ICD-10: M87.35

ICD-10 code M87.35 refers to "Other secondary osteonecrosis, pelvis and femur." This classification falls under the broader category of osteonecrosis, which is a condition characterized by the death of bone tissue due to a lack of blood supply. Understanding the clinical description and details associated with this code is essential for accurate diagnosis, treatment, and reporting.

Clinical Description of M87.35

Definition of Osteonecrosis

Osteonecrosis, also known as avascular necrosis, occurs when blood flow to a bone is disrupted, leading to the death of bone cells. This condition can affect any bone but is most commonly seen in the hip, knee, and shoulder joints. The pelvis and femur are particularly significant sites due to their weight-bearing functions and the potential for severe complications if not treated appropriately.

Causes of Secondary Osteonecrosis

Secondary osteonecrosis, as indicated by the "Other" designation in M87.35, can arise from various underlying conditions or factors, including:

• Trauma: Fractures or dislocations can damage blood vessels, leading to reduced blood supply.
• Chronic corticosteroid use: Long-term use of corticosteroids is a well-known risk factor for developing osteonecrosis.
• Alcohol abuse: Excessive alcohol consumption can interfere with blood flow and bone health.
• Medical conditions: Diseases such as lupus, sickle cell disease, and certain metabolic disorders can predispose individuals to osteonecrosis.
• Radiation therapy: Previous radiation treatment to the pelvis or femur can compromise blood supply to the bone.

Symptoms

Patients with M87.35 may experience a range of symptoms, including:

• Pain: Often the first symptom, which may start as mild and progressively worsen. Pain is typically localized to the affected area (pelvis or femur).
• Limited range of motion: As the condition progresses, patients may find it difficult to move the affected joint.
• Joint stiffness: Stiffness can develop, particularly after periods of inactivity.
• Swelling: In some cases, swelling may occur around the affected joint.

Diagnosis

Diagnosis of secondary osteonecrosis typically involves a combination of:

• Clinical evaluation: A thorough history and physical examination to assess symptoms and risk factors.
• Imaging studies: X-rays, MRI, or CT scans are crucial for visualizing bone changes and assessing the extent of necrosis. MRI is particularly sensitive in detecting early changes in bone marrow associated with osteonecrosis.

Treatment Options

Management of M87.35 can vary based on the severity of the condition and may include:

• Conservative management: This may involve pain management, physical therapy, and lifestyle modifications to reduce weight-bearing on the affected joint.
• Surgical interventions: In more severe cases, options may include core decompression, osteotomy, or joint replacement surgery, particularly if the necrosis leads to significant joint damage.

Conclusion

ICD-10 code M87.35 captures the complexities of secondary osteonecrosis affecting the pelvis and femur, highlighting the need for a comprehensive approach to diagnosis and treatment. Understanding the underlying causes, symptoms, and management strategies is crucial for healthcare providers to effectively address this condition and improve patient outcomes. Accurate coding and documentation are essential for appropriate treatment planning and insurance reimbursement, ensuring that patients receive the care they need.

Osteonecrosis, particularly classified under ICD-10 code M87.35 as "Other secondary osteonecrosis, pelvis and femur," is a condition characterized by the death of bone tissue due to a lack of blood supply. This condition can lead to significant morbidity, particularly in older adults and those with certain risk factors. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this diagnosis is crucial for effective management and treatment.

Clinical Presentation

Signs and Symptoms

The clinical presentation of osteonecrosis can vary depending on the stage of the disease and the specific bones affected. Common signs and symptoms include:

• Pain: The most prominent symptom is often pain in the affected area, which may start as mild and progressively worsen. In the case of pelvic and femoral osteonecrosis, patients may experience deep, aching pain in the hip or groin that can radiate to the thigh or knee[1].
• Limited Range of Motion: Patients may exhibit reduced mobility in the hip joint, leading to difficulty in performing daily activities such as walking, climbing stairs, or getting in and out of chairs[1].
• Swelling and Tenderness: There may be localized swelling and tenderness over the affected area, particularly during physical activity[1].
• Joint Stiffness: Stiffness in the hip joint can occur, especially after periods of inactivity, making it challenging for patients to initiate movement[1].

Progression of Symptoms

As the condition progresses, symptoms may worsen, leading to:

• Increased Pain: Pain may become more severe and constant, even at rest.
• Joint Deformity: In advanced cases, structural changes in the joint may occur, leading to deformities and further functional impairment[1].
• Complications: If left untreated, osteonecrosis can lead to joint collapse, particularly in the femoral head, resulting in osteoarthritis and significant disability[1].

