Presentation
Left hip pain
Patient Data
Unremarkable pelvic radiograph for a patient of this age
There is generalized loss of volume of the left femoral head, which is positioned abnormally within the superior acetabulum, resulting in erosion of the latter structure.
There is now complete necrosis of the femoral head, with the remaining femoral neck positioned abnormally within the superior acetabulum, resulting in erosion and sclerosis of both structures.
This series of hip radiographs demonstrates progressive and rapid loss of volume of the left femoral head without clear underlying pathology, in keeping with avascular necrosis.
Case Discussion
Avascular necrosis of the femoral head can occur at any age with risk factors including corticosteroid treatment, alcohol excess, obesity, scuba diving and sickle cell disease.
Insufficiency fractures within the subchondral bone disrupt the blood supply, become more progressive and result in eventual collapse of the articular surface.
Early signs on plain radiographs may include reduced bone density and the 'crescent sign' of subchondral lucency, with later radiographs demonstrating more conspicuous collapse of the bony cortex.
Unable to process the form. Check for errors and try again.