blood vessels, causing a decreased blood supply to the bones that results in avascular necrosis. Other Risk Factors Other risk factors or conditions associated with nontraumatic avascular necrosis include Gaucher's disease, pancreatitis, radiation treatments and chemotherapy, decompression disease, and blood disorders such as sickle cell disease. Who Is Likely To Develop Avascular Necrosis? Avascular necrosis affects both men and women and affects people of all ages. It is most common among people in their thirties and forties. Depending on a person's risk factors and whether the underlying cause is trauma, it also can affect younger or older people. What Are the Symptoms? In the early stages of avascular necrosis, patients may not have any symptoms. As the disease progresses, however, most patients experience joint pain--at first, only when putting weight on the affected joint, and then even when resting. Pain usually develops gradually and may be mild or severe. If avascular necrosis progresses and the bone and surrounding joint surface collapse, pain may develop or increase dramatically. Pain may be severe enough to limit the patient's range of motion in the affected joint. In some cases, particularly those involving the hip, disabling osteoarthritis may develop. The period of time between the first symptoms and loss of joint function is different for each patient, ranging from several months to more than a year. How Is Avascular Necrosis Diagnosed? After performing a complete physical examination and asking about the patient's medical history (for example, what health problems the patient has had and for how long), the doctor may use one or more imaging techniques to diagnose avascular necrosis. As with many other diseases, early diagnosis increases the chances of treatment success. It is likely that the doctor first will recommend a radiograph, commonly called an x ray. X rays can help identify many causes of joint pain, such as a fracture or arthritis. If the x ray is normal, the patient may need to have more tests. Research studies have shown that magnetic resonance imaging, or MRI, is the most sensitive method for diagnosing avascular necrosis in the early stages. The tests described below may be used to determine the amount of bone affected and how far the disease has progressed. X Ray An x ray is a common tool that the doctor may use to help diagnose the cause of joint pain. It is a simple way to produce pictures of bones. The x ray of a person with early avascular necrosis is likely to be normal because x rays are not sensitive enough to detect the bone changes in the early stages of the disease. X rays can show bone damage in the later stages, and once the diagnosis is made, they are often used to monitor the course of the condition. Magnetic Resonance Imaging (MRI) MRI is quickly becoming a common method for diagnosing avascular necrosis. Unlike x rays, bone scans, and CT (computed/computerized tomography) scans, MRI detects chemical changes in the bone marrow and can show avascular necrosis in its earliest stages. MRI provides the doctor with a picture of the area affected and the bone rebuilding process. In addition, MRI may show diseased areas that are not yet causing any symptoms. Bone Scan Also known as bone scintigraphy, bone scans are used most commonly in patients who have normal x rays. A harmless radioactive dye is injected into the affected bone and a picture of the bone is taken with a special camera. The picture shows how the dye travels through the bone and where normal bone formation is occurring. A single bone scan finds all areas in the body that are affected, thus reducing the need to expose the patient to more radiation. Bone scans do not detect avascular necrosis at the earliest stages. Computed/Computerized Tomography A CT scan is an imaging technique that provides the doctor with a three-dimensional picture of the bone. It also shows "slices" of the bone, making the picture much clearer than x rays and bone scans. Some doctors disagree about the usefulness of this test to diagnose avascular necrosis. Although a diagnosis usually can be made without a CT scan, the technique may be useful in determining the extent of bone damage. Biopsy A biopsy is a surgical procedure in which tissue from the affected bone is removed and studied. Although a biopsy is a conclusive way to diagnose avascular necrosis, it is rarely used because it requires surgery. Functional Evaluation of Bone Tests to measure the pressure inside a bone may be used when the doctor strongly suspects that a patient has avascular necrosis, despite normal results of x rays, bone scans, and MRIs. These tests are very sensitive for detecting increased pressure within the bone, but they require surgery. What Treatments Are Available? Appropriate treatment for avascular necrosis is necessary to keep joints from breaking down. If untreated, most patients will experience severe pain and limitation in movement within 2 years. Several treatments are available that can help prevent further bone and joint damage and reduce pain. To determine the most appropriate treatment, the doctor considers the following aspects of a patient's disease:
The goal in treating avascular necrosis is to improve the patient's use of the affected joint, stop further damage to the bone, and ensure bone and joint survival. To reach these goals, the doctor may use one or more of the following treatments. Conservative Treatment
Conservative treatments have been used experimentally alone or in combination. However, these treatments rarely provide lasting improvement. Therefore, most patients will eventually need surgery to repair the joint permanently. Surgical Treatment
