Osteonecrosis of the patella in patients with nontraumatic osteonecrosis of the femoral head: MRI findings in 60 patients

2000 ◽  
Vol 71 (5) ◽  
pp. 447-451 ◽  
Author(s):  
Takashi Sakai ◽  
Nobuhiko Sugano ◽  
Takashi Nishii ◽  
Keiji Haraguchi ◽  
Hideki Yoshikawa ◽  
...  
Keyword(s):  
Femoral Head ◽  
Mri Findings

The role of the subchondral layer in osteonecrosis of the femoral head: analysis based on HR-QCT in comparison to MRI findings

2018 ◽  
Vol 60 (4) ◽  
pp. 501-508 ◽  
Author(s):  
Alexander R Kolb ◽  
Janina M Patsch ◽  
Wolf-Dieter Vogl ◽  
Emir Benca ◽  
David Stelzeneder ◽  
...  
Keyword(s):  
Femoral Head ◽  
Trabecular Bone ◽  
Severe Disease ◽  
Quantitative Computed Tomography ◽  
Young Patients ◽  
High Signal ◽  
Homogeneity Test ◽  
Special Focus ◽  
Mri Findings ◽  
Bone Parameters

Background Non-traumatic avascular osteonecrosis of the femoral head (ONFH) is a severe disease causing destruction of the hip joint, often necessitating total hip arthroplasty (THA) even in young patients. Magnetic resonance imaging (MRI) is commonly used for diagnosis of ONFH, but provides limited insight into the subchondral bone microstructure. Purpose To analyze routine MRI findings in comparison to high-resolution quantitative computed tomography (HR-QCT) with a special focus on the subchondral layer and to estimate the importance of differences determining the indication for THA. Material and Methods Twelve patients with ONFH were included before THA. Preoperative MRI and HR-QCT of the retrieved femoral heads were aligned using a registration algorithm. Pathological findings and trabecular bone parameters in matched areas were analyzed by two readers. McNemar, marginal homogeneity test, and Pearson’s correlation coefficient were used for comparison. Results Subchondral delamination was found in nine cases on HR-QCT, but missed or underestimated in all but one case on MRI ( P = 0.016). Chondral discontinuity was found in all cases on HR-QCT and in two cases on MRI ( P = 0.016). Areas of complete bone resorption on HR-QCT were linked to high signal intensity on 3D gradient-echo MRI sequences with water-selective excitation, while there was no correlation between trabecular bone parameters and MRI signal intensities in other areas ( P = 0.304). Conclusion Subchondral delamination, subchondral resorption, and chondral discontinuity are found frequently in advanced stages of ONFH. These lesions tend to be underestimated on conventional MRI. Our results support the importance of CT imaging in the evaluation of ONFH.

scholarly journals MRI-based static and functional assessment of complex hip deformities in comparison with CT: a validation study

2020 ◽  
Vol 33 (6) ◽  
pp. 829-838
Author(s):  
Sophia Blum ◽  
Lea Franken ◽  
Albrecht Hartmann ◽  
Falk Thielemann ◽  
Verena Plodeck ◽  
...  
Keyword(s):  
Femoral Head ◽  
Linear Regression Analysis ◽  
Intraclass Correlation ◽  
Alpha Angle ◽  
Acetabular Coverage ◽  
Mri Findings ◽  
Perfect Agreement ◽  
Femoral Torsion ◽  
Center Edge ◽  
Hip Morphology

Abstract Objective This study aimed at investigating the agreement between predefined quantitative parameters of hip morphology derived from magnetic resonance imaging (MRI) and virtual range of motion (ROM) analysis using computed tomography (CT) as standard of reference. Methods Twenty patients (13 females, 7 males, 16–59 years) with hip deformities underwent MRI prior to surgery. Clockwise alpha angle, femoral head and neck diameter, collum caput diaphysis angle, femoral torsion, center-edge angles, acetabular coverage of the femoral head, sourcil angle, and acetabular anteversion were measured. Additionally, tern single and combined movements were simulated using a motion analysis program. The MRI findings were compared with the corresponding results obtained by CT. Correlation of MRI with CT was assessed using different statistical methods (intraclass correlation coefficient, Bland–Altmann plot, two one-sided t test), and linear regression analysis was performed. Results The results showed near-perfect intraclass correlation coefficients (ICCs) for anteversion (0.95), acetabular sector angles (0.98–0.99), sourcil angle (0.95), and acetabular coverage (anterior 0.96, posterior 0.99). Intermethod correlation for femoral parameters showed almost perfect agreement except for the alpha angle (0.73–0.97). No significant proportional bias was detected for traditional acetabular and femoral parameters. ROM analysis was performed for 370 movements in 37 hips. For 78.4% (290/370) of the movements analysed, neither CT nor MRI detected impingement across the physiological ROM. For 18.6% (69/370) of the movements, impingement was detected by both CT and MRI, while 2.2% (8/370) of the movements with impingement in CT showed no impingement in MRI, and 0.8% (3/370) of the movements with impingement in MRI had no corresponding result in CT. Conclusion Finally, it was concluded that MRI-based assessment of hip morphology and virtual ROM analysis is feasible and can be performed with good intermethod agreement in comparison to the gold standard (CT). Therefore, MRI appears to be substantially equivalent to CT for use in virtual ROM analysis and so may reasonably be used in place of CT for this purpose.

Initial MRI findings of non-traumatic osteonecrosis of the femoral head in renal allograft recipients

1997 ◽  
Vol 15 (9) ◽  
pp. 1017-1023 ◽  
Author(s):  
Toshikazu Kubo ◽  
Shoichi Yamazoe ◽  
Nobuhiko Sugano ◽  
Mikihiro Fujioka ◽  
Shoji Naruse ◽  
...  
Keyword(s):  
Femoral Head ◽  
Renal Allograft ◽  
Mri Findings

Psychological distress in patients suffering from femoral head osteonecrosis, with and without white matter lesions: clinical characteristics and personality traits

2011 ◽  
Vol 26 (S2) ◽  
pp. 877-877
Author(s):  
O. Mouzas ◽  
M.N. Papaliaga ◽  
A. Zibis ◽  
G. Hadjigeorgiou ◽  
N. Angelopoulos ◽  
...  
Keyword(s):  
Psychological Distress ◽  
White Matter ◽  
Femoral Head ◽  
Brain Mri ◽  
General Health Questionnaire ◽  
White Matter Lesions ◽  
Self Report ◽  
Cerebral White Matter ◽  
Mri Findings ◽  
Femoral Head Osteonecrosis

BackgroundThe aim of the present study was to investigate clinical parameters in relation to personality characteristics and psychopathology, in patients with non traumatic osteonecrosis of the femoral head (ONFH), with and without cerebral white matter lesions (WML).MethodsSixty seven patients participated in the study, 48 males and 19 females. The mean age was 37.6 years (SD 10.92, range: 15–61). Seventy five healthy individuals age and sex matched, served as controls. Socio-demographic information, clinical data and brain MRI findings were collected. The following self-report instruments were used: General Health Questionnaire (GHQ-28) and Defense Style Questionnaire (DSQ).ResultsThe odds of being assessed with a psychiatric diagnosis upon interview were three times greater among patients with ONFH compared to healthy controls (p < .006). The presence of cerebral WML and secondary nature of ONFH were associated with intense symptoms of psychological distress and especially with somatic symptoms of depression and social dysfunction (p < .003). A specific personality structure was identified in patients with ONFH.ConclusionsPatients suffering from osteonecrosis of femoral head, especially when white matter lesions are present, often present psychological distress and problematic personality organization. Therefore psychological support and/or psychiatric intervention can be beneficial to these individuals.

MRI Findings of New Uptake in the Femoral Head Detected on Follow-Up Bone Scans

2015 ◽  
Vol 204 (3) ◽  
pp. 608-614 ◽  
Author(s):  
Seong Ho Kim ◽  
Hye Jin Yoo ◽  
Yusuhn Kang ◽  
Ja-Young Choi ◽  
Sung Hwan Hong
Keyword(s):  
Femoral Head ◽  
Mri Findings ◽  
Bone Scans

scholarly journals Role of MRI in the Detection and Monitoring of Lower Limb Osteonecrosis after Chemotherapy in Pediatric Patients with Acute Lymphoblastic Leukaemia

2020 ◽  
pp. 39-48
Author(s):  
Aliaa M. Maarek ◽  
Mohammed M. Dawoud ◽  
Tarek A. Rafat ◽  
Khaled I. Elshafey
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Pediatric Patients ◽  
Lymphoblastic Leukemia ◽  
Lower Limbs ◽  
Joint Involvement ◽  
Mri Findings ◽  
Bone Infarction ◽  
Mri Study

Background: Magnetic resonance imaging (MRI) is the technique that demonstrated the highest sensitivity and specificity in the early diagnosis of osteonecrosis. It allows detecting initial typical signal intensity alterations of the bone marrow when other examinations showed nonspecific findings or even no alterations at all. The aim of this study is to assess the role of magnetic resonance imaging in detection and monitoring osteonecrotic lesions in pediatric patient with acute lymphoblastic leukemia after chemotherapy. Materials and Methods: This prospective study was performed on 30 pediatric patients ranged from 4 to 18 years with acute lymphoblastic leukemia on chemotherapy or after 3months from ending chemotherapy with symptoms suspicious for osteonecrosis (i.e., articular pain). All patients were explained about the procedure to be done. MRI study of whole lower limbs was done for all patients. Results: In the present study all patients were symptomatic. 24\30 patients (80%) had hip pain, 25\30 patients (83.3%) had knee pain and 8\30 patients (26.7%) had limping. We reported that knee pain was the most common complaint representing 83.3% of patients. 11\30 patients (36.7%) had no MRI findings. 19\30 patients (63.3%) had different positive findings; 4 patients (13.3%) had non -articular osteonecrosis (ON) only with no joint involvement (bone infarction), 2 patients (6.7%) had avascular necrosis of femoral head epiphysis without bone infarction and 13 patients (43.3%) had combined bone infarction and avascular necrosis with Joint involvement. Follow up by MRI was done for all patients (30 patients), 27 patients showed no change in MRI findings, one patient progressed from avascular necrosis of the femoral head epiphysis without deformity to avascular necrosis of the femoral head epiphysis with deformity. The other two patient showed regressive course. Conclusion: We concluded that MRI study is mandatory for early detection and monitoring of lower limb osteonecrosis in pediatric patients with acute lymphoblastic leukemia under or after chemotherapy. The radiologist and clinician must do MRI lower limbs routinely and follow up MRI after 4-6 months to first MRI due to some patients had regressive or progressive findings.

