Reason: evaluate for avascular necrosis History: hip pain; difficulty with ambulation There is curvilinear bandlike signal abnormality traversing the femoral head near its junction with the femoral neck with smaller foci of subchondral curvilinear signal abnormality indicating avascular necrosis. There is edema within the femoral neck extending into the intertrochanteric region which is also likely due to avascular necrosis. The majority of the proximal femoral epiphysis maintains fat signal intensity and we see no subchondral fracture or articular surface collapse. There is also moderate osteoarthritis of the right hip joint with subchondral cysts within the acetabular dome. There is edema type signal within the acetabular dome and supra-acetabular ilium which may be degenerative in etiology or represent additional osteonecrosis. There is a mild synovitis of the right hip and a small amount of fluid within the right hip joint which is not uncommon in patients with avascular necrosis. Although the study was not protocoled for detailed evaluation of the labrum, there appears to be degenerative tearing of the acetabular labrum. There is also mild inflammation of the obturator externus bursa where it communicates with the hip joint. There is atrophy of the gluteus minimus muscle and enthesopathic changes at its insertion on the greater trochanter. There is also mild inflammation of the peritrochanteric soft tissues of questionable clinical significance.Avascular necrosis and osteoarthritis also affect the left hip as seen on the large field-of-view images, although to a slightly lesser degree than that seen on the right. There is a small joint effusion on the left. There are multiple presumed uterine fibroids.
Avascular necrosis of the right and left femoral heads with osteoarthritis of the hips and other findings as described above.