Role of MRI in the diagnosis of the femoral head AVN

What is the role of MRI in the diagnosis of the femoral head AVN?

MRI is the most sensitive imaging modality for detection of AVN in the early stages, allowing initiation of therapy before the onset of femoral head collapse. Delayed diagnosis and treatment can result in subchondral fracture with collapse of the femoral head, in turn leading to cartilage damage, osteoarthritis, and joint destruction, eventually necessitating arthroplasty. Another use of MRI is assessment of the percentage of bone marrow involvement and evaluation of temporal changes, which can help select appropriate therapy and determine response to treatment. Patients with clinical risk factors for AVN and negative radiographs, who present with classic symptoms of deep throbbing hip, groin, or gluteal pain exacerbated by activity, should undergo MRI.

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