Ficat classification of avascular necrosis of the femoral head

vigente

Stages osteonecrosis of the femoral head.

Índice de referência, não é suporte à decisão clínica. O RadCommons apresenta conteúdo de referência reescrito a partir de critérios publicados e com link para a fonte primária. Confira sempre a publicação primária vigente. Não é um dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

Escala de categorias

0 I II III IV

As figuras e tabelas estão na fonte primária. Abrir a fonte. O RadCommons reescreve e cita, não reproduz figuras protegidas por direitos autorais.

Procedência e vigência

Órgão emissor: Orthopedic consensus
Versão: 1985
Ano: 1985
Família: léxico
Tipo de lógica: flat
Modalidade: XR, MRI
Fonte primária: Idiopathic bone necrosis of the femoral head (Ficat)
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "0",
    "I",
    "II",
    "III",
    "IV"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
0	Grade 0 Preclinical/silent hip: radiographs normal (inconspicuous) and the patient is asymptomatic; diagnosis suspected only by other means (e.g. MRI, opposite-hip disease).	Pre-collapse stage: non-operative/observation (e.g. bisphosphonates) and joint-preserving options; close monitoring given the risk of progression to symptoms or collapse.	Asymptomatic early lesions carry substantial risk of progression: about 59% of asymptomatic lesions progress to symptoms or collapse.	okfonte PMC2323428 Table 1 (criteria); NBK537007 (non-operative/joint-preserving for early stages; 59% of asymptomatic lesions progress).
I	Grade I Symptomatic hip with radiographs still normal or showing only minor changes (e.g. slight patchy osteoporosis); femoral head shape preserved.	Pre-collapse: joint-preserving surgery, particularly core decompression (most effective in early disease with small weight-bearing involvement), with/without bone grafting or biologic adjuncts; non-operative measures may be used.	Pre-collapse but progressive; core decompression failed to prevent progression in roughly 90% of treated hips, reflecting the high rate of eventual collapse.	okfonte PMC2323428 Table 1 (criteria); NBK537007 (core decompression for early stages; ~90% core-decompression failure).
II	Grade II Radiographic changes without overall head collapse: diffuse or focal osteoporosis, sclerosis, and cysts (Ficat IIA), progressing to a subchondral fracture (crescent sign) with segmental flattening (Ficat IIB); joint space preserved.	Still considered pre-/peri-collapse: joint-preserving core decompression (+/- grafting) for lesions before frank collapse, most effective when the lesion is small and limited to a small part of the weight-bearing surface.	Once the crescent sign / subchondral fracture appears, progression to collapse is common and joint-preserving procedures are less likely to succeed.	okfonte PMC2323428 Table 1 (criteria, incl. crescent sign); NBK537007 (joint-preserving most effective in early stages/small lesions).
III	Grade III Broken/disrupted contour of the femoral head with bone sequestrum (true segmental collapse) while the joint space remains normal/preserved.	Post-collapse: total hip arthroplasty is indicated, especially for irreversible etiology, patients over 40, large lesions, or advanced collapse; younger patients with advanced collapse also move toward arthroplasty.	Segmental collapse has occurred; the joint is no longer salvageable by joint-preserving surgery and degenerative end-stage disease typically follows.	okfonte PMC2323428 Table 1 (criteria); NBK537007 (total hip arthroplasty indicated for advanced collapse / age >40 / large lesions).
IV	Grade IV End stage: flattened femoral head contour, joint-space narrowing/collapse, and secondary osteoarthritic (degenerative) changes of the joint.	Post-collapse end stage: total hip arthroplasty (joint replacement) is the definitive treatment.	Irreversible end-stage osteoarthritic destruction of the hip; joint-preserving options no longer applicable.	okfonte PMC2323428 Table 1 (criteria); NBK537007 (total hip arthroplasty for advanced/end-stage disease).

Histórico de versões

Nenhum evento de versão registrado.

Quickstart da APIGET /api/v1/systems/ficataberto

curl -s "https://radcommons.laudos.ai/api/v1/systems/ficat"

Ver documentação completa