There is mixed patchy sclerosis and lucency in the subchondral bone of the humeral head. In addition, note associated flattening and collapse of the articular surface contour. The joint space is well maintained, and the acetabulum is unremarkable.
The images reveal avascular necrosis of the femoral head, the most common presenting symptom of which is pain in the region of affected hip, thigh, groin, and buttock. The femoral head is the most common location for avascular necrosis.
Potential causes of interruption are numerous, and include trauma, corticosteroid use, sickle cell disease, alcoholism, radiation, and Caisson’s disease—with trauma, steroids, and alcoholism predominating. This appears to be stage III disease, based on the Ficat classification of x-ray findings: crescent sign and cortical collapse.
Orthopedic referral is warranted.