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Right hip pain and bone infarction


74 year old female with degenerative osteoarthritis of the lumber spine and multiple hip operations for osteonecrosis. Has been able to walk short distances with assistance of a walker. In the past 4 months patient has noted increasing pain and disability of the right hip and has been unable to walk secondary to right hip pain. The pain is severe and limiting her ability to walk and transfer.

Physical Examination

Short stature, thin but alert female looks older than stated age. Right hip exam reveals shortening and an adduction contracture with an obvious deformity of her proximal femur.

Initial Imaging

Initial imaging studies are shown below

What is the differential diagnosis?

Diagnosis (Click to see answer)




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Christopher Beauchamp
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