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Suggest treatment for constant pain in right hip inspite of having large subarticular cyst of the anterior superior femoral head

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Orthopaedic Surgeon, Joint Replacement
Practicing since : 2002
Answered : 4458 Questions
As per the radiologists report, I have "a large subarticular cyst of the anterior superior femoral head, 2.3 CM in larger transverse dimension exhibiting a slightly lobular sclerotic margin and heterogeneous signal consisting of fluid and sclerotic bone. The subchondral bone is irregular and slightly flattened and there is loss of articular cartilage. This is most likely a geode or possible sequel of an old osteochondral impaction injury. The femoral head is otherwise intact. There is a small joint effusion." I am to be seen by the orthopedist next week for a follow up and am curious what your suggestion for treatment would be. I am a 56 yr. old female. My original complaint was constant pain in right hip most severe when going from sitting to standing position. Thanks.
Posted Thu, 20 Mar 2014 in Bones, Muscles and Joints
Answered by Dr. Naveen Kumar Sharma 34 minutes later
Brief Answer: You may need surgery Detailed Answer: Hello, I have read your query and it looks to me that you may be having early hip arthritis due to AVN. There is loss of blood supply in femoral head. This can happen due to injury, steroids (drugs taken for skin conditions) or alcohol intake. In your case your femoral head has developed a cyst and because of roughening of surface you are feeling pain in all the movement of hip joint like you have mentioned. In your stage of disease with cyst formation and articular cartilage damage, there is very little role medication can play apart from pain killers. You have the following options: 1. Decompression of femoral head through a drill. Femoral head is drill and pressure inside get decreased. After having this procedure disease stopped progressing but its results are not hundred percent. If you do not want to get a major surgery this procedure can be helpful for you. 2. If you wish for permanent treatment answer is total hip replacement. 3. There are slight chance that your other hip can also have this disease, so get MRI of other hip also even if you have no pain on that side. 4. There are medication like alendronates which can help in preventing other hip to get involved. I hope you have got answers of your queries. Feel free to ask any other question if you want. Thanks and take care.
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Follow-up: Suggest treatment for constant pain in right hip inspite of having large subarticular cyst of the anterior superior femoral head 1 hour later
What is AVN?
Answered by Dr. Naveen Kumar Sharma 12 minutes later
Brief Answer: Avascular necrosis of femoral head Detailed Answer: Femoral head is made up of hard - spongy bone. When there is decrease in blood supply due to 1. any injury, 2.side effects of some medication like steriods/smoking/ alcoholism 3.and some time due to unknown reason (idiopathic) There is cyst development and slowly collapse of femoral head take place. This is called AVN or avascular necrosis of femoral head. More often than not it involves both hip joint. Patient complain of pain and difficulty of hip movements. There are multiple treatment depends on stage of your disease. I already suggested treatment in your condition. I hope this answer helps you. Tell me if i can answer any thing else for you.
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