➖➖➖➖➖➖➖➖➖➖➖➖➖ WHAT IS AVN AND HOW ITS DIAGNOSE In layman’s terms, avascular necrosis is a result of the blood supply being cut off from the femoral head (normally because fat cells have become enlarged and prevented blood flow to the weight bearing articular surface of the femoral head), causing bone death and eventually the joint collapses. It is commonly bilateral (both hips) and occurs in younger persons, the elderly are not at risk of *AVN* as fat cells get smaller as you age. You may find that you have to see your GP several times complaining of groin/hip pain before you are sent for any tests. Typically the first test is an x-ray (unless AVN is already suspected). As it takes time for the femoral head to degrade, early stage AVN doesn’t typically show up on an x-ray and the joint may appear normal. Following a clear x-ray result but worsening pain you must request an MRI scan. GP’s are reluctant to refer patients for MRI’s as they are very expensive and so you must insist as it is the only absolute way to diagnose AVN. *WHAT CAUSES AVN?* Anything that damages the blood supply to the hip can cause AVN, the most common being Corticosteroid steroid use, alcohol abuse, severe trauma to the hip and sickle cell disease. It is highly likely that my husband’s condition was caused by Prednisolone, a corticosteroid steroid prescribed for Eczema. He was given two courses of the drug alongside the antibiotic Erythromycin. It turns out that when you do just a little digging around on the internet these two drugs are not compatible with each other, and even though AVN is rare it’s most common cause is the use of corticosteroid steroids. I did after the diagnosis, you will find that most of the hits are from sites in the India. The link between Corticosteroid Steroids (Prednisone, Prednisolone) has been known since the late 80's and have been the cause of many medical malpractice lawsuits in the US and Canada because this drug has been prescribed without the patient being told about the potential side effects, it is now common for a Doctor to obtain written consent before prescribing these drugs and a lot of doctors are spooked by these lawsuits. There is a clear link between Avascular Necrosis of the hips, knees and shoulders with short and long term steroid use, particularly in men over the age of thirty. The drug stops the blood supply to these areas of bone and causes bone death, necrosis. There are few treatments and the sufferer will normally have to have a total replacement of that joint. This disease is debilitating, can take a long time to detect, diagnose and treat and the sufferers will have their mobility severely compromised.