What are the key clinical features and risk factors to consider when diagnosing avascular necrosis in a patient?

When diagnosing avascular necrosis (AVN), key clinical features often include pain, particularly in the groin, buttock, or knee, which is typically aggravated by activity and relieved by rest (Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association, 2015). Patients may also present with a limited range of motion, especially affecting internal rotation and abduction of the hip (Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association, 2015).

Several significant risk factors should be considered. These include the use of glucocorticoids, particularly high-dose and long-duration therapy, and chronic alcohol abuse (Zhu et al., 2014; Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association, 2015). Systemic lupus erythematosus (SLE) is a notable risk factor, as are other autoimmune diseases (Zhu et al., 2014; Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association, 2015). Other important risk factors include trauma, hyperlipidemia, coagulation disorders, and Gaucher disease (Joint Surgery Group of the Orthopaedic Branch of the Chinese Medical Association, 2015). Additionally, older age and male sex have been identified as risk factors (Zhu et al., 2014).