Osteonecrosis of the femoral head: Etiology, imaging and treatment
Abstract
Osteonecrosis of the femoral head is a disabling clinical entity affecting young adults that usually leads to destruction of the hip joint. A high index of suspicion is necessary for the diagnosis due to the insidious onset of the bone infarcts and the lack of specific clinical signs at the early stages. Many etiology-associated factors have been identified reducing thus the number of idiopathic cases. A number of joint salvaging treatment options are available if early diagnosis can be achieved. MR imaging has been proved to be a highly accurate method both for early diagnosis and for staging of the disease. Replacement of the hip joint is the last resort for pain relief and function, although non-desirable because of the young age of the affected population.
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Avascular necrosis of the femoral head is visible in preoperative MRI but hardly detectable intraoperatively; radiographs have low sensitivity for early-stage AVN, while MRI is sensitive to necrotic tissues but hard to acquire intraoperatively.
“A clear example of a lesion that is visible in preoperative MRI but hardly detectable intraoperatively is avascular necrosis (AVN).”
From Towards 2D/3D Registration of the Preoperative MRI to Intraoperative Fluoroscopic Images for Visualisation of Bone Defects (2023) · cites this paper as Malizos et al. 2007
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Arseni, L., Lombardi, A., & Orioli, D. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19051407 · Cited by 186 · see citing works
“Nearly half of patients require hip replacement before 40 years of age [114].”
BackgroundKu, P.-C., Martin-Gomez, A., Gao, C., Grupp, R., Mears, S. C., & Armand, M. (2023) · Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization · doi:10.1080/21681163.2022.2152375 · Cited by 8 · see citing works
“However, studies have shown that radiographs exhibit low sensitivity for the early stages of AVN; while MRI scans are particularly sensitive to the detection of necrotic tissues, MRI scans are hard to acquire intraoperatively (Malizos et al. 2007).”
Background
- Authors
- Malizos, K. N., Karantanas, A. H., Varitimidis, S. E., Dailiana, Z. H., Bargiotas, K., & Maris, T.
- Affiliations
- University of Crete (GR)
- University of Thessaly (GR)
- Venue
- European Journal of Radiology
- Publisher
- Elsevier BV
- Published
- 2007-07
- Volume
- 63
- Issue
- 1
- Pages
- 16-28
- ISSN
- 0720-048X (ISSN-L)
- OpenAlex
- W2124197262
- Cited by
- 316
- References
- 0
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 18 · 2023: 19 · 2022: 24 · 2021: 21 · 2020: 15 · 2019: 18 · 2018: 19 · 2017: 22 · 2016: 13 · 2015: 30 · 2014: 26 · 2013: 15 · 2012: 10
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Radiology (publishedVersion)
- PubMed (publishedVersion)
- University of Thessaly Institutional Repository (University of Thessaly) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone and Joint Diseases
- Health Sciences › Medicine › Surgery › Hip disorders and treatments
- Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
- Keywords
- osteonecrosis of the femoral head, etiology, magnetic resonance imaging, early diagnosis, disease staging, total hip arthroplasty, bone infarction, young adults
- MeSH terms
- Adult, Female, Femur Head, Femur Head Necrosis, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prognosis, Radiography, Radionuclide Imaging, Risk Factors, Disease Progression
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