Avascular necrosis: bilateral hips

Case contributed by Haytham Mohamed Assayed Bedier

Presentation

Bilateral hip pain, more on the right side. History of chronic low back pain, previous back operation 4 months ago, and long-term steroid medication.

Patient Data

Age: 45 years
Gender: Male

Irregular abnormal signal intensities are seen in both femoral heads, which display hypointense signal intensity on T1WI and hyperintense signal intensity on T2 and STIR WI. A hyperintense line is seen in the right femoral head between the ischemic and normal bone marrow. A subchondral bone cyst and cortical irregularities are seen in the left femoral head superiorly

Case Discussion

MRI findings are consistent with avascular necrosis of both femoral heads with a stage III of the right side and stage II of the left side.

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