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Name of the Patient : Abc Xyzlal Korlmn / M / 62 yrs.
Referred by : Dr. Abc Xyzsai.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the RLE since 15 days.
H/O fall 15 years ago with a limp in the LLE since then.

EXAMINATION :

M.R.I of both hips was performed using the following parameters :

5 mm thick T1 Weighted and STIR coronal images.
5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
5 mm thick Proton density sagittal images.

OBSERVATION :

There is a well-marginated, hypointense lesion on the T1 Weighted images in the left femoral head in the superior and medial quadrant which remains hypointense on the T2 Weighted and STIR images. This lesion is demarcated from the normal marrow by a hypointense rim on all pulse sequences. There is mild perilesional edema in the head and neck of the left femur. The articular cartilage overlying the left femoral head and the left acetabulum are unremarkable. There is a small left hip joint effusion.

The right femoral head appears slightly irregular with irregularity of the articular cartilage overlying it. Multiple subchondral femoral herniation pits are noted in the right femoral head. There is a well-marginated hypointense area in the right femoral head, superiorly, which appears hyperintense on the T2 Weighted and STIR images. It is demarcated from the normal marrow by a hypointense rim on all pulse sequences. Perilesional edema is noted around the lesion. There is no significant right hip joint effusion. Marginal osteophytes along the right acetabular rim is noted. There is slight decrease in the bulk of the muscles around the right hip joint as compared to the left.
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IMPRESSION :

1. Class D avascular necrosis of the left femoral head.

2. Class C avascular necrosis of the right femoral head with multiple femoral herniation pits and changes of secondary osteoarthritis in the right hip joint.
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