Magnetic resonance imaging and histopathology in femoral head necrosis

We correlated preoperative magnetic resonance (MR) images and histopathology of eight femoral heads from patients with osteonecrosis. The signal intensity of the MR image was low in the area where fibrovascular tissue, disintegrated fibrovascular tissue, or amorphous necrotic material occupied the medullary space. On the other hand, the necrotic marrow without revascularization showed high signal intensity. Osteonecrosis can be detected by MR imaging as soon as a certain amount of bone marrow is replaced by fibrovascular tissue.