Hello. My name is Jack Henry, DC, DACBR. I am Radiologist-in-Chief of
Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses. All of our services are provided at no cost to doctor and no/low cost to patients.
Selected cases will be presented for your evaluation. The studies may or may not have abnormalities. Use the arrow keys or the scroll bar to carefully evaluate the films.
Step 1: Is the study abnormal or normal?
Step 2: If the study is abnormal, what is your best diagnosis?
Step 3: Which follow-up imaging option would be best?
Step 4: Compare your results with the correct diagnosis.
HISTORY
A 49-year-old African American male reports with chronic low back and hip pain. No history of trauma was reported. Physical exam findings were not provided.
FINDINGS
The study is negative for acute fracture or dislocation. Mild degenerative changes are present within the lumbar spine. Please note the regions of patchy eburnation regarding the right and left femoral capital regions. There is associated subchondral collapse of the weight bearing surfaces bilaterally.
DISCUSSION
Bilateral hip avascular necrosis in an African American noted and described above should be considered secondary to sickle cell anemia until proven otherwise.
FOLLOW UP PROTOCOL
An orthopedic consultation is recommended as an immediate follow-up.