Atraumatic Femoral Head Necrosis in Adults.

Abstract:

BACKGROUND:Atraumatic necrosis of the femoral head is a common cause of hip arthrosis in middle age. In Germany, it affects 5000-7000 patients per year, corresponding to an incidence of 0.01%. Though rarer than primary hip arthrosis, it is still of major clinical and socio-economic significance. Patients with this problem should be diagnosed early and given stage-appropriate treatment. METHODS:This review is based on pertinent publications that were retrieved by a selective search in the PubMed, Embase, Medline, and Cochrane Library databases using the terms "osteonecrosis," "femoral head necrosis," "diagnosis," "classification," "conservative treatment," "surgical treatment," "joint preservation," "osteotomy," and "arthroplasty," as well as a recent guideline on atraumatic necrosis of the femoral head in adults. RESULTS:The etiology and pathogenesis of atraumatic femoral head necrosis in adults are not yet fully clear. The main risk factor is prolonged corticosteroid treatment. Nonspecific complaints and an initially normal plain x-ray of the hip can delay the diagnosis. The diagnosis is established by plain x-ray, computerized tomography, magnetic resonance tomography, and scintigraphy. Conservative treatment alone is not considered adequate. The range of surgical treatments includes joint-preserving and (for more severe necrosis) joint-resecting methods. CONCLUSION:Atraumatic femoral head necrosis in adults is a disease that progresses in stages; depending on its stage, it can either be cured or lead to hip arthrosis. A full cure is possible only in early stages. Current research focuses on the effect of new drugs on the intermediateand long-term outcome.

journal_name

Dtsch Arztebl Int

authors

Arbab D,König DP

doi

10.3238/arztebl.2016.0031

subject

Has Abstract

pub_date

2016-01-22 00:00:00

pages

31-8

issue

3

issn

1866-0452

pii

arztebl.2016.0031

journal_volume

113

pub_type

杂志文章,meta分析,评审
  • Cerebral Amyloid Angiopathy in Stroke Medicine.

    abstract:BACKGROUND:Cerebral amyloid angiopathy (CAA) is a degenerative vasculopathy that is classically associated with lobar intracerebral or sulcal hemorrhage. Its prevalence is estimated at 30% in the seventh decade and 50% in the eighth and ninth decades. In this review, we summarize the risks linked to CAA with respect to...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2017.0037

    authors: Block F,Dafotakis M

    更新日期:2017-01-20 00:00:00

  • Prevalence trends in lifestyle-related risk factors.

    abstract:BACKGROUND:The regional prevalence of risk factors can vary over time. The Study of Health in Pomerania (SHIP) addresses prevalence trends for common risk factors in a region in northeast Germany. METHODS:A longitudinal study was carried out from 1997 to 2001 (SHIP-0, with 4308 subjects), and a second, independent ran...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0185

    authors: Völzke H,Ittermann T,Schmidt CO,Baumeister SE,Schipf S,Alte D,Biffar R,John U,Hoffmann W

    更新日期:2015-03-13 00:00:00

  • Vocal cord dysfunction: an important differential diagnosis of bronchial asthma.

    abstract:INTRODUCTION:Intermittent paradoxical closure of the vocal cords can induce major attacks of dyspnea. Such attacks, called "vocal cord dysfunction" (VCD), are an important element in the differential diagnosis of intractable bronchial asthma. METHODS:Selective review of the literature. RESULTS:The etiology of VCD is ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0699

    authors: Kenn K,Hess MM

    更新日期:2008-10-01 00:00:00

  • Gender identity disorders in childhood and adolescence: currently debated concepts and treatment strategies.

    abstract:INTRODUCTION:Gender identity disorders (GID) can appear even in early infancy with a variable degree of severity. Their prevalence in childhood and adolescence is below 1%. GID are often associated with emotional and behavioral problems as well as a high rate of psychiatric comorbidity. Their clinical course is highly ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0834

    authors: Korte A,Lehmkuhl U,Goecker D,Beier KM,Krude H,Grüters-Kieslich A

    更新日期:2008-11-01 00:00:00

  • The role of the complement system in age-related macular degeneration.

