What examinations should be done for patients with femoral head necrosis, and what examination procedures and methods are there?

Avascular necrosis of the femoral head is a disease that can cause great harm to the body of patients. In recent years, the incidence rate of femoral head necrosis has been increasing, and patients are generally too eager to get treatment effect. However, an important procedure has been neglected. < / P > < p > 1. Doctors will first ask about the condition of the disease, and may do unarmed physical examination to understand some basic conditions, such as observing walking gait, whether the affected limb has deformity; whether there are tenderness points in local compression, the range of motion of the affected limb; special examination, such as “4” test, straight leg raising test, Thomas sign, Ellis sign, etc. < / P > < p > 2. Preliminary screening. It includes blood examination, imaging examination, etc., in which blood examination often includes blood routine, urine routine, rheumatism, etc.; imaging examination includes X-ray, CT, magnetic resonance imaging, etc. Through these examinations, we can understand the basic situation of patients and exclude the influence of rheumatism, immunity and other systemic diseases. In addition, if surgery is needed, it can also be used as a reference to evaluate whether patients can tolerate surgery. < / P > < p > 4. Evaluation of the condition and etiology of the examination. After the diagnosis of avascular necrosis of the femoral head, we may also know the condition through the scale examination. In order to clarify the etiology, blood examination and imaging examination may be further performed. < / P > < p > imaging examination is the “gold standard” for the diagnosis of avascular necrosis of the femoral head, but different imaging examinations have different advantages in different stages of the disease. < / P > < p > 1. Joint X-ray is the most commonly used imaging method in the diagnosis and evaluation of femoral head necrosis. For some patients with severe disease, sometimes even without other imaging means to make a clear diagnosis. Osteonecrosis occurs 12 hours after the interruption of blood supply to the femoral head, but it takes at least 2 months or more to see the change of femoral head density on X-ray film.

  2.CT。 Compared with X-ray film, CT can accurately detect small lesions and identify whether there is bone collapse and its extension, so as to provide effective information for the choice of surgery or treatment. But in the early diagnosis of avascular necrosis of the femoral head, radionuclide scanning and MRI are more sensitive than CT. 3. Radionuclide scanning. For the early diagnosis of avascular necrosis of the femoral head has great value, often 3 to 6 months in advance to find avascular necrosis of the femoral head, the accuracy rate can reach 91% – 95%. 4. Nuclear magnetic resonance. Early diagnosis and sensitivity of avascular necrosis of the femoral head is higher, and intra-articular lesions can be found, such as avascular necrosis of the femoral head in patients with joint synovial fluid than normal people increased. < / P > < p > 1. Hemodynamic examination. For those with normal X-ray or only mild osteoporosis, asymptomatic or mild pain, limited hip joint movement, this examination can diagnose early avascular necrosis of the femoral head, with an accuracy of 99%. < / P > < p > 2. It is to score the items in the scale one by one, evaluate the severity of the disease and help decide the treatment strategy. It is usually used to check the patients who need surgery. The commonly used scales are Harris score, Mayo score and so on. < / P > < p > 3. Some special examinations. For example, if a doctor suspects that the necrosis of the femoral head is caused by sickle cell anemia, a hematological examination may be performed. < / P > < p > after a series of tests, the doctor will give a diagnosis. According to the etiology, femoral head necrosis can be divided into traumatic femoral head necrosis and non traumatic femoral head necrosis. < / P > < p > the average time for these patients to develop femoral head collapse is 3-4 months after fracture, the shortest is 12 months; the probability of femoral head collapse within 1-5 years after fracture is 93.2%. Therefore, X-ray should be performed at least half a year after fracture healing in order to detect the collapse of the femoral head in the early stage, so as to have more treatment options. < / P > < p > in this kind of patients, the time between the primary disease and clinical symptoms is usually very different, for example, decompression sickness often appears joint pain in minutes to hours after abnormal decompression, but the performance on X-ray film may appear in months to years later; patients taking hormone for a long time often get sick between 3 to 18 months after taking medicine; patients with alcoholism usually have clinical symptoms Years to decades of drinking history. < / P > < p > under the premise of relevant risk factors, these patients should receive regular X-ray reexamination under the doctor’s advice, so as to find the collapse of the femoral head early and have more treatment options. CUISINE&HEALTH