Sequence and rate of bone marrow conversion in the femora of children as seen on MR imaging: are accepted standards accurate?

On magnetic resonance (MR) imaging, Modic type 1 (MT1) endplate changes and infectious spondylodiscitis share similar findings. Therefore, this study investigated vertebral bone marrow and endplate changes to enable their differentiation. The lumbar spine MR examinations of 91 adult patients were retrospectively included: 39 with MT1; 19 with early spondylodiscitis without abscess; and 33 with advanced spondylodiscitis with abscess. The assessment included percentage of bone marrow edema on sagittal short tau inversion recovery images, and the signal ratio of edema to unaffected bone and endplate contour (normal; irregular, yet intact; blurred; destructive) on sagittal unenhanced T1-weighted images. Differences were tested for statistical significance by Chi-square test and mixed model analysis of variance. The MR diagnostic accuracy in differentiating MT1 and spondylodiscitis was assessed by cross-tabulation and receiver-operating characteristic analysis. The endplate contours, edema extents, and T1-signal ratios of MT1 (extent, 31.96%; ratio, 0.83) were significantly different (p < 0.001) from early spondylodiscitis (56.42%; 0.60), and advanced spondylodiscitis (91.84%; 0.61). The highest diagnostic accuracy (sensitivity, 94.87%; specificity, 94.23%; accuracy, 94.51%) in identifying MT1 was provided by an irregular, yet intact endplate contour. This may be a useful MR feature for the differentiation between MT1 and spondylodiscitis, particularly in its early stage.

Download Full-text

MR Imaging of Bone Marrow Edema and Joint Effusion in Patients with Osteonecrosis of the Femoral Head: Relationship to Pain

American Journal of Roentgenology ◽

10.2214/ajr.181.2.1810545 ◽

2003 ◽

Vol 181 (2) ◽

pp. 545-549 ◽

Cited By ~ 50

Author(s):

Guo-Shu Huang ◽

Wing P. Chan ◽

Yue-Cune Chang ◽

Cheng-Yen Chang ◽

Cheng-Yu Chen ◽

...

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Mr Imaging ◽

Bone Marrow Edema ◽

Joint Effusion ◽

Marrow Edema

Download Full-text

Bone marrow lesions and subchondral cysts develop in the same area of femoral heads on mr imaging of hip dysplasia population

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2014.02.520 ◽

2014 ◽

Vol 22 ◽

pp. S279-S280

Author(s):

M. Takeuchi ◽

T. Goto ◽

D. Hamada ◽

H. Egawa ◽

K. Sairyo

Keyword(s):

Bone Marrow ◽

Mr Imaging ◽

Hip Dysplasia ◽

Bone Marrow Lesions ◽

Femoral Heads

Download Full-text

Epiphyseal bone-marrow abnormalities and restitution in legg-calvé-perthes disease

Acta Radiologica ◽

10.1080/02841859709172424 ◽

1997 ◽

Vol 38 (5) ◽

pp. 855-862 ◽

Cited By ~ 1

Author(s):

P. Hochbergs ◽

G. Eckervall ◽

H. Wingstrand ◽

N. Egund ◽

K. Jonsson

Keyword(s):

Bone Marrow ◽

Mr Imaging ◽

Perthes Disease ◽

Mr Images ◽

Group I ◽

Radiological Classification ◽

Signal Changes ◽

Over Time ◽

Epiphyseal Bone

Purpose: By means of MR imaging, to determine signal abnormalities in the femoral epiphysis; to determine their location, extent and restitution over time; and to correlate these findings to the Catterall radiological classification. Material and Methods: A total of 247 MR images in 86 patients (101 hips) with Legg-CalvC-Perthes disease were examined. The MR images were taken in the coronal plane, and the images through the center of the femoral head were used for this study. Results: T1-weighted images proved as good as T2-weighted images for the MR evaluation of the extent of the necrosis. In almost every case, the central-cranial part of the epiphysis showed a low initial signal. In Catterall group I, the medial part was never involved. In Catterall III and IV, almost the entire epiphysis showed signal changes. In the period 3–6 years after diagnosis, we still found signal changes in the epiphysis in some hips but there was no correlation with the Catterall classification. After 6 years, the epiphysis showed normal signal intensity in MR imaging. In T1-weighted images, Gd-enhancement occurred in the peripheral regions in the early stages of the disease. The central part of the epiphysis became more enhanced over time and peaked in the period 1–3 years after diagnosis. Conclusion: MR is a valuable modality for monitoring changes in the femoral epiphysis. We propose a new classification of the extent and pattern of epiphyseal bone-marrow abnormalities based on the 4 zones most commonly observed in MR imaging.

Download Full-text