Avascular necrosis of the femoral head following hysteroscopic myomectomy: Evaluation of bone perfusion using dynamic contrast-enhanced MRI and intravoxel incoherent motion.
Tijen Cankurtaran, Büşra Yavuz Sarsam, İlhami Kuru et al.
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Case in brief
A 33-year-old woman developed avascular necrosis of the right femoral head six weeks after undergoing a three-hour hysteroscopic myomectomy. Initial MRI indicated early-stage osteonecrosis, but a subsequent increase in hip pain led to a CT scan revealing intraosseous gas and signs of articular collapse. Dynamic contrast-enhanced MRI and intravoxel incoherent motion sequences were utilized to assess perfusion and microvascular diffusion, providing insights into the necrotic and reparative tissue.
What made this case unusual
The use of dynamic contrast-enhanced MRI and intravoxel incoherent motion techniques allowed for in vivo evaluation of perfusion and microvascular diffusion in the context of avascular necrosis, which is not commonly reported.
Diagnostic / clinical pearl
Clinicians should consider the potential for avascular necrosis following surgical procedures, particularly when patients present with new hip pain, and utilize advanced imaging techniques for comprehensive assessment.
Why it matters
This case underscores the importance of multimodal imaging in evaluating avascular necrosis, enhancing understanding of tissue response to ischemic injury and guiding management strategies.