Thursday, May 6, 2010

Ficat Classification of Avascular Necrosis (AVN) of the Femoral Head

Stage Name Clinical features Radiography
  0 Preclinical    
  I Preradiographic +  
  II   + Osteoporosis, sclerosis, cysts
Transition     Flattening and crescent sign
  III Collapse ++ Irregular contour of head, sequestrum, normal joint space
  IV Osteoarthritis +++ Flattened femoral head, narrowed joint space; collapse of head (see image)

Stage II

Note lucency with well-defined peripheral sclerosis. The frog-leg view is used for assessment of sphericity of the femoral heads. Drawing a circle around the femoral heads on this view will allow for detection of subtle cortical step-offs and early subchondral collapse.


Stage IV


Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br. 1985 Jan;67(1):3-9.

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