Avascular Necrosis of the Shoulder
Also called osteonecrosis, this condition damages the humeral head when its blood supply is disrupted.
Why stage matters
Early disease can affect the bone beneath an intact joint surface. Later, the humeral head may collapse, changing the shape of the joint and contributing to arthritis. The stage of disease, pain, function, and condition of the rotator cuff help guide treatment.
History that helps the evaluation
Relevant history includes a previous shoulder fracture, substantial corticosteroid exposure, heavy alcohol use, and certain blood disorders. Sometimes no clear cause is found. Do not stop prescribed corticosteroids abruptly; medication changes need the prescribing clinician’s involvement.
How it is assessed
An examination and X-rays assess the shoulder and any collapse or arthritis. MRI may be useful when early osteonecrosis is suspected or the X-rays do not explain the symptoms. Other sources of shoulder pain still need consideration.
Bring the timeline of symptoms, prior injury records, and a complete medication history to the visit.
Treatment options
Earlier disease may be managed with monitoring, symptom control, activity adjustments, and discussion of whether a joint-preserving procedure is appropriate. Once substantial collapse or arthritis develops, shoulder replacement may become a more reliable option. Anatomic versus reverse replacement depends on the whole shoulder, not the diagnosis alone.
Ask what stage the condition has reached, what change would prompt treatment, and whether the proposed approach aims to preserve the joint or replace a damaged surface. No treatment should be presented as guaranteed to reverse established collapse.