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Blood dyscrasias cause ONFH by intravascular occlusion. ONFH frequently occurs in sickle cell disease, in which the pathologic sickled erythrocytes obstruct the vessels to the femoral head. Data from Hernigou and colleagues suggest a more rapid clinical progression of ONFH from sickle cell disease compared with other nontraumatic causes. Patients with polycythemia vera, a myeloproliferative neoplasm causing erythrocytosis, are at risk for ONFH due to thrombosis. Hemophilia (a bleeding disorder caused by a lack of clotting factors) has been reported to cause ONFH via intravascular occlusion from recurrent intraosseous hemorrhage. Finally, genetic defects leading to hypercoagulable states (factor V Leiden mutation, protein C or S deficiency, increased von Willebrand factor, and increased lipoprotein levels) are hypothesized to cause ONFH from intravascular thrombosis.