I am writing this about my husband's situation. In Dec 2005 he was involved in an auto accident. He was hit almost head on with his vehicle speed at aprox. 45 mph. The impact was on the front left front fender and drivers side door. After the initial impact with the other vehicle, his truck slammed into a steel light pole. This is where the story really starts. He was taken to the hospital, where the initial exam took place. It was determined that he broke a rib in two places and was bruised pretty good on his left side. He was sent home to recuperate. Several weeks later, he started having pain in his left hip as well as some pain in his left shoulder. The pain in his hip got so bad that he resorted to using a cane to get around. Finally in March, the doctor decided to do a series of MRI's on his hip and shoulder. It was determined that he had Avascular Necrosis of the femoral head as well as a tear in his rotator cuff. Since avascular necrosis can have several causes, including over consumption of alcohol, the surgeon told him she didn't think the accident was the cause of the avascular necrosis because he had not dislocated or fractured the hip in the accident. He ended up having a core decompression on his left hip to relieve the pressure. This was followed by surgery to repair the torn rotator cuff. Then in Nov 2006 he ended up having a full hip replacement because the hip had gone arthritic. Our frustration is the doctors insisting that avascular necrosis cannot be caused by a severe trauma unless the bone has been dislocated or fractured. We don't dispute the fact that he probably had avascular necrosis (brought on by alcohol consumption) going on in the bone, but we feel it was exascerbated by the trauma of the accident. He was getting along just fine before the accident and witihin weeks of the accident he started having the unbearable pain in his hip and leg. I would love to know if someone, somewhere has information regarding avascular necrosis becoming symptomatic after blunt trauma.