Patient Characteristics

Demographics

Osteonecrosis is more prevalent in certain populations, particularly:

• Age: It commonly affects adults aged 30 to 60 years, with a higher incidence in older adults due to age-related vascular changes[1].
• Gender: Males are generally more affected than females, although the reasons for this disparity are not fully understood[1].

Risk Factors

Several risk factors are associated with the development of secondary osteonecrosis, including:

• Chronic Conditions: Conditions such as diabetes, hypertension, and hyperlipidemia can compromise blood flow and increase the risk of osteonecrosis[1].
• Medications: Long-term use of corticosteroids is a well-known risk factor, as these medications can interfere with blood supply to the bones[1].
• Alcohol Use: Excessive alcohol consumption can lead to fatty deposits in blood vessels, impairing circulation to the bones[1].
• Trauma: Previous fractures or injuries to the hip or pelvis can predispose individuals to osteonecrosis due to disrupted blood flow[1].
• Coagulation Disorders: Conditions that affect blood clotting can also increase the risk of osteonecrosis by impairing blood supply to the bone[1].

Clinical Evaluation

A thorough clinical evaluation is essential for diagnosing osteonecrosis. This typically includes:

• Medical History: A detailed history of symptoms, risk factors, and any relevant medical conditions or medications.
• Physical Examination: Assessment of pain, range of motion, and any signs of joint dysfunction.
• Imaging Studies: MRI is the preferred imaging modality for early detection, as it can reveal changes in bone marrow and the presence of necrotic areas before structural changes occur[1].

Conclusion

Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code M87.35 is vital for healthcare providers. Early recognition and intervention can significantly improve outcomes for patients suffering from osteonecrosis of the pelvis and femur. Management strategies may include pain control, physical therapy, and in some cases, surgical intervention to restore blood flow and joint function. Regular follow-up and monitoring are essential to prevent complications and enhance the quality of life for affected individuals.

ICD-10 code M87.35 refers to "Other secondary osteonecrosis, pelvis and femur." This condition is characterized by the death of bone tissue due to a lack of blood supply, specifically affecting the pelvic region and femur. Understanding alternative names and related terms can help in better communication and documentation in medical settings. Here’s a detailed overview:

Alternative Names for M87.35

1. Avascular Necrosis (AVN): This is a broader term that encompasses osteonecrosis, indicating the death of bone tissue due to insufficient blood flow. It is often used interchangeably with osteonecrosis.

2. Bone Infarction: This term describes the process where bone tissue dies due to a lack of blood supply, similar to how a heart attack occurs in heart tissue.

3. Ischemic Bone Disease: This term highlights the ischemic nature of the condition, emphasizing the reduced blood flow that leads to bone necrosis.

4. Secondary Osteonecrosis: This term specifies that the osteonecrosis is a result of another underlying condition or factor, such as trauma, corticosteroid use, or other medical conditions.

5. Necrosis of Bone: A more general term that can refer to any type of bone tissue death, including osteonecrosis.

Related Terms

1. Pelvic Osteonecrosis: Specifically refers to osteonecrosis occurring in the pelvic bones, which is part of the broader M87.35 classification.

2. Femoral Osteonecrosis: This term focuses on osteonecrosis affecting the femur, which is also included in the M87.35 code.

3. Corticosteroid-Induced Osteonecrosis: A specific type of secondary osteonecrosis that occurs due to the use of corticosteroids, which can compromise blood supply to bones.

4. Traumatic Osteonecrosis: Refers to osteonecrosis that results from trauma or injury, leading to compromised blood flow.

5. Osteonecrosis due to Alcoholism: This term describes osteonecrosis that can occur as a result of excessive alcohol consumption, which can affect blood supply to bones.

6. Osteonecrosis Associated with Sickle Cell Disease: This term refers to osteonecrosis that can occur in patients with sickle cell disease due to vaso-occlusive crises affecting blood flow.

Conclusion

Understanding the alternative names and related terms for ICD-10 code M87.35 is crucial for healthcare professionals in accurately diagnosing and documenting cases of osteonecrosis. These terms not only facilitate better communication among medical staff but also enhance patient understanding of their condition. If you need further information on specific aspects of osteonecrosis or related conditions, feel free to ask!