scholarly journals Subchondral Insufficiency Fracture of the Femoral Head Caused by Excessive Lateralization of the Acetabular Rim

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Tetsuya Kimura ◽  
Tomohiro Goto ◽  
Daisuke Hamada ◽  
Takahiko Tsutsui ◽  
Keizo Wada ◽  
...  
Keyword(s):  
Femoral Head ◽  
Mechanical Stress ◽  
Insufficiency Fracture ◽  
Severe Osteoporosis ◽  
Mri Findings ◽  
Subchondral Insufficiency Fracture ◽  
Plain Radiographs ◽  
History Of ◽  
Acetabular Rim ◽  
Acetabular Overcoverage

We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. A diagnosis of SIF was made by typical MRI findings of SIF. The lesion occurred at the antipodes of the extended rim. Increased mechanical stress over the femoral head due to impingement against the excess bone was suspected as a cause of SIF. The distinct femoral head deformity is consistent with this hypothesis. This is the first report of SIF associated with acetabular overcoverage.

scholarly journals Correlation of magnetic resonance imaging and radionuclide bone imaging findings of femoral head necrosis

2019 ◽  
Author(s):  
Jun qiang Yin ◽  
Lei Ding ◽  
Zhenhua Gao ◽  
Xianbiao Xie ◽  
Liangcai Wu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Head ◽  
Type I ◽  
Bone Imaging ◽  
Type Ii ◽  
White Ball ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Black Ball

Abstract Objectives To investigate the radionuclide bone imaging (RBI) manifestation of femoral head necrosis (FHN) in different magnetic resonance imaging (MRI) findings. Materials and Methods 72 hips in 42 patients with FHN underwent MRI and RBI examination to observe the RBI manifestation of FHN in different MRI types. Results There were 23 hips with MRI Type I FHN, 11 hips showing the corresponding RBI manifestation of ‘hands-holding-a-white-ball sign’ and 7 hips showing the ‘doughnut sign’. There are thirty-seven hips with MRI Type II FHN, 16 hips showing the corresponding RBI manifestation of diffusely increased uptake, 7 hips showing the ‘hands-holding-a-black-ball sign’, 7 hips showing the ‘doughnut sign’ and 4 hips showing the ‘hands-holding-a-white-ball sign’. There were 12 hips with Type III FHN, 11 hips showing the corresponding RBI manifestation of diffusely increased uptake and 1 hip showing the ‘hands-holding-a-black-ball sign’. The ‘hands-holding-a-white-ball sign’ in Type I FHN was significantly higher than that of Type II-III FHN (P<0.05), and the diffusely increased uptake in Type I FHN was significantly lower than that of Type II-III FHN (P<0.05). Conclusions Different MRI findings of FHN lead to diverse RBI findings . In addition, the ‘doughnut sign’, the ‘hands-holding-a-white-ball sign’ and the ‘hands-holding-a-black-ball sign’ also have diagnostic value for FHN.

scholarly journals Idiopathic avascular necrosis of the femoral head in adolescents: Diagnostics and management

2005 ◽  
Vol 52 (2) ◽  
pp. 43-48
Author(s):  
Slobodan Slavkovic ◽  
Marko Bumbasirevic ◽  
Slavko Tomic ◽  
Aleksandar Lesic ◽  
Nemanja Slavkovic
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Surgical Procedures ◽  
Joint Space ◽  
The Other ◽  
Mri Findings ◽  
Radiographic Features ◽  
Risk Rate ◽  
Skin Traction

Idiopathic avascular necrosis of the femoral head still represents incompletely explained clinical entity. In the period 1978-2003. we have treated sixteen hips in ten patients with this condition in the IOHB "Banjica". Diagnosis have been founded on clinical and radiographic features, in addition to MRI findings. One patient have been operated, curretaging necrotic part of the femoral head and placing homografts instead. The other fifteen patients have been treated by the same procedure: skin traction for several months following immediate rehabilitation of the hip. The goal of treatment was reducing the pain, increasing the range of movements and preservation of the normal joint space. Evaluation of the treatment was based on unique criteria founded on Howorth-Ferguson index, clinical and radiographic features. The follow-up period was 2-7 years. The authors have stressed the following advantages of the non-operative treatment in adolescents with idiopathic avascular necrosis if the femoral head: increased range of joint movements, decreased pain and low risk rate of any complications following surgical procedures. Formed changes in the femoral head are irreversible, and they are real basic for premature arthrosis of the hip.

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