| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr.,
Stanford, CA 94305.
2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School,
75 Francis St., Boston, MA 02115.
3 Genetics Institute, 87 Cambridge Park Dr., Cambridge, MA 02140.
OBJECTIVE. Our objective was to compare the sensitivity of unenhanced radiography, CT, and MR imaging in revealing subchondral fractures.
SUBJECTS AND METHODS. Forty-five subjects with stage I and stage II osteonecrosis of the femoral head were included in the study as part of a multicenter clinical trial to evaluate the effectiveness of recombinant human bone morphogenetic protein as an adjuvant treatment to core decompression. Patients were evaluated with radiography, CT, and MR imaging 6 and 12 months after surgery.
RESULTS. At 6 months, 18 fractures were shown on CT scans, but only 12 were detected on radiographs and six, on MR images. At 12 months, 20 subchondral fractures were detected on CT scans, but only 17 were seen on radiographs and 11, on MR images. Compared with CT, MR imaging has a sensitivity and specificity of 38% and 100%, and unenhanced radiography has a sensitivity and specificity of 71% and 97%, respectively. On T2-weighted MR images, the subchondral fractures were visualized as crescentic high-signal-intensity lines, and in all patients, on the corresponding CT scans, the fracture clearly breached the femoral cortex.
CONCLUSION. CT reveals more subchondral fractures in osteonecrosis of the femoral head than unenhanced radiography or MR imaging. The high-signal-intensity line seen on T2-weighted MR images appears to represent fluid accumulating in the subchondral fracture, which may indicate a breach in the overlying articular cartilage.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  M. A. Mont, L. C. Jones, and D. S. Hungerford Nontraumatic Osteonecrosis of the Femoral Head: Ten Years Later J. Bone Joint Surg. Am., May 1, 2006; 88(5): 1117 - 1132. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. Griffith, G. E. Antonio, S. M. Kumta, D. S. C. Hui, J. K. T. Wong, G. M. Joynt, A. K. L. Wu, A. Y. K. Cheung, K. H. Chiu, K. M. Chan, et al. Osteonecrosis of Hip and Knee in Patients with Severe Acute Respiratory Syndrome Treated with Steroids Radiology, April 1, 2005; 235(1): 168 - 175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Mont, P. S. Ragland, B. Biggins, G. Friedlaender, T. Patel, S. Cook, G. Etienne, A. Shimmin, R. Kildey, D. C. Rueger, et al. Use of Bone Morphogenetic Proteins for Musculoskeletal Applications: An Overview J. Bone Joint Surg. Am., December 1, 2004; 86(suppl_2): 41 - 55. [Full Text] [PDF]
|
|
|
|
|
|
W. S. Song, J. J. Yoo, K.-H. Koo, K. S. Yoon, Y.-M. Kim, and H. J. Kim Subchondral Fatigue Fracture of the Femoral Head in Military Recruits J. Bone Joint Surg. Am., September 1, 2004; 86(9): 1917 - 1924. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.-S. Huang, W. P. Chan, Y.-C. Chang, C.-Y. Chang, C.-Y. Chen, and J. S. Yu MR Imaging of Bone Marrow Edema and Joint Effusion in Patients with Osteonecrosis of the Femoral Head: Relationship to Pain Am. J. Roentgenol., August 1, 2003; 181(2): 545 - 549. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
