Avascular Necrosis of the Femoral Head
Understanding Avascular Necrosis of the Femoral Head found on Hip Magnetic Resonance Imaging imaging. Learn what this finding means and what steps to take next.
Radiographic Appearance
Magnetic Resonance Imaging FindingSubchondral serpiginous low-signal rim with inner high-signal on T2 (double-line sign); marrow edema early.
Clinical Significance
Progressive collapse risk; early detection guides offloading and surgical planning.
What is AVN?
Bone death from disrupted blood supply, often steroid or alcohol related. MRI is most sensitive early.
Imaging Appearance
- Double-line sign on T2
- Subchondral crescent indicates impending collapse
- Marrow edema in symptomatic phases
Clinical Significance
- Predicts structural collapse; hip preservation possible if caught early
- Guides need for core decompression vs arthroplasty
Symptoms
- Groin or buttock pain, worse with weight bearing
Diagnosis
- MRI hip without contrast
- Consider bilateral imaging (often bilateral)
Treatment
- Offload, bisphosphonates (evidence mixed)
- Core decompression, osteotomy, or arthroplasty depending on stage
Prognosis
- Early-stage managed better; collapse leads to arthritis
What Should You Do?
- Limit weight-bearing per orthopedic advice.
- Address risk factors (steroids, alcohol).
- Follow imaging surveillance for stage progression.
Medical Disclaimer: Educational only; follow orthopedic guidance.
Correlate with Lab Results
Doctors often check these blood tests when Avascular Necrosis of the Femoral Head is found on imaging:
Related Imaging Terms
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