Avascular necrosis of the hip

What you need to know • Common risk factors for AVNFH are alcoholism, use of steroids, chemotherapy and immunosuppressant medication, and sickle cell anaemia • Consider MRI scan of the hip and referral to an orthopaedic team if a patient has a painful hip for longer than six weeks with normal radiographs • Early treatment improves the chances of hip survival by up to 88% at seven years A 36 year old woman presents to her GP with a history of left groin pain radiating to the knee. The pain is severe, worse on walking, and associated with a limp. The patient revisits the GP a year later with persistent pain despite analgesia. Plain radiographs of the hip and knee show slight narrowing of the hip joint space with no other features and she is referred to a secondary care orthopaedic clinic. A magnetic resonance imaging (MRI) scan of the hip shows classic features of avascular necrosis of the femoral head (AVNFH) with collapse. What is avascular necrosis of the femora