Diagnosis | Aseptic bone necrosis


The diagnosis of aseptic bone necrosis can usually be made based on the specific constellation of symptoms. The symptoms occur due to increased stress or especially in childhood. Typical are pains at rest, which are intensified by stress.

Only a few of the bone necroses can be identified by certain tests during physical examination. As a rule, an X-ray of the affected body part is taken to assess the bone structures. An X-ray is always the imaging method of choice when it comes to assessing bone structures.

Since aseptic bone necrosis is the death of bone tissue, characteristic changes are usually visible on the X-ray image. However, the disease can only be detected if bone remodeling or bone destruction has already taken place. In earlier stages, the X-ray image is usually perfectly normalMagnetic resonance imaging (MRI) is usually used to assess structures such as soft tissue, i.e. muscles, tendons and ligaments. However, since aseptic bone necrosis can only be detected in the X-ray image when the first remodelling processes have already taken place, MRI is used in this disease. With the help of contrast medium, unusual metabolic activities of the bone can be detected before pronounced damage occurs.

Treatment and therapy

The therapy of aseptic bone necrosis usually consists of a rather wait-and-see conservative behaviour. In most cases, the cause of bone necrosis is to be found in excessive stress on the affected body part. For this reason, the therapy of choice is usually a ban on sports and stress.

This can last up to several months to prevent a recurrence of the symptoms. To relieve symptoms such as pain, additional painkillers and anti-inflammatory drugs can be taken. Cooling and elevating the affected body part can also provide relief.

If these conservative measures do not improve the symptoms or if they reoccur after a long break, surgery should be considered. This may consist, for example, of removing small pieces of bone that have become detached due to aseptic necrosis. In this way, the affected part of the body is deprived of an irritating factor and the symptoms may recede. Aseptic bone necrosis usually first occurs on one body part on only one side. However, due to the strain, the other side of the body is often affected a short time later.

Healing time

The healing of aseptic bone necrosis is strongly dependent on the stage of necrosis. Particularly in the case of bone necrosis, which occurs due to high stress, a pause of several months must be expected. Only then can the bone have completely regenerated. In addition, one should also be careful afterwards, as the blood circulation situation of the bone does not necessarily regenerate within the months. The consequence of an unhealed aseptic bone necrosis, for example, can be osteoarthritis, which can cause problems for a lifetime.