What typical radiographic features you see ?
-mixed osteopenia and/or sclerosis and/or subchondral cysts, -subchondral lucency -no flatenning
What classification systems exist for AVN ?
-FICAT classification -Mitchell staging -Steinberg staging
Name common risk factors for AVN ?
S: steroids, SLE T: trauma (e.g. femoral neck fracture, hip dislocation, scaphoid fracture, slipped capital femoral epiphysis ) A: alcohol excess (chronic) R: radiation, rheumatoid arthritis, renal failure S: sickle cell disease
There is large geographic marrow abnormality in antero-superior aspect of femoral head on both sides which appear iso to hypointense on T1, hypointense on T2 and showing subtle loss of signal on T1 FAT SAT images. This is surrounded by hypo-intense rim on T1 & T2W images. There is linear subchondral fracture / fissuring in both femoral heads well appreciated on FAT SAT images. Slight contour deformity with mild collapse/flattening is present bilaterally. These findings are representing bilateral avascular necrosis of the hip. This is categorized as stage D according to mitchells classification.
There are mild secondary degenerative changes at right hip joint with small osteophyte is noted along lateral edge of right acetabulum.
Mild to moderate volume effusion is present in both hip joints.
No dislocation is evident.
Imaged both sacro-iliac joints and symphysis pubis appear normal.
Visualized pelvic viscera and bowel loops are normal.
Small volume free fluid is present in the pelvic peritoneal cavity. Diffuse soft tissue edema is present in anterior abdominal wall as well as in the soft tissues of the pelvis and thigh. Diffuse scrotal wall edema is also appreciated. These findings are due to already diagnosed chronic kidney disease.