Imaging comparison for avascular necrosis of the femoral head induced by different etiologies

doi:10.3969/j.issn.2095-4344.2013.48.025

Abstract

Abstract:

BACKGROUND: Imaging examination is the main strategy for clinical diagnosis of avascular necrosis of the femoral head. However, comparative studies of imaging findings between different causes of avascular necrosis of the femoral head are rarely reported.
OBJECTIVE: To compare imaging findings between different causes of avascular necrosis of femoral head, and to determine whether the imaging findings of different causes of avascular necrosis are different.
METHODS: A total of 54 cases of avascular necrosis of the femoral head (60 hips) were confirmed by clinical and imaging findings, and divided into idiopathic, alcoholic, hormonal and femoral neck fractural groups according to the causes. X-ray, CT, MRI findings of these four kinds of avascular necroses were analyzed.
RESULTS AND CONCLUSION: Sixty hips of avascular necrosis of the femoral head included 12 idiopathic hips, 21 alcoholic hips, 15 hormonal hips, and 12 femoral neck fractural hips. X-ray and CT main performances were as follows: “star sign” deformation or disappearance of the femoral head; positive “crescent” sign, mild
bone fracture, mild collapse of the articular surface; femoral head deformation, bone fracture, articular surface collapse, hip degeneration. MRI of four categories of avascular necroses appeared as phase Ⅰ: line-like low signal of weight-bearing area of femoral head on T1WI, high signal on T2WI as the main change. Phase Ⅱ: clear boundary crescent-shaped uneven signal on T1WI, T2WI displayed moderately higher, uneven slightly lower signal around, showing a typical two-line sign. Phase Ⅲ: femoral head deformation, subchondral fracture, collapse, crescent formation, zonal low signal on T1WI, medium or high signal on T2WI. Phase Ⅳ, Ⅴ: complete destruction of articular cartilage, joint space narrowing, significant collapse and deformation of the femoral head, non-specific secondary osteoarthritis of the acetabulum, such as sclerosis, cystic degeneration and marginal osteophyte. The X-ray, CT, MRI performances of four types of avascular necroses at the same period were basically the same.

Key words: femur head necrosis, femoral neck fractures, diagnosis, differential, X-ray, magnetic resonance imaging

CLC Number:

R318

Zhang De-zhou, Yi Xue-bing, Zhong Jian. Imaging comparison for avascular necrosis of the femoral head induced by different etiologies[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(48): 8455-8460.

Figures/Tables 8

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