股骨头坏死的影像学表现演示教学

• A In osteonecrosis, low-intensity band is smooth, concave to articular surface, and circumscribes all of necrotic segments.
• B In subchondral insufficiency fracture, low-intensity band is irregular, convex to articular surface, and discontinuous.
• In all cases of osteonecrosis, the patient had a history of either corticosteroid intake or alcohol abuse.
• Among patients with subchondral insufficiency fracture, the proportion of women was significantly higher than that among patients with osteonecrosis.
MRI Evaluation of Collapsed Femoral Heads in Patients
60 Years Old or Older: Differentiation of Subchondral
Insufficiency Fracture From Osteonecrosis of the Femoral
• In addition, among osteoporotic elderly women without any history of corticosteroid intake or alcohol abuse, a diagnosis of subchondral insufficiency fracture should be considered.
64-year-old man with history of alcohol abuse and osteonecrosis.
SUBJECTS AND METHODS 1
• Between May 1998 and February 2009, we reviewed 30 consecutive hips in 30 patients, 60 years old or older at the time of onset of hip pain, with radiologic evidence of subchondral collapse of the femoral head and with both MR images and histologic results available.
SUBJECTS AND METHODS 2
• The patients were divided into two group according to the shape of low-intensity bands on T1-weighted images. The first group showed concavity of the articular surface, which is characteristic of osteonecrosis, and the second group showed an irregular convexity of the articular surface, which is characteristic of subchondral insufficiency fracture.
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RESULTS
• Sixteen hips (53.3%) showed evidence of osteonecrosis, and 14 (46.7%) showed evidence of subchondral insufficiency fracture, which was consistent with the corresponding histopathologic diagnoses.
OBJECTIVE
• The purpose of this article is to verify the hypothesis that osteonecrosis and subchondral insufficiency fracture of the femoral head can be differentiated on the basis of their appearance on MRI.
Subchondral Insufficiency Fracture
CONCLUSION
• The results of the present study suggest that the shape of the low-intensity band on MRI is useful for the differentiating subchondral insufficiency fracture from osteonecrosis.
Head
2011.4.17 From AJR:195, July 2010
Words
• Subchondral Insufficiency Fracture：软 骨下不全骨折
• Osteonecrosis of the Femoral Head：股 骨头坏死
• Convex 凸 • ncavity 凹
• A crescent sign (subchondral fracture) was present radiographically in about half of all cases in both groups.
TABLE 1: Clinical Characteristics of Patients With Osteonecrosis or