Presentation
Bilateral hip pain since 3 years.
Patient Data
Scattered areas of serpiginous heterogeneous T1 and T2 signal intensity is seen in anterior superior bilateral femur head with areas of normal intervening marrow. Areas of focal collapse and sclerosis within with relative preservation of femoral head contour.
CT highlights extent of sclerosis and bony destruction.
Case Discussion
Ficat classification helps to determine the stage of avascular necrosis. When bony destruction is accompanied by areas of intervening normal bone with whole process confined to femoral epiphysis, it is highly indicative of avascular necrosis. In this case, the disease has progressed to stage II - III. Involvement of metaphysis bring in other differentials like osteomyelitis.
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