Hormones predispose to femoral head necrosis

  Femoral head necrosis, also known as ischemic necrosis of the femoral head, is one of the common bone and joint diseases. Its main symptoms, from intermittent pain to persistent pain, then from pain to muscle spasm, joint movement is restricted, and finally cause severe disability and limp. Due to the lack of awareness of most people about osteonecrosis of the femoral head, not only the treatment is often delayed, but some people even talk about it, which brings great psychological pressure to the patients or themselves, thus causing unnecessary losses and troubles.  According to the latest medical report in 2013, 60 causes of femoral head necrosis have been found, among which hormones, alcohol and trauma are the three major causes.  Hormones tend to trigger the causes of femoral head necrosis.  1, with the widespread use of hormonal drugs in clinical practice, the number of cases of combined hormonal femoral head necrosis is also increasing, and currently, clinical studies have found that the [first] cause of femoral head necrosis is hormones, which exceeds 57% of the total incidence. The occurrence of osteonecrosis of the femoral head is related to the route and dose of hormone intake, as well as to the individual differences and sensitivity of each person. Long-term high-dose application of glucocorticoids, excessive total dose, or short-term excessive dose of adrenal corticosteroids can cause femoral head necrosis, and there are reports that the incidence of femoral head necrosis is significantly higher when the total dose of intake exceeds the total dose of prednisone by more than 200 mg; the relationship between intake route and necrosis: joint cavity injection > static injection > oral intake, but there are also individual differences. The incidence of femoral head necrosis will be higher in heavy drinkers, as well as patients with diabetes mellitus and rheumatoid disease, who then apply hormones in large amounts.  Most of the patients with hormonal osteonecrosis of the femoral head have applied a large amount of hormones due to ophthalmological diseases, neurological diseases, renal diseases, skin diseases, brain disorders or fever that does not go away for as short as 1 week or as long as several months or years, after which they will develop hidden pain in the knee or hip and progressive aggravation of gradual limping, accompanied by different degrees of limitation of hip function, which can be clearly diagnosed by X-ray, CT or nuclear magnetic examination. Because of the atypical early symptoms of the disease, it is easy to misdiagnose the disease. The common reasons for misdiagnosis are: misdiagnosis of early knee pain as arthritis; misdiagnosis of hip and lower limb pain as lumbar disc herniation, misdiagnosis of early onset as hip tuberculosis, etc., which should be noted. Therefore, for those who have the above-mentioned symptoms and signs, they should go to the hospital as soon as possible for examination, so as to provide timely treatment.  2, the mechanism of hormone to femoral head necrosis.  Fat embolism theory: After applying hormones, the fat metabolism in the body is disturbed and hyperlipidemia is formed, and at the same time, the fat cells in the femoral head expand, causing vascular embolism or extrusion, resulting in ischemia and necrosis of bone cells in the femoral head.