    abstract:BACKGROUND:Age-related macular degeneration (AMD) is a common retinal disease in older people. In Europe, about 1.6% of persons over age 65 and more than 13% of persons over age 85 have late-stage AMD, which can severely impair vision. The development of AMD is influenced both by environmental factors and by a strong h...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2014.0133

    authors: Weber BH,Charbel Issa P,Pauly D,Herrmann P,Grassmann F,Holz FG

    更新日期:2014-02-21 00:00:00

  • The Management of Pilonidal Sinus.

    abstract:BACKGROUND:Pilonidal disease is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal cleft. Its incidence in Germany in 2012 was 48 cases per 100 000 persons per year. METHODS:This review is based on pertinent publications retrieved by a selective literature search. RESULTS:The numerous...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2019.0012

    authors: Iesalnieks I,Ommer A

    更新日期:2019-01-07 00:00:00

  • The treatment of anterior dental trauma.

    abstract:BACKGROUND:Avulsed frontal teeth often cannot be saved because of improper or lack of initial treatment. The result is a need for multiple interventions over the patient's lifetime, which also carry a high financial cost. METHODS:We explored the subject of lost anterior teeth in young patients with a PubMed search bas...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0565

    authors: Brüllmann D,Schulze RK,d'Hoedt B

    更新日期:2010-08-01 00:00:00

  • Aggression and violence against primary care physicians—a nationwide questionnaire survey.

    abstract:BACKGROUND:International studies show that aggressive behavior against primary care physicians is not an uncommon occurrence. There has been no systematic study to date of the nature and frequency of such occurrences in Germany. METHODS:A four-page questionnaire was sent to a nationwide random sample of 1500 primary c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0159

    authors: Vorderwülbecke F,Feistle M,Mehring M,Schneider A,Linde K

    更新日期:2015-03-06 00:00:00

  • Vitamin and Mineral Status in a Vegan Diet.

    abstract:BACKGROUND:In Germany, public interest in a vegan diet is steadily growing. There are, however, no current data on the macro- and micronutrient status of vegans. METHODS:In a cross-sectional study entitled "The Risks and Benefits of a Vegan Diet" (RBVD), we investigated the dietary intake, basic laboratory parameters,...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0575

    authors: Weikert C,Trefflich I,Menzel J,Obeid R,Longree A,Dierkes J,Meyer K,Herter-Aeberli I,Mai K,Stangl GI,Müller SM,Schwerdtle T,Lampen A,Abraham K

    更新日期:2020-08-31 00:00:00

  • The diagnosis of fetal alcohol syndrome.

    abstract:BACKGROUND:The estimated prevalence of fetal alcohol syndrome (FAS) is 8 for every 1000 live births. FAS has serious, lifelong consequences for the affected children and their families. A variety of professionals deal with persons who have FAS, including pediatricians, general practitioners, neurologists, gynecologists...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2013.0703

    authors: Landgraf MN,Nothacker M,Kopp IB,Heinen F

    更新日期:2013-10-01 00:00:00

  • The Diagnosis and Treatment of Peripheral Arterial Vascular Disease.

    abstract:BACKGROUND:In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS:This guideline was prepared...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,实务指引

    doi:10.3238/arztebl.2016.0729

    authors: Lawall H,Huppert P,Espinola-Klein C,Rümenapf G

    更新日期:2016-10-28 00:00:00

  • Treatment in a center for geriatric traumatology.

    abstract:BACKGROUND:Although the number of elderly patients with fractures is increasing, there have been only a few studies to date of the efficacy of collaborative treatment by trauma surgeons and geriatricians. METHODS:Data on patients over age 75 with femoral neck, trochanteric, proximal humeral, and pelvic ring fractures ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0113

    authors: Grund S,Roos M,Duchene W,Schuler M

    更新日期:2015-02-13 00:00:00

  • Hoarseness-causes and treatments.

    abstract:BACKGROUND:Hoarseness (dysphonia) is the reason for about 1% of all consultations in primary care. It has many causes, ranging from self-limited laryngitis to malignant tumors of the vocal cords. METHODS:This review is based on literature retrieved by a selective search in PubMed employing the terms "hoarseness," "hoa...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2015.0329

    authors: Reiter R,Hoffmann TK,Pickhard A,Brosch S

    更新日期:2015-05-08 00:00:00

  • Exercise as stroke prophylaxis.

