E5158. It’s All in Your Head: Making Sense of the Various Causes of Femoral Head Edema on MRI - What Every Resident Should Know
  1. Mia Ma; Henry Ford Hospital: Department of Radiology
  2. Syed Raza; Michigan State University College of Human Medicine
  3. Beatrice Knisely; Henry Ford Hospital: Department of Radiology
  4. Chad Klochko; Henry Ford Hospital: Department of Radiology
  5. Courtney Scher; Henry Ford Hospital: Department of Radiology
Femoral head edema on MRI is a nonspecific finding and has a variety of pathological causes that the radiologist needs to be aware of. It is important to recognize the standard anatomy and bone marrow appearance to identify normal findings versus pathology. Our aim of this exhibit will be to arm radiologists with the knowledge on how to generate a broad differential diagnosis and associate findings that may point to a specific pathology for femoral head edema.

Educational Goals / Teaching Points
We provide a brief review of normal anatomy of the femoral head on radiographs and MRI. There will also be a specific review of normal bone marrow appearance on routine MR sequences and a MRI review of patients presenting with femoral head edema, with associated pearls and pitfalls for residents in interpretation. Our last teaching point will be on associated treatment options.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We review basic femoral head anatomy of radiographs, as well as, MRI, routine MRI sequences for evaluation of the pelvis, and bone marrow appearance on different sequences. We also discuss pathologic causes of femoral head edema such as osteoarthrosis, rapidly progressive osteoarthrosis, transient osteoporosis, osteoid osteoma, avascular necrosis, stress/insufficiency fracture, radiographically occult femoral neck fracture, and septic arthritis. Lastly, treatment options for selected pathologies will be discussed.

In summary, femoral head edema has a variety of causes. There are specific pearls and pitfalls that every radiologist should know to accurately interpret scans and guide treatment. With the knowledge we aim to impart, the audience will be well-prepared to have a broad differential for femoral head edema.