-Go first to the coronal view T1 of the upper femur and localize the presence of the lesion.
-If there is no lesion seen, by 99% you can exclude presence of pathology.
-If there is a pathology seen in the form of hypo intense lesion look to T2 film.
-If this lesion is still hypo intense, this will suggests red bone marrow.
-But if the lesion is hyper intense, this will suggests bone marrow edema giving diagnosis of migratory osteoporosis which will heals spontaneously or by receiving drugs within few months.
-After healing of bone marrow edema, we have two possibilities:
*The first one, is complete healing of the disease and the bone return normal.
*or a line will appear in the affected femoral head giving possibility of either avascular necrosis or sub chondral fracture.
-To differentiate between these two entities we can do bone scan.
-In case of avascular necrosis, an area of photopenia is noted at the site of the line.
-While in case of sub chondral fracture, there will be a hot lesion.
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