August 2007

Symptoms

48 year-old male with hip pain after a “lifting injury.” The first two images (fat-suppressed T2 and T1) were obtained four months following the injury. The final image (fat-suppressed T2) was obtained about 6 months later

Diagnosis

Resolved transient marrow edema, originally secondary to avascular necrosis versus a non-displaced fracture. The fat-suppressed T2 weighted image demonstrates abnormal increased signal throughout the proximal femur (white arrows). The T1 weighted image demonstrates a subtle focus of abnormal signal (black arrow) within the superior aspect of the femoral head, suggestive of a nondisplaced fracture versus tiny focus of avascular necrosis. The final image demonstrates resolution of the abnormal signal within the proximal femur.