Bone health and HIV disease

February 2008     View PDF     En español

What is osteonecrosis?

Osteonecrosis is the death of bone tissue. Bone can die if its blood supply is cut off. This is called avascular necrosis, a condition that has been seen in the hips of people with HIV. It may occur in any bone though it most often occurs at the ends of a long bone. It may affect one or more bones or joints at the same time.

It’s not known what causes avascular necrosis in people with HIV. Possibilities include bone and blood vessel damage, long-term use of certain medicines, chronic conditions like rheumatoid arthritis or lupus, and excessive use of alcohol.

Symptoms of osteonecrosis may include pain—sometimes severe—in the affected area, especially in joints like the hip, wrist or spine. This may occur only when you bear down on the bone or joint or it may be constant. Other signs are joint stiffness, soreness, less range of motion, muscle spasms, a feeling of weakness, arthritis, and bone damage and collapse.

The goals for treating the condition are to stop any more damage and to improve the person’s ability to move. A person with less severe osteonecrosis may be given pain killers or medicines to improve bone density as well as support tools like a cane or crutches. In more severe cases, a person may need surgery, which could include reshaping, grafting or replacing the bone or joint.