What examinations are needed for femoral head necrosis?

Most patients with femoral head necrosis have normal laboratory test results. The following examinations can be performed when necessary:

(1) Hemodynamic examination

①Intramedullary pressure measurement

Under local anesthesia or general anesthesia, the The trocar is directly inserted into the medullary cavity of the intertrochanteric area of ??the femur to measure the intramedullary pressure in the diseased area. This method can detect abnormal changes in bone tissue earlier than conventional X-ray and radionuclide bone scan examinations, and is of certain value in the early diagnosis of femoral head necrosis.

②Intramedullary vein X-ray photography

After measuring the intramedullary pressure, the trocar is used to inject contrast agent into the medullary cavity, and continuous X-rays are taken to observe the contrast agent. The stroke and emptying conditions in the medullary cavity, thereby examining the vascular structure, can provide a basis for the early diagnosis of femoral head necrosis.

(2) Histopathological examination

can be used as the basis for the diagnosis of femoral head necrosis. At present, it is rarely used alone and is often used together with bone marrow decompression and bone grafting.

(3) Imaging examination

①X-ray examination

It is the simplest and most practical method to diagnose the disease, but its sensitivity is poor. In the early stage, X-ray examination alone Wire films are difficult to diagnose. The early manifestations of osteonecrosis are normal bone or mild porosis, and there may also be a relatively uniform increase in bone density in the diseased area. Later, wedge-shaped sclerosis zones or the formation of cystic lesions in bone tissue may be seen in the weight-bearing area, and "new" lesions parallel to the joint surface may further appear. Moon-shaped translucent zone", widening of joint space. Finally, subchondral bone plate and articular surface collapse, bone contour changes, step-like discontinuity, bone compression increases, the acetabular articular surface is also damaged, joint space narrows, osteophytes form, and the entire joint shows degenerative arthritis changes.

②Nuclide scan

The 99mTc phosphate bone scan method is used to diagnose bone diseases and has been used clinically for more than 20 years. The sensitivity for diagnosing osteonecrosis is as high as 80%, and it can reflect the disease condition earlier than conventional X-ray examination.

③Computed tomography (Cr) can reflect bone tissue necrosis changes earlier than conventional X-ray examination and tomography.

④Magnetic resonance imaging (MRI)

When other examinations are negative and avascular necrosis is highly suspected, a magnetic resonance imaging test should be performed. It is an ideal method for early diagnosis.

⑤ Tomography

As a supplement to conventional X-ray examination, it has been used for many years. It can reflect the structural changes of bone tissue in more detail, especially in the absence of CT and magnetic examination. When vibrating equipment, it has certain reference value for solving difficult clinical problems.