Salter et al identified radiographic criteria for diagnosing avascular necrosis of the femoral head in a child treated for congenital dislocation of the hip. The authors are from the Hospital for Sick Children in Toronto, Canada.
Radiographic features seen after reduction of the hip:
(1) failure of the ossific nucleus for the femoral head to appear by 1 year after the reduction
(2) failure of the ossific nucleus to grow by 1 year after the reduction
(3) broadening of the femoral neck during the year after reduction
(4) increased density of the femoral head followed by fragmentation
(5) residual deformity of the femoral head and neck after reossification is complete (coxa magna, coxa magna, coxa vara, short broad femoral neck, other)
Other observations:
(1) A child with complete involvement of the femoral head will usually have severe deformaties of the femoral head and neck.
(2) The acetabulum is also affected and will show inadequate development.
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