Hofmann S, Kramer J, Plenk H, Leder K, Imhof H, Engel A
Orthopädische Abteilung, Donauspital, Wien.
Orthopade. 1994 Sep;23(5):331-41.
The causes of osteonecrosis are varied. The pathogenesis of osteonecrosis subsequent to trauma is well known. Furthermore, an association of this disorder with cortisone, haemoglobinopathies, rare metabolic diseases, and risk factors seems to be evident. However, a sizable proportion of patients have osteonecrosis in which none of these associations exists, referred to as idiopathic osteonecrosis. Generally, intraosseous vascularization represents the common pathway for the various causes of the disease. The prognosis is influenced by the age of the patient, the location of the necrosis and the stage of the disease at the time of diagnosis. In recent times diagnosis has been improved by the use of modern imaging modalities, and MR imaging is now widely accepted as the imaging method of choice. It not only allows early diagnosis but also yields exact staging information in advanced disease, which is a requirement for adequate therapy.
骨坏死的病因多种多样。创伤后骨坏死的发病机制已为人熟知。此外，这种疾病与皮质类固醇、血红蛋白病、罕见代谢疾病及风险因素之间的关联似乎也很明显。然而，相当一部分患者患有骨坏死，却不存在上述任何一种关联，这种情况被称为特发性骨坏死。一般来说，骨内血管化是该疾病各种病因的共同途径。预后受患者年龄、坏死部位以及诊断时疾病阶段的影响。近年来，现代成像技术的应用改善了诊断，磁共振成像（MR成像）如今已被广泛公认为首选的成像方法。它不仅能实现早期诊断，还能在疾病晚期提供准确的分期信息，而这是进行充分治疗所必需的。
