Symptoms of femoral head necrosis


Femoral head necrosis is the death of the femoral head, usually in connection with a lack of blood flow to the bone. The symptoms of such necrosis are primarily pain that occurs in specific areas. A number of accompanying symptoms can also occur, which are discussed in more detail below.

Typical symptoms of femoral head necrosis

The following symptoms are typical of femoral head necrosis:

  • Pain: The pain is mainly felt in the hip or thigh. They can radiate into the groin or into the knee. The pain is primarily dependent on movement. Aseptic femoral head necrosis in adults also often causes groin pain at night. The pain in the groin can also be triggered or intensified by pressure in the groin area.

  • Restrictions of movement: Restrictions in mobility are also a key symptom of femoral head necrosis. This mainly leads to restrictions in rotation in the hip joint.In addition, the lateral lifting of the leg (abduction) is restricted.

  • In half of the cases, the symptoms appear on both sides.

Pain in the groin

Because the hip is just behind the groin, the pain often radiates into the groin. This is especially the case with aseptic femoral head necrosis in adults. The pain in the groin occurs mainly at night or at rest, but can also be felt during exercise.

Also read: Pain in the groin - These are the most common causes

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Nocturnal pain

At night, the body's blood circulation is limited to the bare minimum due to the shutdown of body functions. Since the femoral head necrosis is caused by a reduced blood flow to the femoral head, pain often occurs at night, as the blood flow, which has already been reduced, is further reduced.

Pain in the buttocks

The pain of femoral head necrosis can radiate not only to the groin, but also to the buttocks. In addition, a relieving posture is often adopted due to the pain. Relief postures ensure that the muscles become tense. As a result, the tight gluteal muscles can also cause pain. Temporary muscle cramps are also possible.

You may also be interested in this topic:

  • Therapy of femoral head necrosis

What are the symptoms of children?

In children, femoral head necrosis is also known as Perthes' disease or juvenile femoral head necrosis. Children between the ages of four and eight are particularly affected.

The main symptom of the Perthes muscle is a limp - often stress-dependent. In children, the pain radiates mainly in the thigh to the knee joint. Therefore, juvenile femoral head necrosis should always be considered in the case of knee pain in childhood. Children are also often noticed by being lazy to walk. Movement restrictions can be observed especially in the internal rotation and the lateral lifting of the leg.

In 20-30 percent of cases, the symptoms occur on both sides. Often the symptoms on the other side are delayed.

You might also be interested in these topics:

  • Therapy for Perthes disease
  • Causes of femoral head necrosis

Concomitant symptoms

Leg length shortening

The reduced blood supply to the femoral head can lead to remodeling processes in the bone. This conversion process can lead to a leg length difference. In M. Perthes - the femoral head necrosis in childhood - the necrosis can lead to a shortening of the femoral neck. This happens through the growth plate impaired by circulatory disorders, which leads to disturbed growth in length. The leg length difference can lead to a visible limp.

What symptoms are typical of femoral head necrosis?

Necrosis of the femoral head in adults, which usually develops between the ages of 35 and 45 and affects men more often than women, is often noticeable through very unspecific symptoms that are not ascribed to great importance.
A pulling in the groin (this is the area in which the femoral head, which can partially die in this disease due to insufficient blood flow, lies in the depth), which is comparable to sore muscles, is often one of the first signs.
Sometimes a shooting, stabbing pain in the groin area is also described. Paradoxically, diseases of the hip joint can often manifest themselves as pain in the knee joint, especially in children, but this possibility must also be considered in adults.

Often, further limitations are only noticed as the disease progresses, such as reduced or painful mobility in the hip joint, usually the internal rotation is affected first. The movement restriction continues to increase, the person concerned feels increasingly restricted in everyday life, he relieves the leg, possibly so much that a relieving limp can be observed with increased strain on the healthy leg. In the worst case, the affected leg can no longer be loaded at all.
It is important that femoral head necrosis often (in about half of the cases) manifests itself on both sides, this does not mean that both sides have to become ill at the same time, even after an illness one side can be followed by the other at intervals of years.
It should not be forgotten that there are definitely cases of femoral head necrosis in which the disease is asymptomatic for a long time (i.e. without revealing itself to the person affected by one of the symptoms mentioned above) and then leads directly to what is known as secondary osteoarthritis, In other words, irreversible joint destruction (destruction), which becomes noticeable through increasing start-up pain (i.e. pain when walking after sitting or lying down for a long time) and in the course of osteoarthritis through stress pain and later also pain at rest.