ICD-10: M87.151

Osteonecrosis, also known as avascular necrosis, is a condition characterized by the death of bone tissue due to a lack of blood supply. The ICD-10 code M87.151 specifically refers to osteonecrosis that is caused by drug use, affecting the right femur. Below is a detailed clinical description and relevant information regarding this condition.

Clinical Description of Osteonecrosis (ICD-10 Code M87.151)

Definition and Pathophysiology

Osteonecrosis occurs when blood flow to a bone is disrupted, leading to the death of bone cells. This can result from various factors, including trauma, certain medical conditions, and the use of specific medications. In the case of M87.151, the osteonecrosis is attributed to drug-induced factors, which can include corticosteroids, alcohol, and other medications that may compromise blood supply to the bone.

Causes

The primary drugs associated with osteonecrosis include:
- Corticosteroids: Long-term use of corticosteroids is one of the most common causes of drug-induced osteonecrosis. These medications can interfere with the body’s ability to maintain healthy bone tissue.
- Chemotherapy agents: Certain cancer treatments can also lead to osteonecrosis by affecting blood flow.
- Alcohol: Chronic alcohol consumption can lead to fatty deposits in blood vessels, reducing blood flow to bones.

Symptoms

Patients with osteonecrosis of the right femur may experience:
- Pain: Initially, pain may be mild and intermittent but can progress to severe pain in the hip or groin area, especially during weight-bearing activities.
- Limited range of motion: As the condition progresses, patients may find it difficult to move the hip joint.
- Joint stiffness: Stiffness in the hip joint can develop, leading to decreased mobility.

Diagnosis

Diagnosis of osteonecrosis typically involves:
- Medical history: A thorough review of the patient’s medication history and any relevant medical conditions.
- Imaging studies: X-rays, MRI, or CT scans are used to visualize the affected area and assess the extent of bone damage. MRI is particularly useful in early detection of osteonecrosis.

Treatment Options

Treatment for osteonecrosis due to drugs may include:
- Medication adjustments: If possible, discontinuing or changing the offending medication can help.
- Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain.
- Surgical interventions: In advanced cases, procedures such as core decompression, osteotomy, or total hip arthroplasty may be necessary to relieve symptoms and restore function.

Prognosis

The prognosis for patients with drug-induced osteonecrosis varies based on the stage of the disease at diagnosis and the effectiveness of treatment. Early intervention can lead to better outcomes, while advanced cases may result in significant joint damage and require surgical intervention.

Conclusion

ICD-10 code M87.151 identifies osteonecrosis of the right femur due to drug use, highlighting the importance of recognizing the potential side effects of certain medications. Early diagnosis and appropriate management are crucial in preventing further complications and preserving joint function. If you suspect osteonecrosis, it is essential to consult a healthcare professional for a comprehensive evaluation and tailored treatment plan.

Osteonecrosis, particularly when classified under ICD-10 code M87.151, refers to the death of bone tissue due to a lack of blood supply, specifically in the right femur, and is often associated with drug use. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Overview of Osteonecrosis

Osteonecrosis can occur in various bones, but the femur is a common site due to its weight-bearing function. The condition often develops gradually and may not present with symptoms until significant damage has occurred. In the case of drug-induced osteonecrosis, the etiology often involves medications that affect blood flow or bone metabolism, such as corticosteroids or certain chemotherapy agents[1][2].

Signs and Symptoms

Patients with osteonecrosis of the right femur may exhibit a range of signs and symptoms, including:

• Pain: The most common symptom, often described as a deep, aching pain in the hip or groin that may worsen with weight-bearing activities. Pain can also radiate to the knee[3].
• Limited Range of Motion: Patients may experience stiffness and reduced mobility in the hip joint, making it difficult to perform daily activities[4].
• Swelling and Tenderness: Localized swelling around the hip joint may occur, along with tenderness upon palpation[5].
• Joint Instability: In advanced cases, patients may feel a sense of instability in the hip joint, which can lead to difficulty walking or standing[6].

Progression of Symptoms

Initially, symptoms may be mild and intermittent, but as the condition progresses, pain can become more severe and constant. Patients may also develop a limp or altered gait due to pain and instability[7].

Patient Characteristics

Demographics

• Age: Osteonecrosis due to drugs is more prevalent in adults, particularly those aged 30 to 60 years, as this is the age range where the use of corticosteroids and other relevant medications is more common[8].
• Gender: Males are often more affected than females, particularly in cases related to alcohol use or certain medications[9].

