References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2024-066

medsovet-8204

Research Article

РЕВМАТОЛОГИЯ

RHEUMATOLOGY

Асептический некроз головки бедренной кости

Aseptic necrosis of the femoral head

https://orcid.org/0000-0003-3024-9483

Филатова

Ю. С.

Filatova

Y. S.

Филатова Юлия Сергеевна, к.м.н., доцент кафедры терапии имени Е.Н. Дормидонтова Института непрерывного профессионального образования; врач-ревматолог

150000, Ярославль, ул. Революционная, д. 5

150003, Ярославль, пр. Ленина, д. 33

Yulia S. Filatova, Cand. Sci. (Med.), Associate Professor of the Department of Therapy named after E.N. Dormidontov, Institute of Continuing Professional Education; Rheumatologist

5, Revolutsionnaya St., Yaroslavl, 150000

33, Lenin Ave., Yaroslavl, 150003

y.s.filatova@mail.ru

https://orcid.org/0000-0002-9347-1551

Соловьев

И. Н.

Solovyov

I. N.

Соловьев Игорь Николаевич, к.м.н., доцент кафедры травматологии и ортопедии; врач – травматолог-ортопед

150000, Ярославль, ул. Революционная, д. 5

150003, Ярославль, пр. Ленина, д. 33

Igor N. Solovyov, Cand. Sci. (Med.), Associate Professor of the Department of Traumatology and Orthopedics; Traumatologist-Orthopedist

5, Revolutsionnaya St., Yaroslavl, 150000

33, Lenin Ave., Yaroslavl, 150003

giper75@mail.ru

https://orcid.org/0009-0004-0771-7693

Груздев

А. М.

Gruzdev

A. M.

Груздев Алексей Михайлович, врач ультразвуковой диагностики

150003, Ярославль, пр. Ленина, д. 33

Alexey M. Gruzdev, Ultrasound Diagnostics Doctor

33, Lenin Ave., Yaroslavl, 150003

alexey.gruzdev1985@gmail.com

https://orcid.org/0009-0003-0673-8268

Бобылева

В. В.

Bobyleva

V. V.

Бобылева Виктория Владимировна, студент лечебного факультета

150000, Ярославль, ул. Революционная, д. 5

Viktoria V. Bobyleva, Student of the Medicine Faculty

5, Revolutsionnaya St., Yaroslavl, 15000

vika-bobyleva@mail.ru

Ярославский государственный медицинский университет; Центр диагностики и профилактики плюсРоссияYaroslavl State Medical University; Center for Diagnostics and Prevention PlusRussian Federation

Центр диагностики и профилактики плюсРоссияCenter for Diagnostics and Prevention PlusRussian Federation

Ярославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian Federation

2024

02052024

03150157

2024

Филатова Ю.С., Соловьев И.Н., Груздев А.М., Бобылева В.В.

Filatova Y.S., Solovyov I.N., Gruzdev A.M., Bobyleva V.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/8204

Обсуждаются исторические аспекты изучения асептического некроза, а также вопросы терапии и ранней диагностики асептического некроза головки бедренной кости. Анализируются вопросы патогенеза и обсуждаются факторы, влияющих на его развитие. Так, считается, что ведущими факторами являются чрезмерное потребление алкоголя, глубоководное погружение и некоторые аутоиммунные заболевания. Также внимание уделяется долгосрочным последствиям инфекции COVID-19, при которой наблюдаются значительные осложнения со стороны опорно-двигательного аппарата, включая асептический некроз головки бедренной кости. Последствия инфекции могут быть спровоцированы как самим воспалительным процессом, так и как высоким риском осложнений на фоне терапии глюкокортикоидами. Представлена клиника асептического некроза головки бедренной кости и ее отличие от клиники остеоартрита. Отмечается важность ранней диагностики асептического некроза головки бедренной кости. Обсуждаются вопросы медикаментозной терапии, показания к ней и выбор препаратов согласно клиническим рекомендациям. Приводится клинический пример, который демонстрирует важность внимательного сбора жалоб и анамнеза у пациента молодого возраста с нетипичными болями в тазобедренных суставах, а также эффективность назначенной терапии. На конкретном примере продемонстрирована не только важность использования магниторезонансной томографии в диагностике асептического некроза головки бедренной кости, но и эффективность и безопасность терапии. Обсуждается возможный синергизм и плейотропные эффекты назначенной терапии. Сделан акцент на важности дальнейших исследований для разработки показаний и критериев эффективности терапии асептического некроза головки бедренной кости.

The article discusses the historical aspects of the study of aseptic necrosis, as well as the issues of therapy and early diagnosis of aseptic necrosis of the femoral head. The authors raise the issues of pathogenesis and discuss the factors influencing its development. So it is believed that the leading factors are excessive alcohol consumption, deep-sea diving and some autoimmune diseases. Attention is also paid to the long-term consequences of COVID-19 infection, in which significant complications from the musculoskeletal system are observed, including aseptic necrosis of the femoral head. The consequences of infection can be triggered both by the inflammatory process itself and as a high risk of complications during glucocorticosteroid therapy. The article focuses on the clinic of aseptic necrosis of the femoral head and its difference from the clinic of osteoarthritis. As well as the importance of early diagnosis of aseptic necrosis of the femoral head. The article discusses the issues of drug therapy, indications for it and the choice of drugs. The article provides a clinical example that demonstrates the importance of careful collection of complaints and anamnesis in a young patient with atypical hip pain, as well as the effectiveness of prescribed therapy according to clinical recommendations. A specific example demonstrates not only the importance of using magnetic resonance imaging in the diagnosis of aseptic necrosis of the femoral head, but also the effectiveness and safety of therapy. The possible synergism and pleiotropic effects of the prescribed therapy are also discussed. The emphasis is on the importance of further research to develop indications and criteria for the effectiveness of therapy for aseptic necrosis of the femoral head.

аваскулярный некрозCOVID-19диагностикаасептический некроз головки бедренной костимагнитнорезонансная томографияоссеин-гидроксиапатитный комплексхондроитина сульфатсинергизм терапии

avascular necrosisCOVID-19diagnosisfemoral head aseptic necrosismagnetic resonance imagingosseinhydroxyapatite complexchondroitin sulfatesynergism of therapy

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The authors declare that there are no conflicts of interest present.