Role of Magnetic Resonance Imaging in ClinicallyorRadiographically Suspected Patients of Avascular Necrosis of Femoral Head

Abstract

Background- Present study was conducted to diagnose AVN (avascular necrosis) in patients presenting with complaint of pain hip joint pain and to study role of MRI in patients who are clinically or radiographically suspected cases of avascular necrosis of femoral head. Methodology- This cross-sectional study was conducted on patients referred to the Radio-Diagnosis department with suspicion of AVN. X-ray and MRI hip was done and modified Ficat and Arlet classification was used for staging. Results- About 50 patients had AVN, of which 32 had AVN unilaterally and 32 bilaterally. Out of 29 patients who were at stage 0 in X ray (normal plain radiograph), 3 patients were found be at stage 1, 25 patients were found to be at stage II and 1 patient was diagnosed with stage III AVN on MRI. Out of 37 patients with stage 3 AVN on X ray, MRI was also able to confirm stage III in all the 37 patients with additional 3 patients and 1 patient, who were at stage 2 and stage 1 in X ray respectively. Similarly, out of 9 patients diagnosed with stage 4, all were confirmed in stage IV in MRI. Conclusions- As compared to X- ray, MRI has an advantage in terms of being non- invasive, radiation free and ability for detection of earliest changes of femoral head AVN. Majority of patients were diagnosed with early AVN changes where plain radiographs were normal and unable to show any significant changes.