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Instr Course Lect. 1988;37:51-7.

Early diagnosis of avascular necrosis of the femoral head.


Early diagnosis is important because it leads to early treatment and a better chance of saving the femoral head. The first, and perhaps the most important step, in making an early diagnosis is a heightened clinical awareness of this condition. The physician must be familiar with the nonspecific symptoms, physical findings, and laboratory tests, as well as with the various predisposing factors associated with avascular necrosis. Other causes of hip abnormality or symptoms must be ruled out, as AVN is in part a diagnosis of exclusion. Imaging techniques, which are extremely useful in the early diagnosis of this condition, include good-quality plain radiographs, technetium bone scans, and especially MRI. Technetium bone scans and MRI are quite sensitive, although not entirely specific, and must be used in conjunction with a comprehensive clinical evaluation of the patient.

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