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OrthoVellum

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Adult Reconstruction
intermediate
X-Type

Avascular Necrosis of the Femoral Head

Hip Pathology

A 38-year-old man on chronic corticosteroids for inflammatory bowel disease presents with progressive bilateral groin pain over 4 months. Pain is worse with activity. Radiographs show subtle sclerosis of the right femoral head without collapse. MRI shows bilateral femoral head osteonecrosis with the left side showing a small area of necrosis not extending to the subchondral bone. Regarding avascular necrosis (AVN) of the femoral head:

Mark each as TRUE or FALSE

A

AVN results from disruption of blood supply to the femoral head leading to bone death; risk factors ...

B

The pathophysiology involves ischemia followed by necrosis of bone and marrow, then repair with cree...

C

Plain radiographs are the most sensitive test for early AVN; MRI has no role in diagnosis; the Ficat...

D

MRI is the gold standard for early diagnosis (sensitivity greater than 99%); findings include the "d...

E

Treatment depends on stage: pre-collapse disease may be treated with core decompression (with or wit...

Answer the questions to see explanations

Click T (True) or F (False) for each option