Orthopaedics When to Worry About Hip Pain By UPMC Susquehanna, April 8, 2017 Aches and pains in joints are common as you age. But, in rare cases, this pain can be from a serious and rare condition called avascular necrosis. Learn more about avascular necrosis at UPMC Susquehanna. What Is Avascular Necrosis (AVN)? The cause of AVN is cell death in the bones due to a lack of blood supply. Cell death can lead to a collapse of the bone causing severe pain in your knees, shoulders, or — most commonly — your hips. AVN affects 10,000 to 20,000 people each year and often occurs in men, age 40 to 50. In 40 to 80 percent of cases, AVN forms in both sides of the body (bilaterally). Avascular Necrosis Symptoms and Stages The main symptom of AVN is joint pain. You may not notice AVN symptoms in the early stages: Stage I — the hip is healthy. Stage II — you feel pain in the joint. Stage III — you have trouble standing and movement is painful. Stage IV — the joint fully collapses causing degenerative joint disease (DJD). AVN Diagnosis and Treatment If you believe you may have avascular necrosis, it’s vital to discuss your medical history and symptoms with your doctor. Next, your doctor will assess the movements that cause the most pain in your hip or affected joint. An x-ray will confirm a diagnosis of AVN. If your doctor can’t see AVN on an x-ray, he or she may use an MRI to get a more precise image of the hip joint. People who receive an AVN diagnosis in the early stages have better treatment results. Treatments for AVN depend on the stage during diagnosis and your age. During the early stages of AVN, the treatment options include: Drugs to relieve the pain. Crutches to allow the hip to heal on its own. In stages III and IV, doctors suggest surgical treatment.