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    What causes vascular necrosis?

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Posted on Mon, 30 Jun 2014 in Bones, Muscles and Joints
Question: Recent hip xray of my daughter's has revealed vascular necrosis with moderate pain. This is complicated by the problem of lymphedema of the leg. Any surgical intervention would put her at high risk of infection. An orthopeadic surgeon is reviewinf the films. Are my fears valid for a negative outcome? She is 43 with a chromosomal disorder with developmental disability but is very ambulatory.
doctor
Answered by Dr. Albana Sejdini 2 hours later
Brief Answer:
Needs specialized follow up&evaluation...

Detailed Answer:
Hi,

I have gone through the medical history of your daughter and feel sorry for the situation she is in.

Avascular necrosis is a condition when blood flow to the bone or joint is interrupted. This might be due to any trauma she had without taking care of the hip. Possible underlying conditions might have caused it too.

Lymphedema of the leg might be as a consequence to the hip trauma she had and possible infection.

So, the very first thing is to determine why she is having such problems, then, treat them accordingly.

As her situation needs a more specialized evaluation, I advise to wait for the orthopedic surgeon decision on best treatment and to follow his/her advice accordingly.

All the best to your daughter! Let me know if you have further specific questions to ask! I'd be happy to assist you and your daughter for a second opinion!
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 17 minutes later
The peculiar thing is that the lymphedema has been a problem for over 20 years and there has been no trauma or bruising. She just started limping and C/O pain about 5-6 weeks ago. Lymphedema is a very nasty condition that needs constant vigilance to prevent infections. Surgery just worries me since I am a nurse.
doctor
Answered by Dr. Albana Sejdini 12 hours later
Brief Answer:
All the best!

Detailed Answer:
Hi back,

Thank you for following up.

I understand your worries as a mother taking care of her child. As you are a nurse, you may understand that sometimes, medical team would decide the best option which will provide:
- less pain
- improvement of symptoms

to the patient. To calm you down, you can sit down and discuss with her orthopedist about:
- benefits
- risks and complications
- and if benefits of surgery would outweigh the complications.

You must also be aware that pharmaceutical industry has come out with potential antibiotics and other anti-inflammatory drugs that would lessen the risk for sepsis or other complications.

At the end, we should try first everything we can to lessen her suffering praying God that everything will be fine to your daughter!

God bless and all the best!
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 6744 Questions

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