MRT for femoral head necrosis | Stages of femoral head necrosis

MRT for femoral head necrosis

To be able to diagnose aseptic, non-traumatic femoral head necrosis and classify it into a certain stage, imaging procedures are usually necessary. A common classification into 4 stages is the ARCO (Association Research Circulation Osseous) classification, which is made possible by means of an X-ray or MRI examination.

  • Stage 0 is when neither X-ray nor MRI imaging reveals changes in the hip joint, but symptoms are present and the disease of femoral head necrosis in its early stages can be confirmed by histological evaluation.
  • In stage 1, the first changes (in the form of unspecific accumulation of contrast medium in the femoral head area) can already be detected in the MRI, but not in the X-ray image.

    This is due to the fact that the MRI, with its sharper and more detailed imaging capability, allows pathological structural changes to be detected much earlier than an X-ray image. However, stage 2 can then be detected both in the MRI and in the X-ray. The contour of the femoral head is retained in both images, although it is already clearly visible here that tissue is dying off (necrosis).

  • The situation is different in stage 3, where a fracture (a break) below the femoral cartilage can be detected.
  • Finally, stage 4 is characterized by the fact that the femoral head appears clearly flattened and no longer appears normally round on the MRI, the joint space is narrower and the first signs of hip arthrosis are already visible.