For most people with avascular necrosis, treatment is an ongoing process. Doctors may first recommend the least complex and invasive procedure, such as protecting the joint by limiting movement, and watch the effect on the patient's condition. Other treatments then may be used to prevent further bone destruction and reduce pain. It is important that patients carefully follow instructions about activity limitations and work closely with their doctor to ensure that appropriate treatments are used. What Research Is Being Done to Help People With Avascular Necrosis? With proper treatment, most people with avascular necrosis can lead productive lives. But there is still a lot to learn about prevention, diagnosis, and treatment. For example, researchers are studying:
Where Can People Find More Information About Avascular Necrosis? National Institute of Arthritis and Musculoskeletal The clearinghouse provides information about various forms of arthritis and rheumatic disease and bone, muscle, and skin diseases. It distributes patient and professional education materials and refers people to other sources of information. Additional information and updates can also be found on the NIAMS Web site. American Academy of Orthopaedic Surgeons
Osteonecrosis of the Jaw Information Fosamax ( generic name - Alendronate ) is a type of drug known as bisphosphonates. Recently a link has been found between bisphosphonates and a serious bone cancer disease called osteonecrosis of the jaw ( ONJ ). This important discovery clearly shows that Fosamax side effects may include osteonecrosis of the jaw. The discovery, published in the Journal of Oral and Maxillofacial Surgeons, prompted both the US, Food and Drug Administration ( FDA ) and Novartis, the manufacturer of bisphosphonates used in cancer chemotherapy, to issue a warning to health care professionals on September 24, 2004. The warning letter contained information about jaw cancer and bisphosphonates and the risks of osteonecrosis in the jaw. Bisphosphonates are commonly used in tablet form such as Fosamax ( Alendronate Sodium ) to prevent and treat osteoporosis in post-menopausal women. Stronger forms of bisphosphonates are commonly used in the management of advanced cancers that have metastasized to the bone, where the disease often causes bone pain and possibly even fractures. Several cancers can involve or metastasize to the bone, including lung cancer, breast cancer, prostate cancer, multiple myeloma,jaw cancer, and others. When bisphosphonates are given in cancer chemotherapy, the drugs are given intravenously, and usually for longer periods of time.If you or a loved one have jaw cancer and have been injured as a result of Fosamax,Zometa, and Aredia side effects such as osteonecrosis of the jaw contact today the offices of Powell Law Firm, L.C. is the nation's leading law firm for litigation regarding Bisphosphonate Complications. for your free, confidential case evaluation at toll-free 888-238-1998 Please state your name and phone number And we will get back with you promptly or email us at info@mpowelllaw.com www.MPowellLaw.com Accepting Inquiries from the U.S. and Internationally Every case is different. No specific results are
implied.
Accepting Inquiries from the U.S. and Internationally Every case is different. No specific results are
implied.
Osteonecrosis
What Causes Osteonecrosis? Who Gets Osteonecrosis?
Osteonecrosis most commonly occurs in large joints such as the hips, knees, ankles and shoulders. People between the ages of 30 and 50 are most likely to develop osteonecrosis of the hip, with men developing this condition slightly more frequently than women. Osteonecrosis of the knee occurs most often in women between ages 50 and 60. What Are the Symptoms? How is it Diagnosed? Diagnosis at this early stage is best made by magnetic resonance imaging (MRI). MRI is a technique that produces cross-sectional images of the body by exposure to magnetic energy sources (but without harmful radiation). MRI is able to detect osteonecrosis before significant damage to the bone has occurred and before changes on X-ray films are evident. If the diagnosis is not made soon enough and the condition is allowed to progress, inevitable damage to the bone will occur with involvement of the corresponding joint. At this point, osteonecrosis produces changes of the bone that can be detected on routine X-ray films of the joint.
Because early detection vastly improves the likelihood of cure, screening for jaw oral cancer should be an integral part of medical and dental examinations. Osteonecrosis of the jaw growths less than ½ inch across usually can be cured. Unfortunately, most cancerous growths are not diagnosed until they are larger and have spread to the lymph nodes under the jaw and in the neck. Because of delayed detection, 25% of oral jaw cancers are fatal. Although most cases of osteonecrosis of the jaw related to Fosamax side effects have occured after dental work several cases have been reported to occur without any prior dental work. If you are currently taking Fosamax,Zometa, and Aredia you may be at risk of developing osteonecrosis. If you have been injured by Fosamax,Zometa, and Aredia side effects you may be entitled to compensation. For more information about your legal rights contact the offices of
Accepting Inquiries from the U.S. and Internationally Every case is different. No specific results are
implied.
eMJA: Bisphosphonates and osteonecrosis of the jaw
ADRAC : bisphosphonates and osteonecrosis of the jaw
Although most cases of osteonecrosis of the jaw related to Fosamax side effects have occured after dental work several cases have been reported to occur without any prior dental work. If you are currently taking Fosamax,Zometa, and Aredia you may be at risk of developing osteonecrosis. If you have been injured by Fosamax,Zometa, and Aredia side effects you may be entitled to compensation. For more information about your legal rights contact the offices of
Accepting Inquiries from the U.S. and Internationally Every case is different. No specific results are
implied.
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Osteonecrosis of the Jaw Drugs Side Effects Headlines
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