Claudia Lidueña, Alejandro Mendoza1, Andrés Malo, Adel Al Awad
Femoral Head Necrosis (FNC) or osteonecrosis is a pathological process that leads to bone cell death, as a result of a temporary reduction or complete loss of blood supply; It is difficult to establish the relationship of a true cause of NCF due to the low prevalence of some etiologies. The objective of this research was to determine the appropriate diagnostic method for SCN by reviewing the literature. For NCF, the first diagnostic classification used was described by Ficat and Arlet; based on radiographic findings in the anteroposterior and axial planes, it consisted of 4 stages (I, II, III, IV), being easy and simple, however, there are controversies because magnetic resonance imaging (MRI) is not incorporated. There is another Steinberg classification based on the previous one; it presents 7 stages, using the 2 radiographic planes, bone scintigraphy and MR images for disease staging. , the ARCO classification was described, this unites the ficat and arlet models with steinberg, subsequently incorporating radiographs, computed tomography, MR and scintigraphy to locate the size and location of the necrotic area, adapting the Sugano classification, based on NMR, to this method useful to prevent collapse of the femoral head when lesions do not yet appear on plain radiographic examination. This research concluded that the appropriate diagnostic method for NCF corresponds to the ARCO classification due to the incorporation of various diagnostic images that will adopt the best treatment according to the pathology stay. The treatment of NCF can be conservative with drugs or through surgical management depending on the stage of involvement; osteotomy being its objective to remove necrotic tissue from weight-bearing areas or hip arthroplasty being the procedure of choice when treating large collapsed lesions.
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