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Basic Science
intermediate
X-Type

Osteonecrosis and Avascular Necrosis

Bone Pathology

A 38-year-old man presents with a 4-month history of progressive right groin pain. He has a history of systemic lupus erythematosus treated with high-dose corticosteroids. The pain is worse with activity and he has developed a limp. Examination shows decreased internal rotation of the right hip with pain at the end range. Radiographs appear normal. MRI shows a serpiginous line in the femoral head with marrow edema. Regarding osteonecrosis (avascular necrosis):

Mark each as TRUE or FALSE

A

Osteonecrosis results from disruption of blood supply to bone, leading to cell death; the femoral he...

B

The pathophysiology involves ischemia leading to osteocyte death within hours, followed by a repair ...

C

Radiographs are the most sensitive early imaging modality; osteonecrosis primarily affects the media...

D

The Ficat classification stages osteonecrosis: Stage 0 (preclinical, MRI positive), Stage I (pre-rad...

E

Treatment depends on stage and lesion size: non-operative management (protected weight-bearing, bisp...

Answer the questions to see explanations

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