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The ROLE OF MRI IN EARLY AND ACCURATE DIAGNOSIS OF AVASCULAR NECROSIS OF HIP JOINT
Majdy Boissa*, Fawaz Baddour and Maan Saad
Avascular necrosis of the femoral head (AVN) often occurs between the third and fifth decade of life, and since it includes middle-aged patients , and this age group represents the productive group within the community, early diagnosis and better management is necessary, as delays in diagnosis lead to high rates of bone degeneration and loss of joint function, as it usually progresses to the collapse of the femoral head, which often leads to complete degeneration of the hip joint, and the need to replace it with an arthrodesis artificial, while the treatment is more successful in the early stages of avascular necrosis and Here comes the importance of showing the role of magnetic resonance imaging in early detection of avascular necrosis of the femoral head, and thus improving the chance of saving the affected joint. Materials And Methodes- This study was a cross-sectional descriptive study, and the research sample included 45 patients (69 hips) of patients who were referred to the orthopedic clinic or admitted to the Orthopedic Department of Tishreen University Hospital in Lattakia with a story of suspected avascular necrosis in the femoral head, who achieved Inclusion criteria in the research, during the period from March 1, 2021 until the end of April 30, 2022. Results- The study included 45 patients (69 hip joints), and it was evaluated by plain radiography and magnetic resonance imaging. The plain radiograph was able to detect avascular necrosis of the hip joint in 50 hips (72.5%) and did not in 19 hips (27.5%). The male/female ratio was 1.5:1. The mean age of infection was 36.8 ± 11.6 years. The history of corticosteroids intake was the most common risk factor associated with avascular necrosis (40%), followed by a history of previous trauma and sickle cell anemia (20%) for each. The double line sign was seen in (78%) and the band-like sign was seen in (34.7%). Conclusion- The evaluation of an osteonecrosis lesion based on plain radiographs leads to negative results in detecting early stage, as well as inaccurate results in determining the stage of avascular necrosis. Magnetic resonance imaging (MRI) is the most sensitive and qualitative medical imaging method for detection early stage of avascular necrosis of the femoral head and accurately determining the stage where early and accurate diagnosis leads to better treatment results.[Full Text Article]