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Avascular necrosis of the hip classification

The Ficat classification is used for AVN of the hip. and uses a combination on pain film, MRI and clinical features 

  • stage 0
    • plain film : normal
    • MRI : normal
    • clinical symptoms : nil
  • stage I
    • plain film : normal or minor osteopaenia
    • MRI : oedema
    • bone scan: increased uptake
    • clinical symptoms: pain typically in the groin
  • stage II
    • plain film : mixed osteopenia &/or sclerosis &/or subchondral cysts, without any subchondral lucency (crescent sign - see below)
    • MRI : geographic defect
    • bone scan : increased uptake
    • clinical symptoms: pain and stiffness
  • stage III
    • plain film : crescent sign & eventual cortical collapse
    • MRI : same as plain film
    • clinical symptoms : pain and stiffness+/- radiation to knee and limp
  • stage IV
    • plain film : end stage with evidence of secondary degenerative change
    • MRI : same as plain film
    • clinical symptoms : pain and limp

See also

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