Hip avascular necrosis - bilateral

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Right hip pain ?osteoarthritis

Patient Data

Age: 50 years
Gender: Male

Sclerosis and lucency of both femoral heads with right-sided collapse. Joint space narrowing of the right hip but not the left. 

Established avascular necrosis of the right femoral head with marked collapse. Secondary degenerative change of the superior acetabulum with subcortical marrow edema present. There is a large right hip joint effusion with synovial thickening and internal debris.

There is also avascular necrosis of the left femoral head without collapse characterized by serpiginous high T2/low T1 hypointensity within the femoral head.

Case Discussion

Typical plain x-ray and MRI features of femoral head AVN with secondary osteoarthritis of the right hip. The cause of AVN, in this case, is not known.

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