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The levels of urinary miR-4824 abruptly decreased after femoral head collapse (ARCO stage III and IV). Urinary miR-144 was the only marker that correlated with lesion size. The levels of urinary miRNAs are valuable biomarkers for idiopathic ONFH. Given the noninvasive nature of this test, it is potentially useful for diagnosis and monitoring of idiopathic ONFH progression. This article gives novel methods for ONFH diagnosis and progression monitoring in a convenient and non-invasive way. This article gives novel methods for ONFH diagnosi