Right hip pain, sickle cell disease There is a small focus of edema within the femoral head anteriorly that is suspected to represent avascular necrosis. There is a very small hip joint effusion with mild edema within and along the adjacent musculature suggesting mild inflammation.There is perhaps a slight CAM deformity of the femoral head-neck junction anteriorly with a small synovial herniation pit. These findings can be associated with femoral acetabular impingement in the appropriate clinical context. There is mildly increased signal of the anterior labrum suggesting degeneration or perhaps focal fraying.There is diffusely abnormal marrow signal consistent with the stated history of sickle cell disease but we otherwise see no additional focal marrow abnormalities. There is a small amount of free fluid in the pelvis. A 4 cm collection of near fluid signal intensity within the right adnexa likely represents a functional cyst.
Signal abnormality of the anterior femoral head with very small joint effusion and mild surrounding soft tissue inflammation. We favor avascular necrosis as the etiology of these findings but if there is strong clinical concern for infection, aspiration can be considered.