Via practica 3–4/2013

Avascular necrosis of femoral head

The aim of the article is to bring an actual view-point on the avascular necrosis of the femoral head to a broader scientific community. The authors focus in the article on presentation of current procedures in diagnostics, prevention and treatment of the disease. Avascular necrosis (osteonecrosis aseptic bone necrosis etc.) is defined as cellular death of bone elements due to blood supply impairment. This leads to bone destruction and collapse, resulting in pain and limitation of joint function. Aetiology of avascular necrosis is multifactorial. It occurs nearly always in the region of long bone epiphysis. Most commonly it is located in the head of femur, humerus and in femoral condyles. Small bones of tarsus and carpus are often involved. Multilocular appearance is not uncommon. Symmetrical impairment like in case of avascular necrosis of femoral head is often seen. In the case of unilateral femoral head avascular necrosis the disease on the contralateral side must be excluded. MR imaging is ideal diagnostic tool for diagnosis and follow up of the disease. Avascular necrosis appears most often in the femoral head. The severity of the disease, due to functional impairment of the hip, pain and usually progression of the lesion results in spite of adequate conservative therapy or joint preserving procedure inevitably in to joint destruction and physical disability. Early referral of a patient to a specialist (orthopaedic surgeon, rheumatologist) enables timely diagnosis and treatment of the disease.

Keywords: avascular bone necrosis, bone necrosis, femoral head, magnetic resonance, MRI.