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Archives of Orthopaedic and Trauma Surgery

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01-05-2009 | Orthopaedic Surgery

Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head

Authors: Keita Miyanishi, Toshihiko Hara, Shigekazu Kaminomachi, Hiroki Maeda, Hideyuki Watanabe, Takehiko Torisu

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2009

Abstract

Introduction

Subchondral insufficiency fracture of the femoral head (SIF) may be confused with osteonecrosis of the femoral head (ON) due to clinical and imaging similarities.

Materials and methods

Contrast-enhanced MR images in patients with SIF (ten hips in ten patients) were retrospectively reviewed and compared with those from patients with ON (ten hips in six patients).

Results

Low-signal intensity bands on T1-weighted images were present within the femoral head in all hips examined. The segment proximal to the band was contrast-enhanced following IV gadolinium administration in nine of ten hips (90%) with SIF and in none of the 10 hips with ON.

Conclusion

These results suggest that the presence of contrast enhancement in the segment proximal to the low-signal intensity band in the femoral head may serve as a supplemental diagnostic measure for the differentiation of SIF from ON.

Bullough PG (2004) Osteonecrosis and bone infarction. In: Orthopaedic pathology, 4th edn. Mosby, Edinburgh, pp 347–362

Hirota Y, Hotokebuchi T, Sugioka Y (1997) Idiopathic osteonecrosis of the femoral head: nationwide epidemiologic studies in Japan. In: Urbaniak JR, Jones JP Jr (eds) Osteonecrosis: etiology diagnosis and treatment. American Academy of Orthopaedic Surgeons, Rosemont, pp 51–58

Ikemura S, Yamamoto T, Nakashima Y, Shuto T, Jingushi S, Iwamoto Y (2005) Bilateral subchondral insufficiency fracture of the femoral head after renal transplantation: a case report. Arthritis Rheum 52:1293–1296PubMedCrossRef

Mankin HJ (1992) Nontraumatic necrosis of bone (osteonecrosis). N Engl J Med 326:1473–1479PubMed

Merle d’Aubigne R, Postel M (1954) Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am 36:451–475

Steinberg ME, Hayken GD, Steinberg DR (1997) Classification and staging of osteonecrosis. In: Urbaniak JR, Jones JP Jr (eds) Osteonecrosis: etiology diagnosis and treatment. American Academy of Orthopaedic Surgeons, Rosemont, pp 277–284

Sugano N, Atsumi T, Ohzono K, Kubo T, Hotokebuchi T, Takaoka K (2002) The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. J Orthop Sci 7:601–605PubMedCrossRef

Vande Berg B, Malghem J, Labaisse MA, Noel H, Maldague B (1992) Avascular necrosis of the hip: comparison of contrast-enhanced and nonenhanced MR imaging with histologic correlation. Work in progress. Radiology 182:445–450

Yamamoto T, Bullough PG. (1999) Subchondral insufficiency fracture of the femoral head: a differential diagnosis in acute onset of coxarthrosis in the elderly. Arthritis Rheum 42:2719–2723PubMedCrossRef

10.

Yamamoto T, DiCarlo EF, Bullough PG (1999) The prevalence and clinicopathological appearance of extension of osteonecrosis in the femoral head. J Bone Joint Surg Br 81:328–332PubMed

11.

Yamamoto T, Schneider R, Bullough PG. (2001) Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI. Skeletal Radiol 30:247–254PubMedCrossRef

12.

Yamamoto T, Schneider R, Iwamoto Y, Bullough PG (2006) Subchondral insufficiency fracture of the femoral head in a patient with systemic lupus erythematosus. Ann Rheum Dis 65:837–838PubMedCrossRef

13.

Yamashita A, Yamamoto T, Jingushi S, Iwamoto Y, Sugioka Y, Sueishi K (2006) Histopathological study of osteonecrosis 19 years after transtrochanteric rotational osteotomy. J Orthop Sci 11:632–637PubMedCrossRef

14.

Yasunaga Y, Hisatome T, Ikuta Y, Nakamura S (2001) A histological study of the necrotic area after transtrochanteric anterior rotational osteotomy for osteonecrosis of the femoral head. J Bone Joint Surg Br 83:167–170PubMedCrossRef

15.

Yoshiike N, Matsumura Y, Zaman MM, Yamaguchi M (1998) Descriptive epidemiology of body mass index in Japanese adults in a representative sample from the National Nutrition Survey 1990–1994. Int J Obes Relat Metab Disord 22:684–687PubMedCrossRef

Title: Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head
Authors: Keita Miyanishi
Toshihiko Hara
Shigekazu Kaminomachi
Hiroki Maeda
Hideyuki Watanabe
Takehiko Torisu
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-008-0642-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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