AVASCULAR NECROSIS (AVN)

 
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What is avascular necrosis (AVN)?

  • It is caused when red blood cells sickle and block blood flow to the rounded bones of the shoulder, hips, and other joints. When these areas don’t get oxygen from the blood, the bone dies and changes shape, which causes pain.

  • AVN is common in adolescents and adults with sickle cell disease. But it can happen in younger children as well.

 
 

Here are some symptoms OF AVN:

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◦ Constant pain in the hip, shoulder, and other joints

◦ It feels different than your usual sickle cell pain

◦ It can last for several weeks

 

Treatment

Your treatment depends on how much your joints are affected.

At home

  • Use heat (a warm compress, warm bath, or heating pad)

  • Gently massage the area that hurts

  • Do something to distract you from the pain, like listening to music, drawing, watching tv, or writing in a journal

  • Do deep breathing and relaxation exercises.

Physical therapy

  • Physical therapy makes the muscles around the joint stronger and more flexible.

Medicine

  • There are certain medicines that can help control your pain.

Surgery

  • Sometimes surgery is needed if other treatments do not work. Your provider may refer you to a special provider (orthopedic surgeon) for additional evaluation and treatment.

 
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AVN checklist

For you and your health care provider

Abnormal pain:

🄯 If you have pain in your joints that lasts at least several weeks and is different than your sickle cell pain, talk with your health care provider.

🄯 Your provider will examine you and talk with you to get more information about the pain. A picture of the joint, either by x-ray or MRI, will be needed to see if AVN is present in the joint.

Managing the pain:

🄯 Talk with your provider about sending you for physical therapy.

🄯 Talk with your provider about ways other than medicine to manage the pain.

🄯 If these approaches don’t work, talk with your provider about medicines to control the pain.

Surgery:

🄯 If surgery is recommended, talk with your sickle cell provider to see if you should get a blood transfusion before the surgery.

 
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SECTION OVERVIEW

  • Hips and shoulders are common places for avascular necrosis.