ICD-10: M90.55

ICD-10 code M90.55 refers specifically to "Osteonecrosis in diseases classified elsewhere, thigh." This code is part of the broader category of osteopathies, which are disorders affecting the bones. Here are some alternative names and related terms associated with this diagnosis:

Alternative Names

1. Avascular Necrosis of the Thigh: This term emphasizes the lack of blood supply to the bone, leading to its death.
2. Bone Infarction: This term is used to describe the death of bone tissue due to a lack of blood flow, similar to how a heart attack affects heart tissue.
3. Osteonecrosis of the Femur: Since the thigh bone is the femur, this term is often used interchangeably.
4. Thigh Osteonecrosis: A straightforward term that specifies the location of the osteonecrosis.

Related Terms

1. Osteopathy: A general term for bone diseases, which includes osteonecrosis.
2. Osteonecrosis: A broader term that refers to the death of bone tissue due to various causes, including trauma, disease, or lack of blood supply.
3. Secondary Osteonecrosis: This term may be used when osteonecrosis occurs as a result of another disease or condition, which is relevant to the classification of M90.55.
4. Non-traumatic Osteonecrosis: This term highlights cases where osteonecrosis is not caused by an injury but rather by other underlying conditions.

Clinical Context

Osteonecrosis can occur due to various factors, including corticosteroid use, excessive alcohol consumption, or certain medical conditions like lupus or sickle cell disease. The classification under M90.55 indicates that the osteonecrosis is a consequence of another disease, which is crucial for accurate diagnosis and treatment planning.

Understanding these alternative names and related terms can aid healthcare professionals in communication and documentation, ensuring clarity in patient records and treatment approaches.

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 M90.55 specifically refers to osteonecrosis that occurs in the thigh and is classified under the broader category of osteonecrosis in diseases classified elsewhere. This classification indicates that the osteonecrosis is secondary to other underlying conditions rather than being a primary disease itself.

Clinical Description

Definition and Pathophysiology

Osteonecrosis in the thigh typically affects the femoral head, which is the ball part of the hip joint. The condition arises when blood flow to the femoral head is disrupted, leading to bone cell death. This can result from various factors, including trauma, prolonged corticosteroid use, excessive alcohol consumption, or certain medical conditions such as sickle cell disease or systemic lupus erythematosus. The lack of blood supply causes the bone to weaken and may eventually lead to joint collapse if not treated appropriately[1][2].

Symptoms

Patients with osteonecrosis of the thigh may experience:
- Pain: Often localized to the hip or groin, which may worsen with weight-bearing activities.
- Limited Range of Motion: Difficulty in moving the hip joint, which can affect daily activities.
- Joint Stiffness: A feeling of tightness in the hip joint, particularly after periods of inactivity.
- Swelling: In some cases, swelling may occur around the hip joint.

Diagnosis

Diagnosis of osteonecrosis typically involves a combination of clinical evaluation and imaging studies. Common diagnostic methods include:
- X-rays: Initial imaging to assess bone structure and detect any changes.
- MRI: The most sensitive imaging technique for early detection of osteonecrosis, revealing changes in bone marrow and the presence of edema.
- CT Scans: Useful for detailed imaging of the bone structure and assessing the extent of necrosis[3][4].

Treatment Options

The management of osteonecrosis in the thigh depends on the stage of the disease and the underlying cause. Treatment options may include:
- Conservative Management: This may involve pain management with medications, activity modification, and physical therapy to maintain joint function.
- Surgical Interventions: In more advanced cases, surgical options such as core decompression, osteotomy, or total hip replacement may be necessary to relieve pain and restore function[5][6].

Conclusion

ICD-10 code M90.55 encapsulates the complexities of osteonecrosis in the thigh as a secondary condition linked to other diseases. Understanding the clinical presentation, diagnostic approaches, and treatment options is crucial for effective management. Early diagnosis and intervention can significantly improve outcomes and prevent further joint deterioration. If you suspect osteonecrosis, it is essential to consult a healthcare professional for a comprehensive evaluation and tailored treatment plan.