Medical History

• Medication Use: A significant history of corticosteroid use is a primary risk factor for drug-induced osteonecrosis. Other medications that may contribute include bisphosphonates and certain antiretroviral drugs[10].
• Comorbid Conditions: Patients with conditions such as systemic lupus erythematosus, rheumatoid arthritis, or those undergoing chemotherapy are at higher risk for developing osteonecrosis due to drug effects[11].

Lifestyle Factors

• Alcohol Consumption: Chronic alcohol use can impair blood flow to bones and is a known risk factor for osteonecrosis[12].
• Smoking: Tobacco use is associated with vascular compromise, further increasing the risk of osteonecrosis[13].

Conclusion

Osteonecrosis due to drugs, particularly in the right femur, presents with characteristic symptoms such as pain, limited range of motion, and joint instability. Understanding the patient demographics, medical history, and lifestyle factors is essential for healthcare providers to identify at-risk individuals and implement appropriate management strategies. Early diagnosis and intervention can significantly improve outcomes and prevent further joint deterioration.

For further management, imaging studies such as MRI may be utilized to assess the extent of bone damage, and treatment options may include medication adjustments, physical therapy, or surgical interventions depending on the severity of the condition[14].

References

1. Core Decompression for Avascular Necrosis.
2. ICD-10 International statistical classification of diseases.
3. Diseases of the Musculoskeletal System and Connective Tissue.
4. Major joint replacement (hip and knee).
5. Head and Neck Imaging CPT, HCPCS and Diagnoses Codes.
6. 2025 ICD-10-CM Diagnosis Code M87.151: Osteonecrosis due to drugs.
7. ICD-10-CM Diagnosis Code M87.151 - Osteonecrosis due to drugs, right femur.
8. 2025 ICD-10-CM Codes M87*: Osteonecrosis.
9. Osteonecrosis due to drugs, right femur - M87.151 ICD 10 Code.
10. ICD-10-CM Diagnosis Code M87.1 - Osteonecrosis due to drugs - ICD List.
11. M87.151 Osteonecrosis due to drugs, right femur... - Find-A-Code.
12. Instruction manual 2e (volume 1) ICD-10 tabular list.
13. Knee Orthoses - Policy Article (A52465).
14. Clinical guidelines on the management of osteonecrosis.

ICD-10 code M87.151 refers specifically to "Osteonecrosis due to drugs, right femur." This diagnosis is part of a broader category of osteonecrosis, which can occur due to various factors, including drug use. Below are alternative names and related terms associated with this condition:

Alternative Names

1. Avascular Necrosis (AVN): This term is often used interchangeably with osteonecrosis and refers to the death of bone tissue due to a lack of blood supply.
2. Bone Infarction: This term describes the process where bone tissue dies due to insufficient blood flow, similar to how a heart attack occurs in heart tissue.
3. Ischemic Bone Necrosis: This term emphasizes the role of reduced blood flow (ischemia) in the development of necrosis in the bone.

Related Terms

1. Osteonecrosis: A general term for the death of bone tissue, which can be caused by various factors, including trauma, certain medical conditions, and drug use.
2. Drug-Induced Osteonecrosis: A broader category that includes osteonecrosis resulting from various medications, not limited to those affecting the right femur.
3. Corticosteroid-Induced Osteonecrosis: A specific type of drug-induced osteonecrosis often associated with the use of corticosteroids, which can lead to AVN in various joints.
4. Femoral Head Necrosis: This term specifically refers to osteonecrosis occurring in the femoral head, which is a common site for this condition.
5. Secondary Osteonecrosis: This term is used to describe osteonecrosis that occurs as a result of other underlying conditions or factors, including drug use.

Clinical Context

Osteonecrosis due to drugs, particularly in the right femur, can be a significant concern in clinical practice, especially for patients undergoing long-term treatment with corticosteroids or other medications known to affect bone health. Understanding these alternative names and related terms can aid healthcare professionals in diagnosing and managing the condition effectively.

In summary, M87.151 encompasses a specific diagnosis within the broader context of osteonecrosis, with various alternative names and related terms that highlight its clinical significance and the underlying mechanisms involved.

Osteonecrosis, particularly when attributed to drug use, is a significant concern in medical practice, especially regarding its diagnosis and classification under the ICD-10 coding system. The ICD-10 code M87.151 specifically refers to osteonecrosis due to drugs affecting the right femur. Here’s a detailed overview of the criteria used for diagnosing this condition.

Understanding Osteonecrosis

Osteonecrosis, also known as avascular necrosis, occurs when there is a loss of blood supply to the bone, leading to bone death. This condition can result from various factors, including trauma, certain medical conditions, and the use of specific medications, particularly corticosteroids and bisphosphonates.

