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Last updated: October 12, 2025View editorial policy

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Vascular Necrosis Differential Diagnosis

The following differential diagnosis is organized into categories to help guide the diagnostic process for vascular necrosis.

  • Single most likely diagnosis
    • Avascular necrosis of the femoral head: This is the most common form of vascular necrosis and typically occurs due to a disruption in the blood supply to the bone, often as a result of trauma, steroid use, or excessive alcohol consumption.
  • Other Likely diagnoses
    • Kienböck's disease (avascular necrosis of the lunate bone): This condition affects the lunate bone in the wrist and can be caused by trauma, repetitive stress, or poor blood supply.
    • Legg-Calve-Perthes disease (avascular necrosis of the femoral head in children): This condition is similar to avascular necrosis of the femoral head but occurs in children and adolescents.
    • Freiberg's disease (avascular necrosis of the metatarsal head): This condition affects the metatarsal bones in the foot and can be caused by repetitive stress or poor blood supply.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Osteomyelitis: Although less likely, osteomyelitis (bone infection) can present with similar symptoms to vascular necrosis and requires prompt treatment to prevent serious complications.
    • Bone tumors: Certain bone tumors, such as osteosarcoma, can cause vascular necrosis and require early diagnosis and treatment.
    • Vasculitis: Conditions like giant cell arteritis or polyarteritis nodosa can cause vascular necrosis and require prompt treatment to prevent serious complications.
  • Rare diagnoses
    • Kohler's disease (avascular necrosis of the navicular bone): This condition affects the navicular bone in the foot and is relatively rare.
    • Panner's disease (avascular necrosis of the capitellum): This condition affects the capitellum bone in the elbow and is relatively rare.
    • Thiemann's disease (avascular necrosis of the phalanges): This condition affects the phalanges bones in the fingers and toes and is relatively rare.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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