This 58-year-old renal transplant patient complained of a painful right hip following ‘doing the splits’ several weeks ago. He was noted to be on steroids. An MRI was performed to exclude musculotendinous injury or AVN.
Coronal T1 of both hips
Coronal T2 SPIR of right hip
The MRI images show geographical abnormal signal intensity in the head of the right femur, predominantly anteriorly, associated with a subchondral fracture and flattening of the femoral head anteriorly. There is also a small joint effusion but no loose body is demonstrated. These appearances are characterisitic of avascular necrosis with involvement of about 60% of the femoral head.
MRI is the investigation of choice for the early diagnosis and staging of avascular necrosis, before appropriate treatment planning.Dr Craig Dyer
media@nrdgp.org.au
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