DOI: 10.36347/sjams.2019.v07i04.022

Pages: 1481-1486

Osteonecrosis of the femoral head (ONFH) is a pathologic condition primarily affecting younger and active population that usually leads to destruction of the hip joint and hence demanding hip arthroplasty. Of several diagnostic modalities, magnetic resonance imaging (MRI) is considered highly accurate method both for early diagnosis and for staging of the disease, the latter being useful for a positive outcome. The purpose of the present study was to correlate the plain radiographs with MRI in staging of ONFH. Total 104 patients (152 hips) of different age groups with ONFH were evaluated and classified according to the Association Research Circulation Osseous (ARCO) classification criteria with the use of plain radiographs and MRI. Sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and accuracy (AC) of plain radiographs were calculated. According to MRI, 22 hips were classified as stage I, 45 as stage II, 58 as stage III and 27 as stage IV. The SN, SP, PPV, NPV and AC of plain radiographs were for stage II 86.67%, 88.79%, 76.47%, 94.06% and 88.16% ; for stage III 79.31%, 93.62%, 88.46%, 88.00% and 88.16%; for stage IV 88.89%, 100.00%, 100.00%, 97.66% and 98.03% respectively. The results of the present study suggest that MRI should be incorporated in the classification of osteonecrosis to add accuracy and prognostic value.