![]() Several staging systems for osteonecrosis of the hip exist. ![]() T2: may show a second hyperintense inner line between normal marrow and ischemic marrow this appearance is highly specific for osteonecrosis of the hip and is known as the " double-line sign" T1: usually the initial specific findings are areas of low signal intensity representing edema, which can be bordered by a hyperintense line that represents blood products As there is a high rate of bilateral involvement, both hips should be included in the field of view of at least some sequences. MRI is the most sensitive modality, with a sensitivity of 71-100% and specificity of 94-100% 1. Presence of a potentially unstable osteochondral fragment: rim signĬT is often more sensitive than plain film in showing subchondral fractures. Other than describing the general appearance of the affected region, the following are necessary to include in the report as they have a bearing on prognosis and treatment:Įstimating percentage volume of the head involved (axial) and percentage weight-bearing surface involved (coronal)Ĭoexisting osteoarthritis or secondary degenerative change In non-traumatic cases, it is mostly bilateral in 70-80% 10. ![]() Traumatic osteonecrosis is usually unilateral 10. It can be thought of as traumatic (secondary to the neck of femur fractures) or non-traumatic. Typically it affects the superior articular surface (between 10-2 o'clock) and begins in the most anterior part of the hip. However, few patients may remain asymptomatic until the late stages. The most common presenting symptom is pain in the region of the affected hip, thigh, groin, and buttock. Typically affects adults under 50 years of age 12.
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