Sectoral sign is positive in –
**Core Concept**
The sectoral sign, also known as the 'crescent sign', is a radiographic feature that refers to a linear radiolucent band within the femoral head. This sign is indicative of a specific pathophysiological process affecting the femoral head.
**Why the Correct Answer is Right**
Avascular necrosis (AVN) of the femoral head leads to a characteristic appearance on radiographs, including the sectoral sign. This occurs due to the interruption of blood supply to the femoral head, resulting in a sectoral pattern of ischemic necrosis. The sectoral sign is a result of the collapse of the subchondral bone plate, which can be seen as a radiolucent band on radiographs. This collapse is a consequence of the underlying avascular necrosis.
**Why Each Wrong Option is Incorrect**
**Option B:** Osteoarthritis of the hip (B) does not typically present with a sectoral sign. Osteoarthritis leads to joint space narrowing, subchondral sclerosis, and cyst formation, but not a sectoral pattern of radiolucency.
**Option C:** Protrusio acetabuli involves significant posterior displacement of the acetabulum, which can lead to changes in the femoral head, but it is not typically associated with the sectoral sign. The characteristic feature of protrusio acetabuli is the abnormal acetabular morphology.
**Option D:** Slipped capital femoral epiphysis (SCFE) is a condition where the femoral head slips off the capital femoral epiphysis. While SCFE can lead to changes in the femoral head, it is not typically associated with the sectoral sign. The characteristic feature of SCFE is the displacement of the femoral head.
**Clinical Pearl / High-Yield Fact**
In cases of suspected avascular necrosis of the femoral head, it's essential to remember that the sectoral sign is a relatively late finding. Early findings may include a normal radiograph or subtle changes such as a 'double-density sign' or 'crescent sign' which may not be as evident.
**β Correct Answer: A. Avascular necrosis of femur head**