Case Studies: MRI
Hip - Bilateral Avascular Necrosis
- A 39-year-old man presented for MRI of his hips, having received a clinical diagnosis of avascular necrosis (AVN) as a result of steroid abuse
- Imaging was performed in all three planes, utilising a combination of T1- and T2-weighted sequences with and without fat suppression
- The examination demonstrated a moderate right-sided effusion, and extensive signal changes consistent with AVN in both femoral heads
- The changes in the right femoral head are well marginated, consistent with a Mitchell type-B change
- In the left, the changes are more irregular and some slight loss of the normal contour of the femoral head is seen, consistent with a Mitchell type-C change
- There is also a focus of low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, seen in the supero-lateral acetabular margin of the left hip, which is suspected to be a subchondral cyst within an area of subchondral sclerosis
- Cartilage is generally well preserved, and the soft-tissue pelvic contents are within normal limits.
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