I remember seeing someone mentioning knee problems on the MSN board, and Avascular Necrosis was one of the things that had been mentioned as a reason. Has anyone here had knee pain and had a diagnosis of anything similar? I'm having some issues with my knees and am curious if it is a common thing across the various forms of AMN. Thanks, JL

Hi, For a long time I have some articulation problems but since this disease affects the muscles and they are bound to bones and articulations I’ve never gave it too much thoughts. But recently I suffer from knee pain and some swelling. After a quick search (I didn’t even knew what avascular necrosis was) I found it might be a relation between avascular necrosis and a corticosteroid replacement therapy. Having AMN some people has Addison’s Disease (which I was also recently diagnosed) and go trough this kind of therapy… Most references to avascular necrosis I found were hip and not knee related but I’ll leave some links I’ve found anyway. http://bones.emedtv.com/avascular-necrosis/causes-of-avascular-necrosis.html http://www.newyorkbuyersclub.org/resources/recommended-reading-files/10-BONE_PROBLEMS.pdf (long article but you’ll find useful information - “Use of corticosteroid drugs is considered a major risk factor for osteonecrosis…”) http://ard.bmj.com/cgi/content/abstract/42/3/276 Thanks for bringing up the subject, I’ll ask my doctor for sure. Cordially, Ana Matias

Hi Ana, Thank you for the information. I spoke with my doctor about it on Friday and she took X-rays of my knees, I haven't heard results yet, but the technician showed me the X-rays and I couldn't see any bone deterioration but I'm not a radiologist. My doctor said that the replacement therapy doesn't as directly constitute the long term use of corticosteroids as for someone who produces there own and uses them for treatment of other things, this makes sense to a point, but there could still be more than the body requires that may contribute to side effects I think. This is an interesting discussion to consider, my Mother, who was a carrier, had knee problems and had to have both replaced. So I do wonder if it is something common to ALD/AMN. Take care, JL

Hi JL, I posted that message about the link between avn, steriods and amn. Its been a year since I've had core decompression surgery and my knee pains have gone from pure agony to just bad. All amn guys I know have pecular bent knees. This causes knee alignment problems because the weak muscles are unable to support the knee. My knee pains were caused by this and the involvement of the avn and the nerve that passes through the hip. The avn I think was cause by my switching from hydrocortizine to prednisolone because I could not find a supplier. Take care. Deo