Supraacetabular and Femoral Head Stress Fracture during Fluoride Treatment

Linthoudt, D. Van; Ott, H.

doi:10.1159/000212894

Cited by 9 publications

(2 citation statements)

References 12 publications

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“…Other predisposing factors include renal transplantation, corticosteroid intake and prior radiation therapy. Although isolated trabecular fatigue fractures were demonstrated in the femoral heads in cadavers and in patients undergoing femoral head excision for fractures and arthritis [1], subchondral insufficiency fractures of the femoral head have only recently been recognised as a distinct presenting clinical entity [2,3,4,5,6,7,8,9,10]. Clinically, they present with an acute onset of pain around the hip, usually in an elderly woman suffering from osteoporosis, and may be associated with insufficiency fractures elsewhere.…”

Section: Discussionmentioning

confidence: 99%

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Subchondral insufficiency fractures of the femoral head

2004

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The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment.

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Section: Discussionmentioning

confidence: 99%

“…There have been several reports of subchondral insufficiency fractures of the femoral head based mainly on radiological studies [1,2,3,4,5,6,7,8,9,10]. They are important in orthopaedic practice because they may be difficult to diagnose, may result in rapidly destructive hip disease and may, initially, be treated conservatively.…”

Section: Introductionmentioning

confidence: 99%