Subchondral insufficiency fracture - left femoral head

Case contributed by Dr Utkarsh Kabra

Presentation

Pain in left hip

Patient Data

Age: 45 years
Gender: Male

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

Mild edema is seen involving the origin of vastus intermedius. Mild joint effusion is seen on the left side. Anterosuperior acetabular labrum appears attenuated with possible small partial
tear.

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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Case information

rID: 80491
Published: 24th Jul 2020
Last edited: 27th Jul 2020
Inclusion in quiz mode: Included

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