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La necrosis avascular de la cabeza del fémur es una patología multifactorial caracterizada por la destrucción progresiva de la arquitectura ósea en la articulación coxofemoral, secundaria a una alteración del flujo sanguíneo local, y que, de no ser intervenida a tiempo, genera colapso articular total. Puede tener una presentación tanto sintomática, en la cual el dolor es el principal motivo de consulta; como asintomática, siendo un hallazgo de imagen incidental. Afecta individuos de cualquier edad, pero su incidencia es mayor durante la adultez, particularmente en los años de mayor producción laboral. Se asocia a una amplia gama de etiologías tanto traumáticas como médicas, entre las cuales se destacan las fracturas de fémur, el uso prolongado de glucocorticoides y el consumo excesivo de alcohol. El diagnóstico se realiza mediante una detallada revisión de factores riesgo, historia de traumas previos y principalmente la evaluación radiológica, en la cual la resonancia magnética es el estándar de oro. Actualmente el tratamiento puede ser conservador o quirúrgico en función del grado de compromiso, reservándose el remplazo articular total para los casos más severos que presentan colapso articular.
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