Approximately 20,000 Americans develop avascular necrosis every year, according to Marvin Steinberg, M.D., professor emeritus of Orthopaedic Surgery at the University of Pennsylvania School of Medicine in "The Merck Manual for Healthcare Professionals." The disease is a result of the bones not receiving enough oxygen. The bones of a vitamin D deficiency, on the other hand, are weak.
What is Avascular Necrosis?
Avascular necrosis refers to the medical condition where a bone is not getting enough oxygen. Also called osteonecrosis, osteochondritis dissecans, aseptic necrosis and ischemic necrosis results from several causes: certain diseases, some medications, a blood clot, trauma or pregnancy. It is responsible for an estimated 10 percent of all hip replacements and affects men eight times more than women, according to Carol Ziminski, M.D., deputy director of John Hopkins Rheumatology at Good Samaritan Hospital in "Current Rheumatology Diagnosis & Treatment."
Vitamin D Deficiency
A deficiency in vitamin D can affect the heart and the bones but when it damages the bones, it can cause rickets, osteomalacia or osteoporosis. As explained in the "Handbook of Pathophysiology" by Elizabeth Corwin, Ph.D., vitamin D is needed to build strong bones because it increases the absorption of calcium and phosphate, minerals needed for strong, healthy bones. In rickets and osteomalacia, the bones are too soft, while the bones are not dense enough in people with osteoporosis. Thus, a vitamin D deficiency does not cause avascular necrosis, where the bones lack necessary oxygen.
Avascular Necrosis Symptoms
Dr. Steinberg writes in "The Merck Manual for Healthcare Professionals" that people with avascular necrosis may not have any symptoms for months, and then start to have pain, which increases with time. If the disease is in the hip, the most common site, the afflicted can feel pain from the hip all the way down the thigh or buttocks. A limp can even develop. Avascular necrosis in the knee can cause a sudden pain in the knee, tenderness and also a limp.
Vitamin D Deficiency Symptoms
Rickets affects children. Infants may have a soft skull, and sit and crawl later than normal, writes Larry Johnson, M.D., Ph.D., Attending Physician at the Central Arkansas Veterans Healthcare System in "The Merck Manual for Healthcare Professionals." Older children may have bowlegs, permanent skeletal deformities, an abnormal curve in the spine, bad teeth and need help or some kind of support to walk. People with osteomalacia can have bone pain, weak muscles and fractures. Similar to osteomalacia, osteoporosis can cause fractures.
References
- "Current Rheumatology Diagnosis & Treatment"; John Imboden, M.D., David Hellmann, M.D., John Stone, M.D.; 2007
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- The Merck Manual for Healthcare Professionals: Osteonecrosis
- The Merck Manual for Healthcare Professionals: Vitamin D
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