Related Experiment Video
Updated: Jun 20, 2026

Tension-Free Weight-Bearing Model of Steroid-Induced Osteonecrosis of Femoral Head in Rats
Published on: September 27, 2024
The effects of corticosteroids on bone: osteonecrosis (avascular necrosis of the bone)
1Department of Internal Medicine, Texas A&M University Health Sciences Center, College Station, Texas, USA. dweldon@swmail.sw.org
Objective:
To provide information about risk factors for, diagnosis of, and potential treatments and prevention of avascular necrosis (AVN) in patients frequently given systemic corticosteroid therapy for the management of allergic and/or inflammatory diseases.
Data Sources:
Articles on AVN cited in PubMed from 1975 through 2008.
Study Selection:
Publications consisted of case reports, reviews of osteonecrosis, and animal and human studies (mostly open, nonrandomized, and observational).
Results:
Case reports of rare and infrequent use of corticosteroids and the development of osteonecrosis are of great concern to physicians, but most patients affected may also be at risk of developing osteonecrosis because of repetitive systemic corticosteroid use with underlying hyperlipidemia, alcoholism, smoking, connective tissue disorders, and/or previous trauma to the affected area. The use of statins for patients with hyperlipidemias may be useful in decreasing the risk of osteonecrosis but is considered investigational. Enhanced magnetic resonance imaging is the most sensitive tool for diagnosing AVN early. Prophylaxis with bisphosphonates may be worthwhile in certain patients for the early management of pain due to AVN, but eventually surgical intervention is warranted in the treatment of osteonecrosis.
Conclusions:
Recognition of risk factors and educating (enabling) the patient remain the most effective ways of preventing AVN caused by corticosteroid use.
Related Concept Videos
Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Osteoclasts in Bone Remodeling
Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Cushing Syndrome II: Pathophysiology
Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Blood and Nerve Supply to the Bones
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...