Magnetic Resonance Imaging in Evaluation of Avascular Necrosis of Femoral Head

Jyoti Choudhary; Amol Dubepuria; Lovely Kaushal; Pooja Rajput

Jyoti Choudhary Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India
Amol Dubepuria Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India
Lovely Kaushal Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India
Pooja Rajput Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India

Keywords: Avascular necrosis, Hip, Magnetic resonance imaging

Abstract

Introduction: Avascular necrosis (AVN) of the femoral head is one of the common causes of pain and disability of hip. Impaired blood supply and increased intraosseous pressure are predominantly responsible for the necrotic process, which eventually results in collapse of the femoral head. Magnetic resonance imaging (MRI) is the preferred investigation for the evaluation of AVN.
Aims and Objectives: This study aims to assess the role of MRI in the evaluation of clinically suspected cases of AVN of hip and to describe the imaging features along with proper staging.
Materials and Methods: In this prospective study, 100 patients of all age groups with clinically suspected cases of AVN of femoral head were evaluated by MRI hip in the Department of Radiodiagnosis, Gandhi Medical College and Hamidia Hospital over a period of 1 year. Detailed history and associated risk factors were asked from all patients. MRI hip was then performed on 1.5 Tesla Hitachi ECHELON SMART - 523 MRI machine using the required protocol and sequences. The imaging findings were studied and proper staging was given.
Results: In our study of 100 cases of AVN, 132 femoral heads were involved (unilateral 68 and bilateral 32 cases). The most common risk factor associated was alcohol consumption. The most common quadrant of femoral head affected was anterosuperior (49.3%). The most common stage of AVN was found to be Grade III – 39.4% (Ficat and Arlet classification), Type C – 47% (Mitchell’s classification), and Stage IIIC – 37.8% (Steinberg classification). MRI could detect early AVN in 50 femoral heads, in which radiographs were normal.
Conclusion: This study concludes that MRI is the modality of choice for diagnosing and staging AVN. Early diagnosis and appropriate treatment is associated with better outcome.

Author Biographies

Jyoti Choudhary, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India

Senior Resident, Department of Radiodiagnosis,

Amol Dubepuria, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India

Senior Resident, Department of Radiodiagnosis,

Lovely Kaushal, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India

Professor and Head, Department of Radiodiagnosis,

Pooja Rajput, Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India

Resident Doctor, Department of Radiodiagnosis,

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