Update on Diagnosis and Prognosis of Nontraumatic Femoral Head Osteonecrosis

This review outlines updated clinical guidance on nontraumatic osteonecrosis of the femoral head, noting that the condition should be suspected in patients under 50 with persistent hip pain despite normal radiographs. The article states that MRI is the most sensitive modality for early detection, that bilateral involvement is common, and that lesion size and location, along with subchondral collapse, predict disease progression. It further notes that joint-preserving procedures are most effective before structural collapse, while total hip arthroplasty remains the most reliable treatment after collapse occurs.

Most relevant for: Patients under 50 years of age with unexplained persistent hip pain and normal radiographs, including those with suspected bilateral or multifocal disease.

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