MRIMusculoskeletalIntermediate

Hip avascular necrosis

musculoskeletalhipavascular necrosisMRIdouble-line signsteroids

Clinical presentation

Adult on long-term corticosteroids with progressive groin pain worse on weight-bearing; radiographs initially normal.

Key imaging findings

  • Serpiginous subchondral line of low signal on T1 (double-line sign on T2)
  • Geographic subchondral marrow abnormality in the anterosuperior femoral head
  • Crescent sign (subchondral lucency) on radiographs before collapse
  • Later: articular surface flattening and secondary osteoarthritis

Form your diagnosis, then reveal the answer.

Educational teaching content only. Imaging appearances vary; always correlate clinically and confirm with a qualified radiologist.