References

1. ICD-10-CM Diagnosis Code M90.55 - Osteonecrosis in diseases classified elsewhere.
2. ICD-10 International statistical classification of diseases.
3. ICD-10 code M90.5 for Osteonecrosis in diseases.
4. International classification of diseases, 10th edition, clinical.
5. Knee Orthoses - Policy Article (A52465).
6. 2025 ICD-10-CM Diagnosis Code M90.8.

Osteonecrosis, particularly in the context of ICD-10 code M90.55, refers to the death of bone tissue due to a lack of blood supply, specifically affecting the thigh region. This condition can arise from various underlying diseases and is characterized by a range of clinical presentations, signs, symptoms, and patient characteristics.

Clinical Presentation

Overview

Osteonecrosis of the thigh typically manifests as pain and functional impairment. The condition can be asymptomatic in its early stages, but as it progresses, patients often experience significant discomfort and limitations in mobility.

Signs and Symptoms

1. Pain:
   - The most common symptom is pain in the hip or thigh, which may be described as a deep, aching sensation. This pain can worsen with weight-bearing activities and may become constant as the disease progresses[1].

2. Limited Range of Motion:
   - Patients may experience stiffness in the hip joint, leading to a reduced range of motion. This can affect daily activities such as walking, climbing stairs, or sitting for extended periods[1].

3. Swelling and Tenderness:
   - In some cases, there may be localized swelling around the hip joint, and tenderness can be noted upon palpation[1].

4. Joint Instability:
   - As the condition advances, patients may feel a sense of instability in the hip joint, which can lead to difficulty in maintaining balance and an increased risk of falls[1].

5. Muscle Weakness:
   - Muscle atrophy may occur due to disuse, further contributing to functional limitations[1].

Progression of Symptoms

• Initially, symptoms may be mild and intermittent, but as the necrosis progresses, pain can become more severe and persistent, often leading to significant disability and a decreased quality of life[1].

Patient Characteristics

Demographics

• Age: Osteonecrosis is more prevalent in adults, particularly those aged 30 to 60 years. However, it can occur in younger individuals, especially those with risk factors[2].
• Gender: Males are generally more affected than females, although the exact reasons for this disparity are not fully understood[2].

Risk Factors

1. Underlying Diseases:
   - Conditions such as systemic lupus erythematosus, sickle cell disease, and other hematological disorders can predispose individuals to osteonecrosis[2].

2. Lifestyle Factors:
   - Alcohol abuse and long-term corticosteroid use are significant risk factors, as they can impair blood flow to the bones[2].

3. Trauma:
   - Previous fractures or dislocations in the hip region can also increase the risk of developing osteonecrosis[2].

4. Comorbidities:
   - Patients with metabolic disorders, such as diabetes or hyperlipidemia, may have a higher incidence of osteonecrosis due to compromised vascular health[2].

Clinical Evaluation

• Diagnosis typically involves a combination of patient history, physical examination, and imaging studies such as MRI or X-rays, which can reveal changes in bone structure and the presence of necrotic areas[2].

Conclusion

Osteonecrosis of the thigh, classified under ICD-10 code M90.55, presents with a range of symptoms primarily centered around pain and functional impairment. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for timely diagnosis and management. Early intervention can help mitigate the progression of the disease and improve patient outcomes. If you suspect osteonecrosis, it is essential to consult a healthcare professional for a comprehensive evaluation and appropriate treatment options.

Osteonecrosis, particularly when classified under ICD-10 code M90.55, refers to the death of bone tissue due to a lack of blood supply, specifically in the thigh region. This condition can arise from various underlying diseases or conditions, and its diagnosis involves a combination of clinical evaluation, imaging studies, and consideration of the patient's medical history.

Diagnostic Criteria for Osteonecrosis (ICD-10 Code M90.55)

1. Clinical Evaluation

• Symptoms: Patients typically present with pain in the affected area, which may be exacerbated by weight-bearing activities. The pain can be gradual or sudden, depending on the extent of the necrosis.
• Physical Examination: A thorough physical examination may reveal limited range of motion in the hip joint, tenderness over the affected area, and signs of joint effusion.

