AVN

#1. What is the likely diagnosis? (2 marks)

 Avascular necrosis (1 mark) of the right femoral head (1 marks))

B. #2. Outline the blood supply of the femoral head. (2 marks)

 Profunda femoris/deep femoral artery,

 medial and lateral circumflex femoral arteries,

 ascending cervical branches,

 retinacular vessels,

 artery of the ligamentum teres

(0.5 mark each, any 4)

Majority from Medial and lateral circumflex arteries from the profunda femoris form a cervical ring from which retinacular arteries ascend to supply the head of femur.

Nutrient artery of the femur and artery to ligamentum teres supply a small portion.

There is also a less significant arterial supply from the ligamentum teres artery, which is a branch of the obturator artery. 

C. #3. Name 4 possible risk factors. (4 marks)

 Trauma/hip dislocation,

 Steroids,

 Alcohol,

 Chemotherapy,

 Deep-sea diving,

 Sickle cell disease,

 lupus,

 Smoking

(1 mark each, any 4)

Gaucher's disease???? YES Link

prothrombotic states eg Antiphospholipid syndrome ?????

D. #4. What is the treatment of choice for this patient? (2 marks)

 Total hip replacement

Why increase bone density,

crescent
Ficat classification
Crescent sign