Osteonecrosis, also called avascular necrosis or aseptic necrosis, is a condition in which the death of bone cells (due to decreased blood flow) can lead to pain and collapse of areas of bone. This collapse of bone, in turn, can lead to degenerative arthritis of nearby joints, most commonly the hips and knees. Less frequently affected are the shoulders, hands, and feet. In rare instances, osteonecrosis can occur in the jaw— resulting in pain and mouth ulceration. Osteonecrosis is not fatal, but can lead to pain, arthritis, problems with physical activity, and even the need for joint replacement. Most of the 10,000 to 20,000 Americans developing osteonecrosis annually are between age 20 and 50. These individuals usually have a history of serious trauma, corticosteroid use, excess alcohol intake, or other conditions including systemic lupus erythematosus, dysbarism (“the bends” that occur with scuba diving), blood disorders, HIV infection, and radiation therapy.
Rheumatology with Rhythm
The circadian rhythm offers insight into treating rheumatic diseases
Pain Management Meditations
Thoughts from a career spent understanding—and alleviating—pain
ACR Makes Available Spinal Stenosis Fact Sheet
Spinal stenosis, or narrowing, is a common condition that occurs when the small spinal canal that contains the nerve roots and spinal cord becomes restricted. This narrowing can squeeze the nerves and the spinal cord, causing lower back and leg pain. People suffering from spinal stenosis have trouble walking any significant distance and frequently must sit or lean forward.
My Michael Moore Moment
In which an angry letter finds its mark, to no avail
Rehabilitation and Myositis
Physical therapy to manage inflammatory muscle disease
Myositis Mysteries
Why isn’t my myositis patient getting better?
Watch Those Eyes
What you need to know about Uveitis in Rheumatic Diseases
Pursue Remission
Disease remission should be the goal for all rheumatologists treating childhood arthritis
Know Your Unknown Unknowns
Making life-or-death decisions based on unknown information is the challenge of medicine.