4/19/11

There was a bit more variety of injuries and cases today. None of the conditions were foreign to me but I was happy to learn more. One case in particular is of a young lady in her 20s who has become a candidate for a total hip replacement due to avascular necrosis. Necrosis is cellular death by definition, usually affecting the bones of a joint. Dr. Williams explained that AVN (avascular necrosis) typically targets the hip joint, particularly the femoral head, and the talus in the ankle joint because blood vessels tend to be finer at these sights. The disruption in blood supply causes bone to die and collapse, no longer functioning as it’s supposed to and causing a great deal of pain. This condition can develop due to several different factors, including: alcoholism, excessive steroid use and in this patient’s case, sickle cell anaemia. Of course, the patient’s age offers complications. Candidates for total hip replacements are usually 65-70 years of age, so any surgical convention would have to be precise. Dr. Williams felt this patient would have to see someone that deals more with these types of complications. It is important that a doctor recognizes that he/she are not the best person for the job because a patient’s health is at risk. I often see both doctors, Dr. Williams and Dr. Love, collaborating and consulting each other about their cases. Sometimes a second opinion is necessary if a case is questionable. One doctor may see something different or what the other cannot. This ultimately allows the health provider (physician assistants included) to devise the best treatment possible for a patient.