Femoral head avascular necrosis

Case contributed by Dr Henry Knipe

Presentation

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Patient Data

Age: 40 years
Gender: Male
Modality: X-ray

Flattening and sclerosis of the right femoral head, consistent with advanced avascular necrosis. 

Modality: MRI

RIGHT

Flattening and collapse of the right femoral head particularly anteriorly with low T1 signal in the femoral head epiphysis and adjacent serpiginous high T2FS signal. Oedema extends throughout the femoral neck to the intertrochanteric region. Diffuse full-thickness chondral loss posterior joint space with irregular chondral loss anteriorly. Second area of acetabular/coverage and degenerative labral tearing anterior and superior labrum. Small hip joint effusion and iliopsoas bursa effusion.

LEFT

Femoral head has a normal appearance with no marrow signal change or evidence of avascular necrosis. No joint space narrowing or chondromalacia. No hip joint effusion.

Case Discussion

Classic changes of severe right femoral head avascular necrosis (AVN) with evidence of secondary degenerative change. The left femoral head is completely normal with no evidence of AVN. This patient had been treated with high-dose steroids (one of the most common causes) after a bone marrow transplant. 

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Case Information

rID: 44260
Case created: 13th Apr 2016
Last edited: 16th Apr 2016
Inclusion in quiz mode: Included

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