Role of routine and limited MRI imaging in diagnosis and screening of femoral head AVN



Case Type

Clinical Cases


Madhuri Ghate, Rashmi Kotkar, Geetanjali Kadam
Krsna Diagnostics PVT LTD; Pawana Nagar Housing Society 411033 Chinchwad, India;


2 months, male


Area of InterestNeuroradiology brain ; Imaging Technique MR
Procedure Education ; Special Focus Seizure disorders ;


Explain the pathophysiology of AVN. Classifying AVN based on MR imaging findings. Use of limited MRI imaging in screening as well as in early detection of AVN.


Avascular necrosis (AVN) or osteonecrosis of the femoral head occurs due to compromise in vascular supply. Early diagnosis is of utmost importance as delay in diagnosis increases cost of treatment and morbidity.MRI is the sensitive imaging tool for detection of AVN. Our review will focus on imaging findings, classification and use of limited sequences for screening and early diagnosis of AVN.


30 patients who were suspected clinically or radiographically of having AVN of femur were studied using both limited and routine protocol for MRI HIP on 1.5T magnet. Total of 44 hip joints were diagnosed as having AVN. Routine imaging protocol included T1-weighted image (T1WI), T2WI, STIR sequences in the coronal plane, T2WI sequence in the sagittal plane and T1WI and T2WI sequences in the axial plane. Limited protocol included only coronal T1 weighted images. Detailed imaging findings were described and the patients were classified into Class A,B,C,D based on MRI signal characteristics at the center of ischemia. AVN was diagnosed on T1WI as low signal intensity peripheral rim in 95.5% of patients. Double line sign on T2WI which is specific for AVN was found in 54.5% of the patients.


MRI is a sensitive imaging tool for early detection and follow up of AVN. Limited MRI protocol using coronal T1W sequence can be used for screening and early detection which is cost effective and saves time.
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