    abstract:BACKGROUND:Stroke is the third most common cause of death in industrialized countries, accounting for more than 10% of deaths over age 65. Most strokes are due to arteriosclerosis. Regular physical activity lowers arterial blood pressure and body weight and improves glucose and lipid metabolism, thereby slowing the dev...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztbl.2009.0715

    authors: Reimers CD,Knapp G,Reimers AK

    更新日期:2009-10-01 00:00:00

  • Endoscopic or Surgical Resection for Gastro-Esophageal Cancer.

    abstract:BACKGROUND:Early gastro-esophageal cancer is staged as m1 to m3 depending on the infiltration of the anatomical layers of the mucosa or, analogously, as sm1 to sm3 depending on the depth of infiltration into the submucosa. The risk of lymph node metastases is low in mucosal carcinoma but increases with the depth of inf...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2018.0513

    authors: Gockel I,Hoffmeister A

    更新日期:2018-08-06 00:00:00

  • The conservative and interventional treatment of the complications of liver cirrhosis: Part 2 of a series on liver cirrhosis.

    abstract:BACKGROUND:It is estimated that 1 million persons in Germany suffer from hepatic cirrhosis, which is the final stage of chronic inflammation of the liver. Cirrhosis has multiple causes, all of which lead to structural changes of the liver and to portal hypertension. The main complications of cirrhosis arise in turn: Th...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2013.0126

    authors: Sauerbruch T,Appenrodt B,Schmitz V,Spengler U

    更新日期:2013-02-01 00:00:00

  • Mental Disorders in Early Childhood.

    abstract:BACKGROUND:About 17% of all children suffer from a mental disorder in early childhood, defined as the period up to the age of 6 years. METHODS:This review is based on publications retrieved by a selective search in PubMed and the Web of Science, as well as on the authors' clinical and scientific experience. RESULTS:I...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2015.0375

    authors: von Klitzing K,Döhnert M,Kroll M,Grube M

    更新日期:2015-05-25 00:00:00

  • The impact of arterial hypertension on polytrauma and traumatic brain injury.

    abstract:BACKGROUND:Pre-hospital hypotension in trauma patients is associated with high mortality. Especially for patients with severe traumatic brain injury (TBI), arterial normotension or even hypertension (AHT) is considered an important mechanism for sustaining adequate cerebral perfusion pressure. The effect of pre-hospita...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2012.0849

    authors: Sellmann T,Miersch D,Kienbaum P,Flohé S,Schneppendahl J,Lefering R,DGU Trauma Registry.

    更新日期:2012-12-01 00:00:00

  • The Pathology of Severe COVID-19-Related Lung Damage.

    abstract:BACKGROUND:The histomorphological changes of lung damage in severe coronavirus disease 2019 (COVID-19) have not yet been adequately characterized. In this article, we describe the sequence of pathological changes in COVID-19 and discuss the implications for approaches to treatment. METHODS:Standardized autopsies were ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0500

    authors: Kommoss FKF,Schwab C,Tavernar L,Schreck J,Wagner WL,Merle U,Jonigk D,Schirmacher P,Longerich T

    更新日期:2020-07-20 00:00:00

  • The Diagnosis and Treatment of Nail Disorders.

    abstract:BACKGROUND:Nail disorders can arise at any age. About half of all nail disorders are of infectious origin, 15% are due to inflammatory or metabolic conditions, and 5% are due to malignancies and pigment disturbances. The differential diagnosis of nail disorders is often an area of uncertainty. METHODS:This review is b...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2016.0509

    authors: Wollina U,Nenoff P,Haroske G,Haenssle HA

    更新日期:2016-07-25 00:00:00

  • Not all acne is acne vulgaris.

    abstract:BACKGROUND:Acne is the most common skin disease in adolescence, with a prevalence of nearly 100%. About 60% of affected adolescents have mild acne for which they use non-prescription preparations without consulting a physician. The remaining 40% constitute the population of acne patients seen in medical practice. The c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2014.0301

    authors: Gollnick HP,Zouboulis CC

    更新日期:2014-04-25 00:00:00

  • Skin tumors in childhood.

