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MRI scans can detect avascular changes in the epiphysis before it is evident on plain radiographs and hence it is useful as a diagnostic modality very early in the disease. MRI perfusion scans with gadolinium enhancement and fat suppression sequencing can quantify the extent of avascularity of the femoral epiphysis as soon the disease is diagnosed . This is particularly useful as recent studies have based treatment decisions on how much of the epiphysis is devoid of blood supply ( greater or less than 50% involvement). The use of treatment algorithms based on MRI perfusion scans is still under investigation at present. Arthrography is useful during the course of treatment. In particular, dynamic arthrography performed under anaesthesia can identify alterations in the contour of the cartilaginous portion of the femoral head and congruency of the joint surfaces in different positions of the hip. Arthrography is also useful to confirm the presence of hinge abduction where dye pools medially as the hip is abducted .