The Orthobullets Podcast Shoulder & Elbow | Avascular Necrosis of the Shoulder
Jul 31, 2025
Dive into the intriguing world of avascular necrosis of the shoulder! Discover the causes behind this condition and the impact it has on mobility and pain. Learn about innovative diagnosis techniques that aid in understanding the disease. Explore a range of treatment options, from non-surgical to surgical approaches, tailored to the progression of avascular necrosis. It's a compelling look at shoulder health that promises to enlighten and engage!
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Pathophysiology and Diagnosis
- Avascular necrosis of the shoulder results from interrupted blood supply causing bone death and collapse.
- Early diagnosis requires MRI; advanced disease shows sclerosis and collapse on X-rays.
ASEPTIC Mnemonic for Etiology
- The ASEPTIC mnemonic covers main etiologies including alcohol, steroids, sickle cell, trauma, and caisson's disease.
- Steroids are the most common risk factor for shoulder avascular necrosis.
Humeral Head Blood Supply
- The main blood supply to the humeral head is from the posterior humeral circumflex artery (65%).
- The anterior humeral circumflex artery and arcuate artery provide 35%, and are vulnerable during proximal humerus plating.