The diagnosis of ICD-10 code M87.35, which refers to "Other secondary osteonecrosis, pelvis and femur," involves a combination of clinical evaluation, imaging studies, and patient history. Here’s a detailed overview of the criteria typically used for diagnosing this condition:

Clinical Criteria

1. Patient History:
   - A thorough medical history is essential, focusing on risk factors associated with osteonecrosis. This includes:

   • Previous trauma or injury to the hip or pelvis.
   • History of corticosteroid use, which is a known risk factor for osteonecrosis.
   • Alcohol use, which can contribute to the development of the condition.
   • Underlying medical conditions such as systemic lupus erythematosus, sickle cell disease, or other hematological disorders.

2. Symptoms:
   - Patients often present with symptoms such as:

   • Pain in the hip or groin area, which may worsen with weight-bearing activities.
   • Limited range of motion in the hip joint.
   • Symptoms may progress to include pain at rest as the disease advances.

Diagnostic Imaging

1. X-rays:
   - Initial imaging typically involves X-rays of the hip and pelvis. Early stages of osteonecrosis may not show significant changes, but as the condition progresses, X-rays may reveal:

   • Subchondral lucency (dark areas beneath the cartilage).
   • Collapse of the femoral head in advanced cases.

2. MRI:
   - Magnetic Resonance Imaging (MRI) is the gold standard for diagnosing osteonecrosis. It can detect early changes in the bone marrow and is more sensitive than X-rays. MRI findings may include:

   • Areas of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, indicating edema and necrosis.
   • The presence of a "double-line sign," which is indicative of the boundary between necrotic and viable bone.

3. CT Scans:
   - Computed Tomography (CT) scans may be used for further evaluation, especially if MRI is contraindicated. CT can provide detailed images of the bone structure and help assess the extent of the necrosis.

Differential Diagnosis

• It is crucial to differentiate osteonecrosis from other conditions that may present similarly, such as:
• Avascular necrosis due to other causes.
• Bone tumors or metastases.
• Infections such as osteomyelitis.

Conclusion

The diagnosis of M87.35: Other secondary osteonecrosis, pelvis and femur requires a comprehensive approach that includes a detailed patient history, clinical examination, and appropriate imaging studies. Early diagnosis is critical for effective management and to prevent further joint damage. If you suspect osteonecrosis, it is advisable to consult a healthcare professional for a thorough evaluation and appropriate diagnostic testing.

Osteonecrosis, particularly classified under ICD-10 code M87.35 as "Other secondary osteonecrosis, pelvis and femur," is a condition characterized by the death of bone tissue due to a lack of blood supply. This condition can lead to severe pain and disability, particularly in weight-bearing joints like the hip and knee. The treatment approaches for this condition vary based on the severity of the disease, the patient's overall health, and the specific joints affected.

Standard Treatment Approaches

1. Conservative Management

For early-stage osteonecrosis, conservative treatment options are often recommended:

• Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help alleviate pain and reduce inflammation[1].
• Activity Modification: Patients are advised to limit weight-bearing activities to reduce stress on the affected joint, which can help slow the progression of the disease[2].
• Physical Therapy: A structured physical therapy program can improve joint function and strengthen surrounding muscles, which may help support the affected area[3].

2. Medications

In addition to pain management, other medications may be prescribed:

• Bisphosphonates: These drugs, commonly used to treat osteoporosis, may help in reducing bone loss and promoting bone health in osteonecrosis patients[4].
• Anticoagulants: If the osteonecrosis is related to blood flow issues, anticoagulants may be used to improve circulation[5].

3. Surgical Interventions

When conservative treatments fail or the disease progresses, surgical options may be considered:

• Core Decompression: This procedure involves removing a portion of the inner bone to reduce pressure and improve 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 damaged bone and promote healing[7].
• Joint Resurfacing or Replacement: For advanced osteonecrosis, particularly in the hip, joint resurfacing or total hip replacement may be necessary to restore function and relieve pain[8].

4. Emerging Treatments

Research is ongoing into new treatment modalities, including:

• Stem Cell Therapy: This experimental approach aims to regenerate bone tissue and restore blood supply to the affected area[9].
• Growth Factor Injections: Injections of growth factors may promote healing and regeneration of bone tissue[10].

Conclusion

The management of osteonecrosis classified under ICD-10 code M87.35 involves a combination of conservative and surgical approaches tailored to the individual patient's condition and needs. Early diagnosis and intervention are crucial for improving outcomes and preventing further joint damage. Patients should work closely with their healthcare providers to determine the most appropriate treatment plan based on their specific circumstances. Regular follow-up and monitoring are essential to assess the effectiveness of the chosen treatment strategy and make adjustments as necessary.