ROLE OF MRI IN ASSESSMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

Abstract

Avascular necrosis (AVN) of the femoral head is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Although patients are initially asymptomatic, avascular necrosis of the femoral head usually progresses to joint destruction, requiring total hip replacement (THR), usually before the fifth decade. In fact, 50% of patients with avascular necrosis experience severe joint destruction as a result of deterioration and undergo a major surgical procedure for treatment within 3 years of diagnosis. Femoral head collapse usually occurs within 2 years after development of hip pain. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and a traumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear.