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Xray and MRI. Unfortunately most of the time it is not diagnosed until it appears on an Xray, which will put you into Stage 2+. Many MDs and Ortho Surgeons are reluctant to order an MRI, because they feel they will not treat you any differently with an MRI, and MRI is more costly. AVN is much easier to detect via MRI, and you can much more clearly visualize the impact. My recommendation is that if it shows on an xray you should seek out an AVN Specialist asap.