The diagnosis and treatment of nontraumatic osteonecrosis of the femoral head.

Osteonecrosis of the femoral head is a potentially debilitating disease that frequently affects young patients in the third through fifth decades of life. If untreated, this disease will result in total destruction of the hip joint; therefore, early diagnosis and intervention are essential to optimize outcome. Although the etiology of osteonecrosis of the femoral head is poorly understood, awareness of well-established risk factors and associated disorders can assist in early detection and possible prevention of hip joint destruction. All patients with symptomatic hip disease should undergo standard radiographic evaluation; however, MRI remains the most sensitive diagnostic modality. Depending on the stage of the disease, options for treatment range from minimally invasive procedures such as core decompression to total joint arthroplasty.