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The mechanisms by which these two risk factors (alcohol and steroids) cause ON are not well understood. The third most common group, are those patients who have no risk factors at all, and these patients are a true medical mystery. No matter what the cause, the symptoms and course of the disorder are remarkably similar.
FIRST SYMPTOMS
Unfortunately many patients with ON have had the disease for quite some time before symptoms are present. The initial symptoms are usually pain or aching in the affected joint with activity, which subsides after the activity has stopped. Symptoms usually begin slowly and may initially be intermittent. As the disease progresses, the pain increases and is associated with stiffness. Limping becomes common. In the hip, the most common joint affected, the pain is usually felt in the groin.
DIAGNOSIS
The principle diagnostic tool is the x-ray. By the time that most patients have significant symptoms, the disease is advanced enough to be seen on standard x-rays. In most cases the x-ray will show the area of bone that is involved. However, the very earliest stages of the ON cannot be seen on a regular x-ray. A widely used and relatively new tool is called an MRI which stands for Magnetic Resonance Imaging. These special images are able to detect tissue changes that are seen on a plain x-ray. Occasionally, your doctor may order a CAT scan which is a special series of x-rays, interpreted by the computer to show the three dimensional structure of the bone. Any of these tests will help the doctor to determine how advanced the disease is in your case.