What is the Steinberg Classification System for femoral head avascular necrosis (AVN)?

Updated: Oct 22, 2018
  • Author: John D Kelly, IV, MD; Chief Editor: Craig C Young, MD  more...
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See the list below:

  • Steinberg proposed the following staging system, known as the Steinberg Classification System, which is concise and delineates the progression and extent of AVN involvement more accurately. [9, 10] This staging system has gained increasing acceptance in the orthopedic community.

    • Stage I – Normal radiographs; abnormal MRI or bone scan

    • Stage II – Abnormal lucency or sclerotic site in femoral head

    • Stage III – Subchondral collapse (ie, crescent sign) without flattening of femoral head

    • Stage IV – Flattening of the femoral head; normal joint space

    • Stage V – Joint space narrowing, acetabular changes, or both

    • Stage VI – Advanced degenerative changes

    • Stages I-IV are further subdivided according to the percentage of femoral head involvement: A (< 15%), B (15-30%), or C (>30%).

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