 Good evening everyone. I am presenting a paper on city bus. My topic is role of MRI in detecting a vascular necrosis. Myself Dr. Taron Sagal, I am from MJ Medical College, Arangabad. Introduction of the topic, COVID-19, it was caused by SARS-CoV-2 is the reason of the current pandemic. Since the pandemic, outbreak people are being killed due to the virus. Many medications have been used, including various antivirus and utensil receptor blockers, corticostroids for the treatment of COVID-19. Although many patients are recovering from COVID-19, patients are suffering from many complications after the treatment, including pulmonary and non-pulmonary complications. One of these non-pulmonary complications, rare complication is A-vascular necrosis. Single nucleotide polymorphism in various gene encodes for pro-inflammatory protein, which may affect biological activity and contribute to hypercovability in COVID-19 patients, thereby increasing the risk of bone necrosis. The combination of hypercovability, leukocyte aggregation and vasculitis can impair the blood flow in the blood vessels of the bone and contribute to the development of bone necrosis. Hence, it is important to diagnose avian early to decrease the morbidity and requirement of the surgery. The main aims and objective of these studies is to identify an early diagnosis of avian of hip joint in post-COVID-19 patients presenting with hip pain. Medial methods. This study was done in M.J. Medical College in Rangabat. The duration was 12 months. Sample size was 20 patients, including criteria PCR-indicating COVID-positive COVID-19 infection and hip joint pain during the course of the disease. Prior injury to the affected hip joint, prior treatment with steroids and severe chronic illness like diabetes, malitis and hypertension were included. The study included a group of 20 patients who dwelled symptoms of joint dysfunction, which were classified as avian necrosis in COVID-19 or MR images. Patient was screened with plain radiograph of the affected joint. MRI examination of the hip joint was done on the same day as as plain radiograph. Informed concerns were obtained from the patient. MRI was performed using a 1.5 tesla philis paradoxus CX. Established MRI criteria and staging systems were used for the diagnosis of avian. Pfizer and Arlett classification system for MRI was used for staging avian of femoral head. Results. The main interval between the onset of initial symptoms and MRI was 2-4 weeks. As per the Pfizer and Arlett classification were seen of the cases. Stage 4 avian was seen in 0 cases. Stage 1 avian was seen in 9 cases. Stage 2 avian was seen in 8 cases. Stage 3 avian was seen in 3 cases. 45% of the patients were classified into stage 1. 40% into stage 2, which was seen more in middle and elderly age group. Stage 3 was seen in 3 people. They were seen in elderly age group, which were more than 60 years old. Stage 4 avian was not seen in any cases. This is because the cases were detected early due to the presentation of affected patients earlier. Gender-wise distribution of the cases. Total 14 males and 6 females were taken. The symptoms included fever and hip pain. 10 of the male patients had fever and 9 of them had hip pain. 4 females had fever and 5 had hip pain. Comorbidities, diabetes, malitis. 5 male patients had diabetes and 3 had hypertension. 3 females had diabetes and 3 had hypertensive. So these are the radiograph image. Clean radiograph of right hip showing subtle irregularities. So here we can see there were certain irregularities of right femoral head and marginal sclerosis of the femoral head and the acetabular rim. This is the acetabular rim. On the same day MRI was done, in which coronal, this is the coronal T21 section of the MRI hip joint, which shows certain irregularities of the femoral head. Coronal stud image was taken, which is showing hyper-intensities in the right femoral head and neck extending into the intra-trochanteric region and acetabulum, which is suggestive of marrow edema. The fourth figure suggests it's a coronal stud section image, which shows minimal, here we can see minimal fluid collection in the right hip joint. Plain radiograph and MRI of the patients. This is the plane MRI and the plane radiograph and MRI of the patient, in which there is seen and tested changes in both femoral heads in the geographical pattern. No collapse of the femoral heads and contiguity of the both hip joints maintained. Suggestive of feis and and outlets stage two osteonecrosis of both femoral heads. In coronal MRI, normal appearance of the femoral head is seen in the image. There is normal appearance. In B image, coronal MRI, stud image was taken. Here we can say hyper-intensities are seen, which suggests bilateral stage one avian. In third image, coronal MRI T1 weighted images, bilateral stage two avian of the femoral head, we can see osteonecrosis of the femoral heads. In the fourth image, we can see coronal MRI T1 weighted images, in which we can say right stage three avian of the femoral head and left side we can see stage two. In this whole study, avian is one of the non complications after steroid treatment of severe COVID-19 infections in long COVID-19 infections. We described 20 cases who suffered from avian shortly after a COVID-19 infection without prior steroid treatment. COVID-19 infections alone may aid as a risk factor for developing avian. On average, avian begins two to three weeks after COVID-19 its own cell. The mean age of the patient was 40 years and six women and 14 men were included. The most commonly affected age group in the present study was more than 50 years of age. Clinical symptoms and signs of musculoskeletal system occurred 72 days after 72 days from infection onset and appeared 5 to 10 days after the resolution of acute respiratory symptoms and with elevated body temperature. 11 out of 20 patients were initially treated conservatively, no steroidal and anti-inflammatory drugs, intraarticular steroid injections and therapeutic aspiration of the senile fluid. Three out of 20 patients required arthroplasty also. Conclusion. In post COVID-19 patients, there is a greater risk of developing avian. Mainly if the patient has been on steroids, steroids are a life-saving advantage for the treatment of COVID-19. However, if the avian is diagnosed early, progression of the disease can be controlled. Therefore, it is crucial to diagnose avian early in order to decrease the morbidity and requirement of the surgery. The most sensitive and invasive test to diagnose early avian hip joint is MRI of the both hip joints. Therefore, when post COVID-19 patient present with hip pain, it is recommended that MRI should be advised to rule out avian hip. So, these are the references. Thank you.