Editorial comment: osteonecrosis in HIV-infected persons--does delayed diagnosis matter?

Osteonecrosis, also known as avascular necrosis or aseptic necrosis, refers to ischemic death of the cellular constituents of bone and marrow when it occurs in the epiphyseal or subarticular region. The incidence of osteonecrosis may be increased by as much as 100-fold in HIV-infected persons relative to the general population,1 making this condition an increasingly important cause of morbidity. While it typically involves the hip, other joints may also be affected, including the shoulders, wrists, knees, and ankles.2 Hip involvement is often bilateral.