Avascular Necrosis of the Femoral Head. Imaging Evaluation by Magnetic Resonance Imaging : A Retrospective Study in The Kurdistan Region of Iraq

Saeed, Maysaloon Shaman

doi:10.52573/ipmj.2025.157642

	Avascular Necrosis of the Femoral Head. Imaging Evaluation by Magnetic Resonance Imaging : A Retrospective Study in The Kurdistan Region of Iraq
Iraqi Postgraduate Medical Journal
Article 15, Volume 24, Issue 1, January 2025, Pages 105-113 PDF (703.05 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2025.157642
Author
Maysaloon Shaman Saeed^*
FIBMS, PHD, Consultant Radiologist
Abstract
Background: Avascular necrosis of the femoral head is a frequent cause of musculoskeletal disability. Its preoperative staging is of utmost importance in determining the appropriate treatment option. Patients and Methods: In this retrospective cross-sectional study, data were collected from one hundred patients of various ages ,conducted from May 2022 to November 2023 to those patients who were referred and diagnosed with avascular necrosis from specialized orthopedics at specialized hospitals in Duhok city, magnetic resonance imaging study with different sequences suitable to the hip region has been undergone .Data included information about the demographic distribution of the patients and the prevalence of avascular necrosis in addition to imaging staging of avascular necrosis of the femoral heads, following the Ficat - Arlet and Mitchell classifications. Results: The age group most affected by the disease is between 20 and 40 years, accounting for 56% of the cases. Males show a statistically significant higher prevalence than females, making up 86% of the total number. Bilateral involvement is more common than unilateral involvement, accounting for 62% compared to 38%. Trauma shows significant correlation as the most common risk factor for the disease, accounting for 51% of cases. Bone marrow edema shows statistically significant values as the most commonly found symptom, accounting for 91% of cases. Stage II is the most common stage among individuals under the age of 20. Stage III is the most common among individuals aged 21-40. Stage IV is the most prevalent in the age group of 41-60 (Ficat and Arlet). Class D shows the most common values, accounting for 37% of cases, followed by Class C at 34% (Mitchell). Conclusions: MRI is indispensable for the early and accurate detection and staging of AVN, which facilitates a better response to treatment.
Keywords
Avascular necrosis; Femoral head; Magnetic Resonance Imaging; Staging

References
Tiemey Jr. LM, McPhee. Papadakis MA .Current Medical diagnosis and treatment .36^th Stamfoord.Appleton&Lange 1997;789-99 Kamal D, Traistaru R, Alexandru D, Grecu D, Moganta L. Epidemiologic Study of Avascular necrosis of The Femoral Head. Current health science journal 2013;39(3):169-74 Ficat RP,Arlet J.Necrosis of the femoral head .In :Hungerford DS,ed.Ischemia and Necrosis of Bone.Lipponcott Williams&Wilkins;1980:171 Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br. 1995;77(1):34-41. Gehlot PS, Agrawal K, Mangal R, Sodani V.Avascular Necrosis of Femoral Head: A Retrospective Study of MRI Scans.J Clin of Diagn Res.2019; 13(10):TC04-TC06. https://www.doi.org/10.7860/JCDR/2019/40929/13251 Mitchell DG, Rao V, Dalinka M, et al. MRI of joint fluid in the normal and ischemic hip. AJR Am J Roentgenol. 1986;146(6):1215-1218. doi:10.2214/ajr.146.6.1215 Choudhary J, Dubepuria A, Kaushal L, Rajput P. Magnetic Resonance Imaging in Evaluation of Avascular Necrosis of Femoral Head. Int J Sci Stud 2019;7(7):50-55. Chougule SR. The role of magnetic resonance imaging in non-traumatic chronic hip joint pain in adult rural population. Int J Res Med Sci 2022;10:2821-5. Khaladkar M S, Randhawa S, Singh G, Aditi G, Rajesh K, Rajeshwar S. Rapid magnetic resonance imaging protocol for detecting femoral head avascular necrosis: A case series-it's utility in the general population in developing countries. Med J DY Patil Univ 2015;8:189-95 Gehlot PS, Agrawal K, Mangal R, Sodani V.Avascular Necrosis of Femoral Head: A Retrospective Study of MRI Scans.J Clin of Diagn Res.2019; 13(10):TC04-TC06. https://www.doi.org/10.7860/JCDR/2019/40929/13251 Rangareddy S, Kumar P. Femoral Head Avascular Necrosis: Correlation of Clinical Findings, Radiographic Staging and Magnetic Resonance Imaging 2016; J. App. Med. Sci.; 4(11C):4064-69 Saleem M, Dahiphale D, Apte A. Role of MRI in Evaluation of Avascular Necrosis of Femoral Head: A Prospective Study .JMSCR 2019;7 (4):480-89 D, Triastaru R, Alexandro D,Grecu D.Mogonata L. Epidemiologic Study of Avascular Necrosis of the Femoral Head. Current Health Scie. Jour.2013; 39( 3):169-74 Rashmi U Turamari, Prashant B Channaveerappanavar, Arjun Prakash, Naveen Jayaram, Chandrashekar H M, Apoorva Muralidhar. Role of MRI in the diagnosis of hip joint pain. International Journal of Contemporary Medicine Surgery and Radiology. 2019;4(4):D35-D38. Väänänen M, Tervonen O, Nevalainen MT. Magnetic resonance imaging of avascular necrosis of the femoral head: predictive findings of total hip arthroplasty. Acta Radiol Open. 2021;10(4):20584601211008379. Published 2021 Apr 27. doi:10.1177/20584601211008379. Akshit Gakhar, Sanjay Sethi, Ranjana Gupta, Puneet Mittal, Kunal Singh Ahluwalia, Dharna Sharma. Role of plain radiograph and MRI in the evaluation of painful hip joint. International Journal of Contemporary Medicine Surgery and Radiology. 2021;6(1):A59-A63. Sarker S, Yesmin L, PervinR, Farzana MN, Huda N,Yasmin MS, Islam I. Avascular Necrosis of the Femoral Head: A Retro-spective Study of MRI Scan in A Orthopedic Hospital. Sir Salimullah Med Coll J 2022;30: 180-185 https://www.researchgate.net/publication/364590952 Vaghamashi A, Bhatt J, Doshi J, Patel V. MRI in Evaluation of painful Hip Joint. 2017;16(5):85-96 Goyal, S., Desai, P. , Ambadekar, D., & Singh, S. . (2016). CORRELATION BETWEEN FICAT-ARLET AND MITCHELL’S STAGING FOR AVASCULAR NECROSIS OF FEMUR HEAD. National Journal of Medical Research, 6(04), 301–304. Retrieved from https://njmr.in/index.php/file/article/view/217
Statistics Article View: 305 PDF Download: 156