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Vascular Disorders of Bone

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Clinical Foundations of Musculoskeletal Medicine

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Abstract

The vascular disorders of bone encompass a broad range of disorders ranging from necrosis due to ischemia to hyperemia from coagulopathy. Reducing the vascular supply to the bone, a highly metabolic organ, creates devastating pathology to vulnerable areas, classically affecting the long bone epiphyses in adults and physeal growth plates in children and adolescents. These patients typically present with pain of the affected joint, diminished range of motion, and loss of use of the limb. If the pathology is able to be corrected, then permanent deformity can be avoided. However, permanent deformity and disability may result requiring operative intervention. Coagulopathic disorders commonly affect soft tissue, where recurrent microtrauma to the synovium causes hemarthrosis, to the muscle causes intramuscular hematoma, and to the dura causes spinal epidural hematoma. Untreated hemarthrosis causes cartilage destruction through hematogenous cytokines, producing an erosive and painful arthropathy. Hematomas are generally benign and amenable to nonoperative management unless they produce neurologic compression. After review of this chapter, the learner should be comfortable with the basics of avascular and hypervascular disorders of bone and joint.

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Authors and Affiliations

  1. Department of Orthopaedics, University of North Carolina, Chapel Hill, NC, USA

    Joshua A. Shapiro

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Correspondence to Joshua A. Shapiro .

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  1. Department of Orthopedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Robert J. Esther

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Shapiro, J.A. (2021). Vascular Disorders of Bone. In: Esther, R.J. (eds) Clinical Foundations of Musculoskeletal Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-42894-5_15

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  • DOI: https://doi.org/10.1007/978-3-030-42894-5_15

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