Diagnostic Criteria for M87.151

Clinical Evaluation

1. Patient History: A thorough medical history is essential. The clinician should inquire about:
   - Previous use of medications known to cause osteonecrosis, such as corticosteroids or chemotherapy agents.
   - Any history of trauma to the femur or other risk factors, including alcohol use or systemic diseases like lupus or sickle cell disease.

2. Symptoms: Patients typically present with:
   - Pain in the hip or groin area, which may worsen with weight-bearing activities.
   - Limited range of motion in the hip joint.

Imaging Studies

1. Magnetic Resonance Imaging (MRI): MRI is the most sensitive imaging modality for detecting early changes in osteonecrosis. It can reveal:
   - Bone marrow edema.
   - The presence of a crescent sign, indicating subchondral fracture.

2. X-rays: While X-rays may initially appear normal, they can show changes in later stages, such as:
   - Sclerosis or collapse of the femoral head.

3. CT Scans: In some cases, a CT scan may be used to assess the extent of the necrosis and to plan surgical intervention if necessary.

Laboratory Tests

• Blood Tests: While no specific blood test confirms osteonecrosis, tests may be conducted to rule out other conditions or to assess for underlying diseases that could contribute to the condition.

Differential Diagnosis

It is crucial to differentiate osteonecrosis from other conditions that may present similarly, such as:
- Osteoarthritis.
- Fractures.
- Tumors.

ICD-10 Coding Guidelines

According to the ICD-10 coding guidelines, the code M87.151 is specifically used when:
- The diagnosis of osteonecrosis is confirmed to be due to drug use.
- The affected site is the right femur.

Conclusion

The diagnosis of osteonecrosis due to drugs, particularly for the right femur coded as M87.151, involves a comprehensive approach that includes patient history, clinical evaluation, imaging studies, and differential diagnosis. Understanding these criteria is essential for accurate diagnosis and appropriate management of the condition, ensuring that patients receive timely and effective treatment. If you have further questions or need additional information on this topic, feel free to ask!

Osteonecrosis, particularly when associated with drug use, is a serious condition that can lead to significant morbidity. The ICD-10 code M87.151 specifically refers to osteonecrosis of the right femur due to drugs. Understanding the standard treatment approaches for this condition is crucial for effective management.

Overview of Osteonecrosis

Osteonecrosis, also known as avascular necrosis, occurs when blood flow to a bone is disrupted, leading to bone death. In the case of M87.151, the condition is induced by pharmacological agents, which can include corticosteroids, bisphosphonates, and certain chemotherapy drugs. The right femur is commonly affected due to its weight-bearing role and vascular supply.

Standard Treatment Approaches

1. Conservative Management

Initial treatment often involves conservative measures, especially in the early stages of osteonecrosis:

• Activity Modification: Patients are advised to limit weight-bearing activities to reduce stress on the affected femur. Crutches or a walker may be recommended to assist mobility without putting pressure on the joint[1].

• Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to manage pain and inflammation associated with osteonecrosis[2].

• Physical Therapy: A tailored physical therapy program can help maintain joint function and muscle strength without exacerbating the condition[3].

2. Medications

In cases where osteonecrosis is linked to specific drug use, addressing the underlying cause is essential:

• Discontinuation or Adjustment of Medications: If the osteonecrosis is drug-induced, the healthcare provider may consider adjusting the dosage or switching to alternative medications that have a lower risk of causing osteonecrosis[4].

• Bone Health Supplements: Calcium and vitamin D supplementation may be recommended to support bone health, especially if the patient is at risk for osteoporosis[5].

3. Surgical Interventions

If conservative management fails or if the osteonecrosis progresses, surgical options may be considered:

• Core Decompression: This procedure involves removing a portion of the inner bone to relieve pressure and promote blood flow to the affected area. It is often performed in the early stages of osteonecrosis[6].

• Bone Grafting: In cases where there is significant bone loss, a bone graft may be used to replace the necrotic bone and promote healing[7].

• Total Hip Replacement: For advanced cases where the femoral head is severely damaged, total hip arthroplasty may be necessary to restore function and alleviate pain[8].

4. Monitoring and Follow-Up

Regular follow-up appointments are crucial to monitor the progression of the disease and the effectiveness of the treatment plan. Imaging studies, such as MRI or X-rays, may be used to assess the condition of the femur over time[9].

Conclusion

The management of osteonecrosis due to drugs, particularly in the right femur, requires a multifaceted approach that includes conservative treatment, medication adjustments, and potentially surgical interventions. Early diagnosis and intervention are key to preventing further joint damage and improving patient outcomes. Collaboration between healthcare providers, including orthopedic specialists and primary care physicians, is essential to tailor the treatment plan to the individual needs of the patient. Regular monitoring and adjustments to the treatment strategy can help manage this complex condition effectively.