[Diagnosis and treatment of idiopathic necrosis of the femoral head].

Fourteen cases, 25 hips, of idiopathic necrosis of femoral head (INFH) were included in our series. The role of radiographs, isotopic bone scanning, intraosseous pressure measurement and intraosseous venography in diagnosis of INFH was evaluated. Radiological examination cannot reveal early case, while isotopic bone scanning was more sensitive. There was increase of intraosseous pressure in most diseased hips. Intraosseous venography was abnormal in all examined hips. These two tests could therefore detect early INFH. Core decompression was performed on 21 hips. The operated hips were followed for 3.5 months to 20 months. Functional evaluation of 18 hips were good or excellent. Radiographic re-examination of 20 hips remained unchanged. The postoperative intraosseous pressure measurement and intraosseous venography in examined hips revealed a decrease of intraosseous pressure and improvement of venous drainage. Core decompression is therefore an ideal method of treatment for early INFH.