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Subchondral insufficiency fracture - femoral head

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Pain in left hip

Patient Data

Age: 40 years
Gender: Male

Marrow edema involving head of left femur with subchondral flattening, irregularity of anterosuperior aspects. Subtle subchondral irregular, linear hypointensity seen parallel to articular surface.
Marrow edema is extending to neck.

Case Discussion

Findings are suggestive of subchondral insufficiency fracture of the left femoral head. It needs to be differentiated from avascular necrosis, wherein a double line is seen which is convex to the articular surface as opposed to insufficiency fracture which is parallel to the articular surface.

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