HEAD OF FEMUR - Osteoarthritis

The head is flattened and elongated; there is gross osteophytic lipping surrounding the whole head; cartilage is fissured and shows a nodular appearance; over the anterior part of the articular surface there is thinning of the cartilage with irregular nodules of cartilage which may be regenerating cartilage or may be fibrous tissue. The flattening of the head suggests that there may be a component of ischaemic necrosis allowing collapse.
This 46 year old man was overweight; he had a history of a painful hip for 5 years. There was pain limitation of movement on internal rotation and associated wasting of the right buttocks and quadriceps.