2. Imaging Studies

• X-rays: Initial imaging often includes X-rays, which may show changes in bone density or the presence of a crescent sign indicating subchondral fracture.
• MRI: Magnetic Resonance Imaging (MRI) is the gold standard for diagnosing osteonecrosis. It can detect early changes in the bone marrow and identify the extent of necrosis before changes are visible on X-rays.
• CT Scans: Computed Tomography (CT) scans may also be used to assess the extent of the disease and to plan surgical interventions if necessary.

3. Medical History and Risk Factors

• Underlying Conditions: The diagnosis of M90.55 necessitates identifying any underlying diseases that may contribute to osteonecrosis, such as corticosteroid use, alcohol abuse, trauma, or conditions like sickle cell disease or systemic lupus erythematosus.
• Risk Factor Assessment: A comprehensive review of the patient's medical history, including any previous surgeries, trauma to the hip, or chronic diseases, is crucial in establishing the diagnosis.

4. Differential Diagnosis

• It is essential to differentiate osteonecrosis from other conditions that may present similarly, such as osteoarthritis, avascular necrosis due to trauma, or metastatic disease. This may involve additional imaging or laboratory tests to rule out other causes of hip pain.

5. Histological Examination (if applicable)

• In some cases, a biopsy may be performed to confirm the diagnosis, especially if the clinical and imaging findings are inconclusive. Histological examination can reveal necrotic bone and marrow changes consistent with osteonecrosis.

Conclusion

The diagnosis of osteonecrosis classified under ICD-10 code M90.55 involves a multifaceted approach that includes clinical assessment, imaging studies, and consideration of the patient's medical history and risk factors. Early diagnosis is crucial for effective management and to prevent further joint damage. If you suspect osteonecrosis, it is advisable to consult a healthcare professional for a comprehensive evaluation and appropriate diagnostic testing.

Osteonecrosis, particularly in the thigh, is a condition characterized by the death of bone tissue due to a lack of blood supply. The ICD-10 code M90.55 specifically refers to osteonecrosis that arises as a complication of other diseases. Understanding the standard treatment approaches for this condition is crucial for effective management and recovery.

Overview of Osteonecrosis

Osteonecrosis can occur in various locations in the body, but when it affects the thigh, it often involves the femoral head, which is the ball part of the hip joint. This condition can lead to joint pain, limited mobility, and, if untreated, may result in joint collapse and severe arthritis. The causes of osteonecrosis can include trauma, long-term use of corticosteroids, excessive alcohol consumption, and certain medical conditions such as lupus or sickle cell disease[1][2].

Standard Treatment Approaches

1. Conservative Management

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

• Rest and Activity Modification: Reducing weight-bearing activities can help alleviate pain and prevent further damage to the bone[3].
• Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain and inflammation associated with osteonecrosis[4].
• Physical Therapy: A structured physical therapy program can help improve joint function and strengthen surrounding muscles, which may provide additional support to the affected area[5].

2. Medications

In addition to NSAIDs, other medications may be prescribed:

• Bisphosphonates: These drugs, typically used to treat osteoporosis, may help in reducing bone loss and pain in osteonecrosis patients[6].
• Statins: Some studies suggest that statins may improve blood flow to the affected area and promote bone healing[7].

3. Surgical Interventions

If conservative treatments fail or if the condition 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[8].
• Bone Grafting: In cases where there is significant bone loss, a bone graft may be used to replace the necrotic bone and promote healing[9].
• Joint Replacement: In advanced cases where the joint has collapsed, total hip replacement may be necessary to restore function and relieve pain[10].

4. Emerging Treatments

Research is ongoing into new treatment modalities, including:

• Stem Cell Therapy: This innovative approach aims to regenerate bone tissue and restore blood supply to the affected area, although it is still largely experimental[11].
• Growth Factor Injections: Injections of growth factors may promote healing and regeneration of bone tissue, but further studies are needed to establish their efficacy[12].

Conclusion

The management of osteonecrosis in the thigh, classified under ICD-10 code M90.55, involves a combination of conservative and surgical approaches tailored to the stage of the disease and the patient's overall health. Early diagnosis and intervention are critical to preventing joint collapse and ensuring the best possible outcomes. Patients experiencing symptoms of osteonecrosis should consult with a healthcare provider to discuss the most appropriate treatment options based on their specific circumstances.

Continued research into innovative therapies holds promise for improving the prognosis for individuals affected by this challenging condition.