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Review Question - QID 6011

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QID 6011 (Type "6011" in App Search)
Figure 30 shows the MRI scan of a 68-year-old woman who has left hip pain. What is the most appropriate treatment?
  • A

Open reduction and internal fixation

0%

3/894

Total hip arthroplasty

95%

851/894

Incisional biopsy

3%

29/894

Proximal femoral resection and reconstruction

1%

6/894

Arthrodesis

0%

2/894

  • A

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The patient has a large zone of osteonecrosis of the left femoral head. The wedge-shaped zone of decreased signal intensity on the T1 image in the subchondral region of the femoral head is typical. Based on these findings, total hip arthroplasty is the most appropriate treatment. Open reduction and internal fixation will not help this condition. Incisional biopsy is indicated only if the MRI scan shows a probable neoplasm. Resection of the proximal femur is indicated only for aggressive malignancy. Arthrodesis may be considered in a younger patient but not in a 68-year-old individual. Other treatments, not listed, such as core decompression, vascularized fibular transplant, and osteotomy may be options in selected patients.

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