CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 24 Avascular Necrosis of the
Hip or Other Joints

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig B 24-1 Sickle cell disease. Avascular necrosis of the femoral
head, with mottled areas of increased and decreased density
reflecting osteonecrosis without collapse. The trabeculae in the
neck and intertrochanteric region are thickened by apposition of
new bone. A solid layer of new bone has been laid down in
continuity with the inner aspect of the cortex of the femoral shaft,
with consequent narrowing of the medullary canal.30

4. • Fig B 24-2 Steroid therapy. Avascular necrosis
of the head of the humerus in a transplant
recipient.

5. • Fig B 24-3 Legg-Calvé-Perthes disease.
Flattening of the femoral capital epiphyses
along with fragmentation and sclerosis.

6. • Fig B 24-4 Legg-Calvé-Perthes disease. In a
teenager with chronic disease, there is severe
flattening of the right femoral head with
virtually complete failure of the ipsilateral
femoral neck to grow. This led to shortening of
the leg and a clinically obvious limp.

7. • Fig B 24-5 Gaucher's disease. Bilateral
avascular necrosis of the femoral heads.

8. • Fig B 24-6 Radiation therapy. After radiation
therapy for carcinoma of the cervix, there has
been flattening and sclerosis of the left femoral
head (reflecting avascular necrosis) and patchy
areas of dense sclerosis in the pelvis.

9. • Fig B 24-7 Osteochondrial defect. (A) Knee. (B)
Ankle.