Femoral Head Necrosis Diagnosis

Femoral head necrosis is a chronic orthopedic disease caused by interrupted blood supply leading to progressive bone tissue necrosis, commonly seen in young and middle-aged individuals. If not diagnosed and treated early, it may progress to hip collapse and even complete loss of function, ultimately requiring hip replacement. Accurate diagnosis relies on imaging, physical examination, and medical history analysis.

Diagnostic Basis of Femoral Head Necrosis

1. Magnetic Resonance Imaging (MRI)

MRI is the most sensitive imaging tool for early diagnosis of femoral head necrosis. It can detect bone marrow edema and necrotic areas even when X-rays show no obvious changes, making it especially suitable for screening high-risk populations.

2. X-ray Examination

X-rays are useful in mid-to-late stages, revealing features such as femoral head collapse and joint space narrowing. They provide value for treatment decisions and prognosis evaluation.

3. CT Scan

CT scans allow clearer observation of trabecular structural changes and internal density alterations of the femoral head. They are useful in monitoring mid-stage progression and for surgical planning.

4. Bone Scintigraphy

Nuclear bone scans can detect local bone metabolism abnormalities and are especially effective for suspected early cases or patients with bilateral involvement but atypical symptoms.

5. Clinical Symptom Analysis

Doctors evaluate hip pain characteristics, motion limitations, and gait abnormalities, along with changes in daily functional ability, to determine disease progression.

6. Medical History Investigation

Identifying long-term corticosteroid use, alcohol abuse, trauma, or underlying metabolic disorders helps pinpoint causes and high-risk individuals.

7. Range of Motion Testing

During physical examination, doctors assess limitations in abduction, internal rotation, and flexion of the hip joint, as well as tenderness or crepitus, to assist in clinical judgment.

8. Bone Density and Bone Metabolism Markers

Some patients present with osteoporosis or metabolic abnormalities. Assessing bone mineral density and markers such as vitamin D, calcium, and phosphorus provides a comprehensive understanding of bone status, supporting integrated treatment.

9. Joint Fluid Analysis (if necessary)

If infection or other inflammatory conditions are suspected, joint aspiration may be performed to exclude other causes of hip pain that could interfere with diagnosis.

10. Bilateral Comparison Assessment

As femoral head necrosis can affect both hips, clinical evaluation should include simultaneous assessment of both joints to avoid missing symmetrical involvement.

Conclusion

Experts at United Life International Medical Center emphasize that once hip discomfort appears, patients should undergo professional evaluation as early as possible. Combined use of MRI, X-rays, and clinical assessments enables early and accurate diagnosis, securing valuable time for novel treatments such as stem cell therapy, and significantly improving hip-preserving success rates.