Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Pelvis/Hip Case 1 ED Management

Bilateral Avascular Necrosis of the Femoral heads


ED Management

Conservative treatment includes crutches, possible immobilization, fosamax, and lovenox; however, femoral head collapse is common with such conservative therapy.

Surgical treatment when there is no bony collapse is bone graft with core decompression, usually performed prior to the onset of subchondral fracture (stage I and II). If there has been femoral head collapse, surgical treatment is joint replacement.

When AVN is diagnosed, orthopedics should be consulted to select the proper management strategy.