AVSCULAR NECROSIS (AVN)

(ASEPTIC NECROSIS)

DEFINITION:-

    Avascular necrosis is a condition that results from poor blood supply to an area of bone causing bone death. This is a serious condition because the dead areas of bone do not function normally, are weakened and can collapse.

CAUSES:-

     Aseptic necrosis can be caused by trauma and damage to the blood vessels that supply oxygen to its bone. Other causes of poor blood circulation to the bone include an embolisum 0f air or fat that blocks the blood flow through the blood vessels.

                     ·  Hyper coaguable state [abnormally thick blood]

                     ·  Vasculitis [inflammation of the blood vessel walls]

                     · Steroid usage.

                     · Cushing`s syndrome

                     · Radiation exposure

                     · Sickle cell disease

                     · Pancreatitis

                     · Guachar’s disease

                     · Systemic lupus erythematosus

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 even when resting.

       Pain usually develop gradually and may be mild or severe.

       If vascular necrosis progresses and the bone and surrounding joint surfaces collapse, pain may develop or increase dramatically.

       Pain may be severe enough to limit the patient`s range of motion in the affected joint.

       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 year.

SOME HOMOEOPATHIC MEDICINES:-

Bilberry, ginkgobiloba, angelica sinensis, allium sativum, evening primrose, angustra vera, argentum met, calcarea fluor, calcarea phos, fluoricum acidcum, mezereum, phosphoricum, silicea, strontium carb.

CASE:-

This is the case of a man (Mr. J. P.) aged 29 years with severe pain in left hip joint. Pain extended from hip to knee. Severe hip joint pain would prevent his daily activities. Pain aggravated by standing, walking, sitting.   Ameliorate by lying. He had bursting headaches which is ameliorate by sleep. He had thirst for large quantity of water and desire for spice food.

This was a diagnosed case of avascular necrosis of hip joint (AVN)

 MRI: - FOCAL ABNORMAL SINGAL INTENSITY AREA ANTEROLATERALLY IN THE REGION OF HEAD OF LEFT FEMUR WITH LINEAR HYPOINTENSE AREA ADJACENT TO THE PREVIOUS ONE S/O CLASS B AVN OF LEFT HIP JOINT.MINIMAL JOINT EFFUSION.

He came on 11/05 /10 with MRI report. He was prescribed following medicines.

A) Gikgobiloba               Q TDS

B) Stramonium                1M

C) Bryonia                      200 OD

D) Ammonium mur.         30 TDS

E) Carbo veg.                  200 OD

F) Bell+ natrum mur.        0/3 sos

He was called after one month for his follow up

I^st follow up

On 12/06/10 his hip pain was better. No headache but have pain in heel aggravate by standing and ameliorate by sitting. He was given cimicifuga 30 and cyclamen 30 along above medicines for one month.

 II^nd follow up

He was reported on 29/07/10 with improvement. He was repeated same medicines for one month.     

III^rd follow up

On 11/09/10 he was reported 80 % improvement in pain of hip joint.

IV^th follow up

On 22/11/10 he had no pain hip, no headache. He was completely asymptomatic. Medicines repeated.

Dr. G. S. Bhatnagar

D.H.M.S.  B.H.M.S.

Research officer

Sewa Mandir

Mobile 9829978284

E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com