Single-centre epidemiological investigation and diagnosis analysis of osteonecrosis of the femoral head

Purpose: In this retrospective case investigation, we analysed the data of patients with osteonecrosis of the femoral head (ONFH) in a single centre to reveal demographic and clinical diagnostic features of ONFH and provide a reference for its prevention, diagnosis, and treatment. Methods We collected data from patients in our hospital, focusing on the aetiology and diagnosis of ONFH. Medical records and self-design questionnaires were used to collect information for statistical analysis, including age, aetiology, reason for glucocorticoid use, hospital level at first visit, and diagnosis. Results In total, 203 patients with complete medical records were included in the analysis. The mean patient age was 41.23 ± 12.61 years. The peak age distribution was in the 30s among men and in the 40s among women. Of the total, 100 patients had steroid-induced ONFH (49.26%), 55 had alcoholic ONFH (27.09%), 23 had traumatic ONFH (11.33%), and 25 had idiopathic ONFH (12.32%). Forty-seven patients had intakes of ≥ 2 g prednisone or its equivalent within a 3-month period, and fifty-three patients had a history of low-dose steroid in the past 3 years. Of the total, 112 patients were diagnosed with ONFH at the first visit (diagnosis rate55.17%). The rate of misdiagnosis at all hospital levels was highest for lumbar disc herniation. Conclusions Most patients with ONFH were middle-aged and had steroid-induced ONFH. The misdiagnosis rate of ONFH at the first visit was very high, especially for misdiagnosis of lumbar disc herniation, indicating that the diagnosis of ONFH must be improved.