AVN
#1. What is the likely diagnosis? (2 marks)
#1. What is the likely diagnosis? (2 marks)
Avascular necrosis (1 mark) of the right femoral head (1 marks))
Avascular necrosis (1 mark) of the right femoral head (1 marks))
B. #2. Outline the blood supply of the femoral head. (2 marks)
B. #2. Outline the blood supply of the femoral head. (2 marks)
Profunda femoris/deep femoral artery,
Profunda femoris/deep femoral artery,
medial and lateral circumflex femoral arteries,
medial and lateral circumflex femoral arteries,
ascending cervical branches,
ascending cervical branches,
retinacular vessels,
retinacular vessels,
artery of the ligamentum teres
artery of the ligamentum teres
(0.5 mark each, any 4)
(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)
C. #3. Name 4 possible risk factors. (4 marks)
Trauma/hip dislocation,
Trauma/hip dislocation,
Steroids,
Steroids,
Alcohol,
Alcohol,
Chemotherapy,
Chemotherapy,
Deep-sea diving,
Deep-sea diving,
Sickle cell disease,
Sickle cell disease,
lupus,
lupus,
Smoking
Smoking
(1 mark each, any 4)
(1 mark each, any 4)
D. #4. What is the treatment of choice for this patient? (2 marks)
D. #4. What is the treatment of choice for this patient? (2 marks)
Total hip replacement
Why increase bone density,
Total hip replacement
Why increase bone density,
crescent
Ficat classification
Crescent sign
crescent
Ficat classification
Crescent sign