    abstract:BACKGROUND:Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. METHODS:Selective literature review. RESULTS:Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of maligna...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0347

    authors: Hamm H,Höger PH

    更新日期:2011-05-01 00:00:00

  • Case Numbers and Process Quality in Breast Surgery in Germany: A Retrospective Analysis of Over 150,000 Patients From 2013 to 2014.

    abstract:BACKGROUND:Numerous studies from around the world have shown a positive association between case numbers and the quality of medical care. The evidence to date suggests that conformity to guidelines for the treatment of patients with breast cancer is better in German hospitals that have higher case numbers. METHODS:We ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,多中心研究

    doi:10.3238/arztebl.2015.0585

    authors: Köster C,Heller G,Wrede S,König T,Handstein S,Szecsenyi J

    更新日期:2015-08-31 00:00:00

  • The Treatment of Illnesses Arising in Pregnancy.

    abstract:BACKGROUND:The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians. METHODS:We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri ci...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0616

    authors: Bolz M,Körber S,Reimer T,Buchmann J,Schober HC,Briese V

    更新日期:2017-09-15 00:00:00

  • The diagnosis of urinary tract infection: a systematic review.

    abstract:BACKGROUND:Urinary tract infections (UTI) are among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Because this problem is so common and so significant in routine clinical practice, a high level of diagnostic accuracy is essential....

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2010.0361

    authors: Schmiemann G,Kniehl E,Gebhardt K,Matejczyk MM,Hummers-Pradier E

    更新日期:2010-05-01 00:00:00

  • Spontaneous Pneumothorax.

    abstract:BACKGROUND:Few reliable data are available on the epidemiology and treatment of spontaneous pneumothorax. We studied the sex and age distribution, frequency of hospitalization, mortality, and conservative versus surgical care of this condition in Germany in order to draw well-founded conclusions about its in-hospital d...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0739

    authors: Schnell J,Koryllos A,Lopez-Pastorini A,Lefering R,Stoelben E

    更新日期:2017-11-03 00:00:00

  • Dextromethorphan withdrawal and dependence syndrome.

    abstract:BACKGROUND:The N-methyl-D-aspartate (NMDA) antagonist dextromethorphan has been available in pharmacies without a prescription since 1954 as an antitussive agent. There is an alarming increase in reports of its abuse. Dextromethorphan is avidly taken, mainly by young people, as a psychoactive drug. The currently availa...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2010.0537

    authors: Mutschler J,Koopmann A,Grosshans M,Hermann D,Mann K,Kiefer F

    更新日期:2010-07-01 00:00:00

  • The investigation and treatment of female pelvic floor dysfunction.

    abstract:BACKGROUND:25% of all women report involuntary loss of urine, and 7% may require treatment. METHODS:This review is based on a selection of pertinent literature, including guidelines and Cochrane reviews. RESULTS:The assessment of pelvic floor dysfunction in women begins with a basic evaluation that is followed by spe...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2015.0564

    authors: Jundt K,Peschers U,Kentenich H

    更新日期:2015-08-17 00:00:00

  • Hospital Incidence and Mortality Rates of Sepsis.

    abstract:BACKGROUND:Sepsis, the most severe manifestation of acute infection, poses a major challenge to health care systems around the world. To date, adequate data on the incidence and mortality of sepsis in Germany have been lacking. METHODS:Nationwide case-related hospital DRG statistics for the years 2007-2013 were used t...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2016.0159

    authors: Fleischmann C,Thomas-Rueddel DO,Hartmann M,Hartog CS,Welte T,Heublein S,Dennler U,Reinhart K

    更新日期:2016-03-11 00:00:00

  • Prescription prevalence and continuing medication use for secondary prevention after myocardial infarction: the reality of care revealed by claims data analysis.

    abstract:BACKGROUND:Current guidelines recommend using aspirin, clopidogrel, beta-blockers, statins, and angiotensin converting enzyme (ACE) inhibitors after acute myocardial infarction (AMI). Although there is evidence that patients often stop taking these medications prematurely, long-term data reflecting the actual reality o...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2011.0856

    authors: Mangiapane S,Busse R

    更新日期:2011-12-01 00:00:00