Imaging evaluation of patients with osteonecrosis of the femoral head

Pierce, Todd P.; Jauregui, Julio J.; Cherian, Jeffrey J.; Elmallah, Randa K.; Mont, Michael A.

doi:10.1007/s12178-015-9279-6

Cited by 55 publications

(46 citation statements)

References 47 publications

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“…We found that MRI is the modality of choice for early detection of AVN, even in stage I in which X-rays are normal. Our study is comparable with many studies in the literature like Stoica et al, 20 Rupp et al, 21 and Pierce et al 22 Accurate localization and knowledge of the extent of the necrosis by means of MRI make it possible to plan an osteotomy accurately.…”

Section: Sensitivity Of Magnetic Resonance Imaging In Patients With Hsupporting

confidence: 90%

Sensitivity of Magnetic Resonance Imaging in Evaluation of Patients with Hip Joint Pain

Singhania

Dhande

Gupta

et al. 2018

IJRSMS

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Introduction Modern magnetic resonance imaging (MRI) has a great sensitivity in detecting hip joint abnormalities, and because of its property of excellent visualization of soft tissue and nonionizing radiation, it is the modality of choice these days in not only adults but also pediatric musculoskeletal pathologies. Materials and Methods It was a prospective study performed in a tertiary care institute from 2016 to 2018. Total 64 cases with hip pathology attending orthopedics OPD (out patient department) and consenting to participate were included in the study. All the consenting participants were subjected to MRI scan. Results The most common pathology detected was avascular necrosis consisting of 28 cases. The next most common abnormality detected was infective arthritis, found in seven cases. Three patients were diagnosed with metastasis. Conclusion MRI is the diagnostic modality of choice for pathologies of hip for which radiographic and clinical findings are inconclusive. With MRI, one can stage the pathology to prognosticate and influence therapeutic decisions. AbstractKeywords ► hip pain ► magnetic resonance imaging ► pathologies ► avascular necrosis Int J Recent Surg Med Sci 2018;4:71-75

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Section: Sensitivity Of Magnetic Resonance Imaging In Patients With Hsupporting

confidence: 90%

Sensitivity of Magnetic Resonance Imaging in Evaluation of Patients with Hip Joint Pain

Singhania

Dhande

Gupta

et al. 2018

IJRSMS

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“…Kerboul et al (12) measured the arc of the femoral surface involved considering two different angles, obtained drawing two lines from the center to the periphery of the affected femoral head on both AP and lateral radiographs. According to a recent diagnostic algorithm (13), when morphological changes of the femoral head are demonstrated at radiography and in particular when there is a depression of the articular surface between 2 and 4 mm associated or not with acetabular changes, no further imaging is required. An additional CT examination could be performed when the areas of sclerosis are associated with lucency lines of uncertain significance to rule out the presence of subchondral fractures.…”

Section: Conventional Radiographymentioning

confidence: 99%

The role of imaging in diagnosis and management of femoral head avascular necrosis

Manenti

Altobelli

Pugliese

et al. 2015

ccmbm

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SummaryThe aim of this paper is to critically review the literature documenting the imaging approach in adult Femoral Head Avascular Necrosis (FHAVN). For this purpose we described and evaluated different radiological techniques, such as X-ray, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Nuclear Medicine. Plain films are considered the first line imaging technique due to its ability to depict femoral head morphological changes, to its low costs and high availability. CT is not a routinely performed technique, but is useful to rule out the presence of a subchondral fracture when MRI is doubtful or contraindicated. MRI is unanimously considered the gold standard technique in the early stages, being capable to detect bone marrow changes such as edema and sclerosis. It may be useful also to guide treatment and, as CT, it is a validated technique in follow-up of patients with FHAVN. Nuclear medicine imaging is mostly applied in post-operative period to detect graft viability or infective complications. More advanced techniques may be useful in particular conditions but still need to be validated; thus new research trials are desirable. In conclusion, X-ray examination is the first line approach, but lacks of sensitivity in early stage whereas MRI is indicated. CT easily depicts late stage deformation and may decrease MRI false positive results in detecting the subchondral fracture. However, the role of both Nuclear Medicine Imaging and advanced MR techniques in FHAVN still need to be investigated.

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“…MRI is considered the gold standard for the diagnosis of ON and it has a very high diagnostic performance (1,5,9,11). Other imaging modalities such as plain radiography, bone scanning, positronemission tomography and computed tomography for the diagnosis of femoral head ON have been previously studied extensively (11)(12)(13)(14). Prompt diagnosis and early treatment of ON is critical because it is associated with a more favorable prognosis (13,15).…”

Section: Discussionmentioning

confidence: 99%

Corticosteroid-induced Knee Osteonecrosis and Accompanying Femoral Head Osteonecrosis

Sabir¹,

Ufuk²

2019

Istanbul Med J

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Amaç: Bu çalışmadaki amacımız kortikosteroid tedavisi alan ve artralji şikayeti olan hastalarda diz ON'nin (ON) manyetik rezonans görüntüleme (MRG) ile prevalansını ve görüntüleme bulgularını araştırmaktır. Ayrıca MRG altın standart olarak kabul edildiğinde diz ON'de düz radyografinin tanısal performansını göstermeyi ve bu hastalarda eşlik eden femur başı ON'nin prevalansını araştırmayı amaçladık. Yöntemler: Kortikosteroid alımı öyküsü ve diz ağrısı olan 136 hastaya ait 162 diz grafisi ve MRG tetkiki ON varlığı açısından retrospektif olarak değerlendirildi. ON'si olan hastalarda lokalizasyon, maksimum dominant lezyon boyutu, lezyonun çokluğu, kemik ödemi varlığı, çift hat işareti ve subkondral tutulum değerlendirildi. Kalça MRG uygulanan hastalarda eşlik eden femur başı ON'si de araştırıldı. Bulgular: MRG'de 28 hastaya ait 37 dizde ON vardı. Diz eklemi ON tanısında düz grafinin duyarlılık ve özgüllüğü sırasıyla %29,73 ve %98,40 idi. Otuz bir dizde çok sayıda lezyon vardı ve 24 dizde subkondral boşluk etkilenmekteydi. Lezyonların çoğunda çift çizgi işareti ve kemik iliği ödemi mevcuttu. Diz ON'si olan 28 hastanın sadece 16'sında kalça eklemi MRG yapılmıştı ve bu hastaların 5'inde (%31,3) femur başı ON'si vardı. Sonuç: Düz radyografi diz ON tanısı için düşük duyarlılığa ve yüksek özgüllüğe sahiptir. Kortikosteroid kaynaklı ON çok odaklı olma eğilimindedir ve kortikosteroid tedavisi sırasında diz ON'si olan hastaların önemli bir kısmında kalça eklemi ON'si vardır.

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Imaging evaluation of patients with osteonecrosis of the femoral head

Cited by 55 publications

References 47 publications

Sensitivity of Magnetic Resonance Imaging in Evaluation of Patients with Hip Joint Pain

Sensitivity of Magnetic Resonance Imaging in Evaluation of Patients with Hip Joint Pain

The role of imaging in diagnosis and management of femoral head avascular necrosis

Corticosteroid-induced Knee Osteonecrosis and Accompanying Femoral Head Osteonecrosis

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