The Causes & Symptoms of Avascular Necrosis

As discussed in previous blogs and elsewhere on the Greater Dallas Orthopaedics website, Avascular Necrosis (also known as bone death) is a condition that can potentially lead to a joint replacement and/or complex reconstruction. Unlike many of the other conditions that necessitate those procedures, such as arthritis, injury, & wear, Avascular Necrosis is related to blood supply, in particular, a lack of blood supply.

In this blog, we’ll be discussing what causes Avascular Necrosis to occur in individuals and the symptoms present at various stages of the ailment. Like most conditions that bring patients through our doors, early diagnosis can make all the difference. Unfortunately, Avascular Necrosis symptoms can at first be subtle, resulting in many people not realizing they are suffering from bone death until it’s in later stages. While this post doesn’t constitute medical advice, our hope is that this information can help you or a loved one become more aware of the symptoms, and thus more likely to seek early treatment.

Before discussing those symptoms, we’ll discuss the causes of Avascular Necrosis.

Causes & Risk Factors


Avascular Necrosis is broadly defined as the lack of blood flow to a bone. The causes of Avascular Necrosis are equally as broad, and include bone/joint trauma, blockages in blood vessels (typically fatty deposits), as well as diseases like Gaucher’s Disease and sickle cell anemia. The Mayo Clinic also estimates that 25% of Avascular Necrosis diagnoses are of unknown cause. For this reason, it’s also important to discuss the risk factors that make Avascular Necrosis more likely.

Risk Factors

Studies show that poor blood supply to bones is often linked to excessive alcohol intake and the long-term use of high-dose steroidal drugs, as well as certain health conditions and radiation therapy. Bone/joint injury is a risk factor, as well as taking medication to increase bone density.

Medical conditions often associated with Avascular Necrosis include:

It’s critical to be aware of these risk factors, especially if you are dealing with multiple conditions or diagnoses from this list, which would make Avascular Necrosis even more likely. It should also be noted that though Avascular Necrosis can occur in anyone, it’s most likely to occur in individuals between 30 and 50 years of age.


Now that we’ve discussed the causes and risk factors that could result in Avascular Necrosis, let’s talk through the various symptoms of bone death. Some of these symptoms may seem mundane, so it’s important to be aware of the causes and risk factors. If you are dealing with multiple risk factors and start to notice these symptoms, we encourage you to seek medical evaluation.

The most common symptom is joint pain. While this may seem broad, the particular types of joint pain to monitor are a little more specific. First, if you’re experiencing bone/joint pain near a recent injury, especially if the bone/joint itself wasn’t injured, this could be a sign of Avascular Necrosis.

The most common areas affected are centered on the lower body, with Avascular Necrosis of the hip causing pain in the thigh, groin, and buttock area. One of the most common ailments to be concerned with is a dislocation. Though often not a major injury, dislocations can easily lead to poor circulation and bone death.

The key when monitoring bone/joint pain for Avascular Necrosis is to be mindful of gradual increases in pain. Even if you’re avoiding putting weight on a bone or joint, if the pain continues to grow, this could be a symptom of worsening Avascular Necrosis.

Persistent and growing pain in any joint is cause for concern, so seek medical treatment immediately if this is the case.

If you meet one or many of the risk factors of Avascular Necrosis and are experiencing worsening joint pain, especially following an injury, we urge you to schedule a medical evaluation as soon as possible. Early diagnosis of bone death is key, as there are many minimally-invasive treatment options that rely on catching this ailment early.

If you do require a procedure like a joint replacement or complex reconstruction to treat Avascular Necrosis, we encourage you to reach out to our team at Greater Dallas Orthopaedics. No other team in the region has more experience with these procedures than GDO.

Contact Us