[MRI relevance in femoral head osteonecrosis: 3 case studies]

Aseptic osteonecrosis of the femoral head is the partial or total destruction of the femoral head due to impaired blood flow. It affects young adults (30-60 years), predominantly male (3 male:1 female) and is often bilateral. The aim of the present work is to define the role of MRI in the diagnosis, classification and therapeutic management of osteonecrosis of the femoral head.

This study focused on three observations of osteonecrosis of the femoral head in the 20 Aout Radiology Department of the Ibn Rochd of Casablanca University Hospital with a review of the literature. All patients underwent MRI of both hips with sagittal sequences, coronal T1, T2 and T2 SE DP Fat Sat.

The ages of our patients were 62 years for case 1 (male); 37 years for case 2 (female) and 58 years for case 3 (male). The MRI in all 3 patients objectified: subchondral bone fragment on the outer compartment of the femoral head bilaterally with minimal bilateral effusion in the first patient. In the other two patients, we note the presence of subcortical signal abnormalities of the femoral heads with demarcation piping T1 hypointense, T2 hyperintense and associated subchondral fractures. A minimal effusion was also observed.

Medical imaging is an essential element of the radiological diagnosis of osteonecrosis of the femoral head. MRI finds its best indication in the precocious and differential diagnosis, as well as the classification of osteonecrosis of the femoral head.