Leg Pain - bone problems

[tito]

About three months ago, I started having pain in my legs after going on vacation and walking a lot. It seemed to be centered in the thigh, but radiated down into the knee. One side was worse than the other. I am having difficulty walking, pain at night, limping, can't turn my legs out or in (a necessity in some yoga poses, which I now avoid).

I was diagnosed today by an orthopedic surgeon as having avascular necrosis, where the top of the femur actually suffers an infarction and the bone dies. Eventually the bone collapses. We are going to give it 3-6 months to see if the circulation starts up and the bone regenerates. Causes of AVN include steroids (which I took about 30 years ago), alcohol (I don't abuse) and a long list of other conditions, including ESRD. In other words, like ESRD itself, they don't always know the cause.

The doctor said there was nothing that could have or should have been done to prevent this. The ultimate fix is a hip replacement.

Anyone else have AVN?

The only good thing is that it gets me a handicap parking pass!

[Red from Canada]

Tito, That was why I had to have my hip replacement.  I was told better sooner than later, before the bone deteriorates too much.  I am also now having bone pain all over caused by hyperparathyroidism.  Have you been tested for PTH lately?

[Red from Canada]

Tito, One thinG I forgot to mention, if you have your hip operation, please make sure they give you LOTS of stool softeners!  Because of the pain killers I became constipated and my PD tube was pushed out of place and had to be replaced.  Make very sure you don't stay constipated AT ALL.

[tito]

Red,

Thanks for the advice. My nephrologist checked me carefully for any kidney-related causes of bone pain before I saw the orthopedist. He even did an MRI to look for hernias in the lower abdomen. MY pth is 55 - so I don't believe there are any problems there. We're monitoring it carefully.

I take lactulose and have no constipation problems, but I'll watch for it should I have the hip replacement. It's funny, I didn't have my tablespoon the other night, so I just took some swigs of lactulose from the bottle. Guess I took too much - I was up all night!!

Pete

[Lisa]

  

I have AVN...mine is bad 

I have it in my hip so bad I was told a replacement probably wouldn't work because of the fact the blood flow is really poor.  I may actually need some sort of grafts to restore the flow just to "maybe" allow a replacement in the future.  I had a knuckle on my hand replaced a few years ago and they had to use synthetic material instead of titanium due to the lack of blood flow there as well.

I was on high doses of steroids in the early 90's, which was transplant protocol in PHX where I had my 1st transplant and of course since I was born with PKD I have had poor kidney function all my life..  Now I am hardly able to walk sometimes and others I am fine.  I take oxycodone as little as possible but short of Motrin (which we as kidney patients aren't really supposed to take) absolutely nothing else works for pain.