Vishnyakov A. Aseptic necrosis of the femoral head in adults (diagnosis and prognosis).

Object: aseptic necrosis of the femoral head in adults. Objective: To improve the quality of diagnosis of aseptic necrosis of the femoral head in adults through the use of ultrasound articular and periarticular tissues of the hip. Methods: The clinical, radiographic, ultrasonic, biochemical, information and patent research, statistical research. First identified ultrasound criteria manifestations of aseptic necrosis of the femoral head in adults by assessing the state of the articular and periarticular tissues of the hip. The way of ultrasound diagnosis of necrotic lesions of the femoral head (patent of Ukraine for useful model number 48253), which allows during an ultrasound examination clearly identify violations in the subchondral layer of aseptic necrosis of the femoral head kistki. First proved that the expansion of the neck-capsular space and presence in the joint cavity fluid nizkoehogennoy indicates inflammation in the joints of patients with osteonecrosis of the femoral head kistki. First developed quantitative and qualitative indicators of the pelvis muscles in aseptic necrosis of the femoral head. First developed quantitative Doppler indices of blood flow in the hip in adults and found an association between the development of hip joint pathology and blood flow. For the first time on the basis of a comprehensive methodology hip ultrasound to determine the magnitude of necrotic lesions of the femoral head (patent of Ukraine for useful model number 66421), which allows to predict the course of the disease. We prove the usefulness of ultrasonography in the diagnosis of avascular necrosis of the femoral head in adults in primary diagnosis. Accounting for the identified lesions by ultrasound research method will plan treatment activities, depending on the stage of the disease. The use of ultrasound criteria specific to the inflammation in the joint will identify process activity in the joint without the use of X-ray method. The use of ultrasound criteria that characterize the changes in the muscle tissue of patients with osteonecrosis of the femoral head and blood flow changes in the hip joint, contribute to the understanding of mechanisms that accompany osteonecrosis and will improve the diagnosis. Ultrasonic method for evaluating necrotic lesions of the femoral head can prevent its destruction and early to predict the outcome of the disease. The use of ultrasonic method limits the use of invasive and costly research methods in patients at different stages of diagnosis of aseptic necrosis of the femoral head and helps to reduce radiation exposure. Results of the study put into practice the Kharkiv Medical Academy of Postgraduate Education, State Enterprise "Institute of Spine and Joint Pathology them. prof. MI Sitenko Medical Sciences of Ukraine, "SI" Institute of Medical Radiology. SP Grigorieva Medical Sciences of Ukraine, "medical-diagnostic center" Modern medical technology ", Kharkiv Regional Hospital Emergency Medical Care. prof. AI Meshchaninova. Traumatology and orthopaedy.