Can avascular necrosis be seen on CT scan?
CT scans are insensitive for detecting stage 0 and 1 AVN, but are excellent for detecting femoral head collapse, early degenerative joint disease (DJD), and the presence of loose bodies.
What is the best imaging for avascular necrosis?
MRI is the most sensitive and specific imaging procedure for AVN, of the hip with an overall sensitivity that exceeds 90%. The specificity of MRI is also very high. The use of gadolinium is particularly useful in early detection.
How is avascular necrosis of the femoral head diagnosed?
Diagnosis is made by pairing the clinical presentation with appropriate imaging. Imaging can include x-rays, radionuclide bone scanning, and magnetic resonance imaging (MRI). The use of imaging in the context of the patient’s symptoms can help guide appropriate treatment.
What is avascular necrosis of femoral head?
Avascular necrosis (AVN) of the femoral head is a pathologic process that results from interruption of blood supply to the bone. AVN of the hip is poorly understood, but this process is the final common pathway of traumatic or nontraumatic factors that compromise the already precarious circulation of the femoral head.
What type of CT is avascular?
Cartilage
Connective tissues can have various levels of vascularity. Cartilage is avascular, while dense connective tissue is poorly vascularized.
Do you need contrast for AVN?
If radiographs are normal or show femoral head lucencies suspicious for osteonecrosis, magnetic resonance imaging (MRI) of the hips without contrast is most appropriate.
How does AVN clinically present?
Pain in the affected joint is typically the presenting symptom of AVN, regardless of the location. Patients with AVN of the femoral head often report groin or anterior thigh pain that is exacerbated by weight bearing.
Does avascular necrosis need contrast?
What is the difference between vascular and avascular tissue?
Vascular tissue refers to tissue that contains blood vessels while avascular tissue refers to the tissue that does not contain blood vessels. Hence, this is the main difference between vascular and avascular tissue.
Does AVN pain come and go?
Symptoms usually begin slowly. In fact in the earliest stage there are usually no symptoms at all. Other people may notice that you are limping before you feel any pain. Once symptoms begin they come and go.
Does AVN cause muscle pain?
It usually develops gradually. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock. Besides the hip, the shoulder, knee, hand and foot can be affected. Some people develop avascular necrosis on both sides, such as in both hips or in both knees.
How is avascular necrosis of the femoral head treated?
In early stages of AVN (precollapse), core decompression with or without bone graft is typically considered the most appropriate treatment. In late stages, characterized by collapse, femoral head deformity, and secondary osteoarthritis, total hip arthroplasty is the most appropriate treatment.
Can you see AVN on xray?
X-rays. They can reveal bone changes that occur in the later stages of avascular necrosis. In the condition’s early stages, X-rays usually don’t show any problems. MRI and CT scan.
Which of the four main tissue types is avascular?
Epithelial tissue is a highly cellular tissue that overlies body surfaces, lines cavities, and forms glands. It is avascular but innervated.
What tissue is always avascular?
Whereas most tissues in the body are vascular (contain blood vessels), epithelium is avascular (a-vas′ku-lar), meaning it lacks blood vessels. Epithelial cells receive their nutrients from capillaries in the underlying connective tissue.
How do you increase blood flow to the femoral head?
- The simplest operation is to drill one or several holes through the femoral neck and into the femoral head, trying to reach the area that lacks blood supply.
- A more complicated procedure to try to increase the blood supply to the femoral head is a vascularized fibular bone graft procedure.
Can plain film detect avascular necrosis of the femoral head?
Introduction Avascular necrosis of the femoral head (AVN) is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Using plain film, the sensitivity for detecting early stages of the disease is as low as 41% [3].
What is the prevalence of femur head avascular necrosis?
Keywords: osteonecrosis, femur head necrosis, diagnostic imaging, disease management Background Femoral head avascular necrosis is a common disease of the hip joint with an incidence of 10,000–20,000 new cases in the United States (1). Though most of patients are asymptomatic the prevalence is supposed to be markedly higher.
What are the signs and symptoms of avascular necrosis of the femur?
The most commonly affected site is the femoral head and patients usually present with hip and referred knee pain. Early detection of avascular necrosis of the femoral head allows conservative treatment to be effective, with alleviation of pain and preservation of normal joint function.
Is the diagnosis of femoral head necrosis improving?
Over the past years, the diagnosis of femoral head necrosis has experienced tremendous improvement due to the use of MRI and CT scans. Because of these improvements the correct stage can be diagnosed early and the appropriate therapy can be initiated immediately.