hip
Avascular Necrosis of the Femoral Head
intermediate
6 min
28 marks
6 questions
Clinical Scenario
A 38-year-old male presents with a 6-month history of progressive right hip pain. He has a background of systemic lupus erythematosus treated with long-term corticosteroids. He reports groin pain aggravated by weight-bearing and at rest. Examination reveals reduced internal rotation and an antalgic gait.
Radiographs and MRI of the hip are provided.
Radiographs and MRI of the hip are provided.
Clinical image for Avascular Necrosis of the Femoral Head
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (4 marks)
Define avascular necrosis. What is the pathophysiology and what are the risk factors?
Question 2 (5 marks)
Describe the classification systems used for AVN of the femoral head. How do they guide treatment?
Question 3 (6 marks)
What imaging modalities are used to diagnose and stage AVN? Describe the key findings.
Question 4 (5 marks)
What are the treatment options for AVN? Describe the indications for each.
Question 5 (4 marks)
Describe the technique of core decompression. What adjuvant therapies are available?
Question 6 (4 marks)
What is the natural history of untreated AVN? What are the outcomes of joint-preserving surgery?