MRI Evaluation of Collapsed Femoral Heads in Patients 60 Years Old or Older: Differentiation of Subchondral Insufficiency Fracture From Osteonecrosis of the Femoral Head

• DOI: 10.2214/ajr.09.3271
• Publication Date: 2010-06-21T18:40:11Z
• Authors: Satoshi Ikemura; Takuaki Yamamoto; Goro Motomura; Yasuharu Nakashima; Taro Mawatari; Yukihide Iwamoto
• Keywords: Insufficiency fracture; Articular surface

The purpose of this article is to verify the hypothesis that osteonecrosis and subchondral insufficiency fracture femoral head can be differentiated on basis their appearance MRI.Between May 1998 February 2009, we reviewed 30 consecutive hips in patients, 60 years old or older at time onset hip pain, with radiologic evidence collapse both MR images histologic results available. Both clinical appearances were investigated. patients divided into two groups according shape low-intensity bands T1-weighted images. first group showed concavity articular surface, which characteristic osteonecrosis, second an irregular convexity fracture.Sixteen (53.3%) 14 (46.7%) fracture, was consistent corresponding histopathologic diagnoses. In all cases patient had a history either corticosteroid intake alcohol abuse. Among proportion women significantly higher than among osteonecrosis. A crescent sign (subchondral fracture) present radiographically about half groups.The study suggest band MRI useful for differentiating from addition, osteoporotic elderly without any abuse, diagnosis should considered.