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Necrotic bone and inflammation histology slide. The current etiology or origin of this disease is unknown. Some studies theorized that bone remodeling is maintained in a microenvironment in the FH meaning that there is a greater local component to changes to the femoral head than the normal systemic way that bone remodeling is handled throughout the body.
The primary aim of surgery is to correct the fit of the femoral head and acetabulum to create a hip socket that reduces contact between the two, allowing a greater range of movement. [30] This includes femoral head sculpting and/or trimming of the acetabular rim. [30] [31] Surgery may be arthroscopic or open. [7]
Staging according to Ficat classification ranges between normal appearance (stage I), slight increased density in the femoral head (stage II), subchondral collapse of the femoral head with or without “crescent” sign (stage III), and advanced collapse with secondary osteoarthritis (stage IV).
The goals of treatment are to decrease pain, reduce the loss of hip motion, and prevent or minimize permanent femoral head deformity so that the risk of developing a severe degenerative arthritis as an adult can be reduced. [12] Assessment by a pediatric orthopaedic surgeon is recommended to evaluate risks and treatment options.
Femoral head showing a flap of cartilage due to avascular necrosis (osteochondritis dissecans). Specimen removed during total hip replacement surgery. Specialty: Orthopedics: Symptoms: Joint pain, decreased ability to move [1] Complications: Osteoarthritis [1] Usual onset: Gradual [1] Risk factors: Bone fractures, joint dislocations, high dose ...
In radiology, the crescent sign is a finding on conventional radiographs that is associated with avascular necrosis. [1] [2] [3] It usually occurs later in the disease, in stage III of the four-stage Ficat classification system. [1] It appears as a curved subchondral radiolucent line that is often found on the proximal femoral or humeral head. [1]
The superior-lateral coverage of the femoral head. >20° (<55 years old) [notes 2] <24° (>55 years old) [notes 2] >40° indicates overcoverage; Reimer's migration index [9] The percentage of the femoral head that lies outside of the acetabular roof. It is also called the femoral extrusion index. <25% Tönnis angle
Radiographic systems to classify osteoarthritis vary by which joint is being investigated. In osteoarthritis , the choice of treatment is based on pain and decreased function, but radiography can be useful before surgery in order to prepare for the procedure.