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Osteonecrosis (avascular necrosis): the symptoms, who gets it, getting a diagnosis, treatment, and living with it
For anyone with hip, groin or joint pain that is getting worse, anyone who has taken steroid medicine for a long time, and anyone just told they have osteonecrosis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS, part of the NIH) says that in osteonecrosis, also called avascular necrosis, blood flow to part of a bone is disrupted: the bone tissue dies, and over time the bone can break down and the joint can collapse. It most often affects the hip, and it is most common in people in their 30s and 40s. Early diagnosis increases the chance that treatment will work. This page passes on, by name, what NIAMS says: the symptoms, the risk factors, the tests and who treats it, treatment without surgery, the surgeries, and living with it. It builds the words to say to a provider, and prints a card for the visit.
Right now
- After a fall or an injury, a bone may be broken or a joint is out of place (it looks out of shape, you cannot put weight on it, or the pain is severe): go to an emergency room now (ours).
- Joint pain that suddenly gets much worse: call your provider the same day; if you cannot put weight on it, go to an emergency room (ours). NIAMS says that if the end of the bone collapses, the pain may intensify abruptly.
- After a dive, joint pain, numbness, weakness or trouble breathing: call 911 (ours). NIAMS names decompression sickness (the bends) as a risk factor.
- Thinking about suicide: call or text 988, any time.
More help
- Related: Arthritis · Osteoporosis · Lupus · Sickle cell · Gout · HIV · Pain, bones and joints.
- Day to day: Symptom diary · Medicines list · Pain that lasts · Quit smoking · When drinking or drugs have become a problem · Depression.
- Care and costs: When you need a doctor and can’t pay · When medicine costs too much · Get ready for the appointment.
- In a crisis: Help right now (988, 911). All our free tools.
Pain, a bone or a joint, and not sure this is the right page? The pages on this site for back pain, arthritis, pain that lasts, headaches, broken bones and sickle cell, on one list.
This page and its wording were written with AI (Claude) for Scarlet Beast (our AI policy). No doctor or nurse has reviewed it. The facts were read on October 15, 2026 on NIAMS’s Osteonecrosis page, both parts: Overview, Symptoms, & Causes and Diagnosis, Treatment, & Steps to Take (NIH, last reviewed January 2021), and on its shorter Spanish twin, Osteonecrosis (February 2021). Ours: going to an emergency room now after a fall or injury when a bone may be broken or a joint is out of place; calling the provider the same day for joint pain that suddenly gets much worse, and an emergency room if you cannot put weight on it; calling 911 after a dive for joint pain, numbness, weakness or trouble breathing; not stopping a prescribed corticosteroid on your own; writing down which joint hurts and when; keeping a list of every medicine; asking what a test, treatment or surgery would change, its risks and what it costs; 988; and the order of the steps. What we left out: any medicine’s brand or dose, staging systems, any treatment NIAMS does not name, any supplement, device, remedy or product, and NIAMS’s research pages. This page saves nothing and loads no trackers.