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Orthopaedic Clinic

Avascular necrosis of femoral head 2
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Clinical Features:
 
Pain in the groin, ocassionaly in buttock or knees: deep throbbing, intermittent with insidious onset.
 
Pain and restriction of hip range of movement.
 
Differential rotation: due to sectorial involvement:Greater restriction of internal rotation with flexion of the hip.
 
Classification:
 
FICAT AND ARLET:
 
Stage I : Normal X rays, abnormal bone scan, and/or MRI findings.
 
Stage IIa: Cystic and sclerotic changes in the femoral head.
 
Stage IIb: Subchondral collapse(crescent sign) without flattening.
 
Stage III: Femoral head flattening.
 
Stage IV: Joint narrowing and secondary arthritic changes.
 
 
Other classification systems:
 
Radiographic classification of Marcus and Enneking.
 
Steinbergs Classiffication.
 
International classification.
 
MRI classification by Sugano et al.
 
 
 

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