Editorial for Guidelines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version)

摘要

The guidelines detail the diagnostic criteria for ONFH, including clin- ical features, various imaging techniques (including conventional radiog- raphy, computed tomography, magnetic resonance imaging, and radionuclide examination), bone biopsies, and presentation at different pathological stages, with particular regard to vascularisation of the tissue. Furthermore, the guidelines provide instruction for differential diagnosis of disorders that may appear similar to that of ONFH, such as hip osteo- arthritis, insufficiency and traumatic fractures, ankylosing spondylitis, and rheumatoid arthritis, amongst others. The guidelines also present an updated version of the ARCO Staging System, which was presented and approved at the “2019 ARCO Conference” in Dalian, People's Republic of China, providing a better system to assess the pathological stage of osteonecrosis. The guidelines provide a diagnostic flowchart to aid clini- cians in making an appropriate diagnosis of ONFH at different stages of progression. Prevention and treatment strategies are discussed in the guidelines, providing both surgical and nonsurgical treatment options for patients at different stages of the disease. Lastly, post-treatment evaluation practices are presented, which may help clinicians determine if their treatment strategies are efficacious, or if any modifications are required.