Femoral Head Avascular Necrosis Clinical Presentation

Updated: Oct 20, 2023
  • Author: John D Kelly, IV, MD; Chief Editor: Craig C Young, MD  more...
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AVN may present with nonspecific signs and symptoms.

Early in the disease process, the condition is painless; however, patients ultimately present with pain and limitation of motion.

The pain is most commonly localized to the groin area, but it may also manifest in the ipsilateral buttock, knee, or greater trochanteric region.

Painful symptoms are usually exacerbated with weight bearing but are relieved by rest.


Physical Examination

Passive range of motion of the hip is limited and painful, especially forced internal rotation.

A distinct limitation of passive abduction is usually noted.

A straight-leg raise against resistance provokes pain in most symptomatic cases.

Passive internal and external rotation of the extended leg ("log roll test") may elicit pain that is consistent with an active capsular synovitis.