Bilateral hip pain. Patient on steroids for treatment of lymphoma. Evaluate for evidence of osteonecrosis. Left Hip: There is serpentine, bandlike signal abnormality within the femoral head indicating osteonecrosis involving the entire weight-bearing surface of the femoral head (4-5 cm in diameter). There is moderate edema and enhancement within the subjacent femoral neck but currently we see no subchondral fracture or articular surface collapse. There is a small joint effusion with mild synovial enhancement which commonly accompanies osteonecrosis of the femoral head. Please note that the study is not protocoled for evaluation of the cartilage of the hip, but we see no gross labral deformity or hyaline cartilage defect.Right Hip: There is serpentine, bandlike signal abnormality within the femoral head indicating osteonecrosis involving the entire weight-bearing surface of the femoral head (4-5 cm in diameter). There is mild edema within the adjacent femoral neck but currently we see no subchondral fracture or articular surface collapse. There is a small joint effusion with mild synovial enhancement which commonly accompanies osteonecrosis of the femoral head. Please note that the study is not protocoled for evaluation of the cartilage of the hip, but we see no large articular cartilage defect. There appears to be a small ossicle in the anterior superior labrum, which may not be of any current clinical significance.The remaining bone marrow signal intensity is normal. The pubic symphysis and sacroiliac joints are normal in appearance. Moderate degenerative disk disease affects L4/L5. The visualized musculature is within normal limits.
Bilateral femoral head osteonecrosis.