To review the principal causes and pathophysiology of osteonecrosis (ON), the common sites affected, and illustrate the spectrum of radiologic findings on different imaging techniques.

Osteonecrosis (ON) results from a reduction or total loss of blood supply to a region of bone, followed by sclerosis, collapse and secondary osteoarthritis. The terms avascular or aseptic necrosis have been applied to subarticular or epiphyseal bone commitment. Usually, ON is a non-symptomatic condition and therefore its true prevalence is underestimated. The clinical significance depends on the grade of articular collapse. The core causes for bone ischemia are trauma, corticosteroids and alcoholism, although many have no evident explanation [1,2]. Osteonecrosis is a common situation...

We will review the typical radiologic findings of some sites that can be affected by avascular necrosis presenting selected cases from our Imaging Department: femoral head in adults and children, humeral head, scaphoid and metatarsal bone. All the cases were first studied by radiography and some followed by MR and CT. The clinical history and possible associated cause were correlated with the imaging findings. The pathology progressionwas documented by radiography imaging. The first radiographic sign in avascular necrosis of the hip occurs weeks or months...

Osteonecrosis is a frequent musculoskeletal abnormality that needs correct diagnosis for an optimal and successful patient management. The typically imaging appearance of a serpentine or undulating sclerotic rim on radiographs is suggestive of underlying pathology. MR is considered the most sensitive and specific imaging modality due to its ability to prevent future associated complications brought by early diagnosis.

[1] – Ito H, Kaneda K, Matsuno T. Osteonecrosis of the femoral head: simple varus intertrochanteric osteotomy. J Bone Joint Surg Br 1999; 81 (6):969-974. [2] – Mankin HJ. Nontraumatic necrosis of bone (osteonecrosis). The New England Journal of Medicine 1992;326(22):1473-1479. [3] - Murphey MD, Foreman KL, Klassen-Fischer MK, Fox MG, Chung EM, Kransdorf MJ. From the Radiologic Pathology Archives Imaging of Osteonecrosis: Radiologic-Pathologic Correlation. RadioGraphics 2014 34:4, 1003-1028. [4] - Manaster BJ, May D, Disler GD. Musculoskeletal Imaging: The Requisites. 4th ed. Philadelphia: Elsevier,...