HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Huang, G.-S. Articles by Yu, J. S. Search for Related Content PubMed PubMed Citation Articles by Huang, G.-S. Articles by Yu, J. S. Social Bookmarking                      What's this?

MR Imaging of Bone Marrow Edema and Joint Effusion in Patients with Osteonecrosis of the Femoral Head: Relationship to Pain

¹ Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Rd., Section 2, Neihu, Taipei 114, Taiwan, Republic of China.
² Department of Radiology, School of Medicine, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan, Republic of China.
³ Department of Radiology, Taipei Medical University-Municipal Wan Fang Hospital, 111 Hsing-Long Rd., Section 3, Taipei 116, Taiwan, Republic of China.
⁴ Department of Mathematics, Tamkang University, 151 Ying-Chuan Rd., Tamsui, Taipei County 251, Taiwan, Republic of China.
⁵ Department of Radiology, Taipei Veterans General Hospital, 201 Shih-Pai Rd., Section 2, Taipei 112, Taiwan, Republic of China.
⁶ Department of Radiology, Ohio State University Medical Center, S-255 Rhodes Hall, 450 W. 10th Ave., Columbus, OH 43210.

OBJECTIVE. Our aim was to determine the occurrence of bone marrow edema and joint effusion and their relationship to pain in patients with osteonecrosis of the femoral head on the basis of MR imaging.

MATERIALS AND METHODS. There were 71 patients with osteonecrosis of the femoral head based on characteristic radiographic and MR imaging findings. All patients had surgical confirmation of the disease. Both hips were affected with osteonecrosis in 39 patients, whereas only one hip was involved in 31 patients. The last patient underwent an arthroplasty of one hip during the study and had only one hip imaged. We evaluated a total of 110 hips in this study, of which 98 were painful. We staged osteonecrosis of the femoral head, using the classification of Steinberg et al. The 31 unaffected hips served as controls. Bone marrow edema and joint fluid were evaluated on MR images. Bone marrow edema was defined as an ill-defined area of low signal intensity on T1-weighted images with corresponding high signal intensity on T2-weighted or inversion recovery images localizing to the femoral head, neck, and intertrochanteric region. The amount of joint fluid was graded from 0 to 3.

RESULTS. The peak of bone marrow edema occurred in stage III disease (72%); its odds ratio was seven times greater than that for stage I osteonecrotic hips. Effusions of a grade greater than or equal to 2 were seen most often in stage III disease (92%), compared with 10% in the control hips. With an effusion, bone marrow edema was 12.6 times greater when the hip was painful than when it was not.

CONCLUSION. Both bone marrow edema and joint effusions existed with a peak occurrence in stage III disease. Bone marrow edema seems to have a stronger association with pain than does joint effusion in osteonecrosis of the femoral head.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H. Ito, T. Matsuno, and A. Minami Relationship between bone marrow edema and development of symptoms in patients with osteonecrosis of the femoral head. Am. J. Roentgenol., June 1, 2006; 186(6): 1761 - 1770. [Abstract] [Full Text] [PDF]