Rapidly Destructive Osteoarthritis of the Hip: MR Imaging Findings
Nathalie Boutry1,
Christelle Paul1,
Xavier Leroy2,
David Fredoux1,
Henri Migaud3 and
Anne Cotten1
1 Department of Radiology, Hôpital Roger Salengro, Blvd. du Professeur
Leclercq, CHRU de Lille, 59037 Lille Cedex, France.
2 Department of Pathology, Hôpital Roger Salengro, CHRU de Lille, 59037
Lille Cedex, France.
3 Department of Orthopaedics, Hôpital Roger Salengro, CHRU de Lille, 59037
Lille Cedex, France.
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Fig. 1A. —Rapidly destructive hip osteoarthritis in 68-year-old woman
with right-sided hip pain. Anteroposterior radiograph obtained at onset of
symptoms shows moderate superolateral joint-space narrowing and small
subchondral cystic lesion in acetabulum.
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Fig. 1B. —Rapidly destructive hip osteoarthritis in 68-year-old woman
with right-sided hip pain. Anteroposterior radiograph obtained 6 months after
A shows superior loss of joint space, flattening of femoral head, and
heterogeneous bone aspect.
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Fig. 2A. —Rapidly destructive hip osteoarthritis in 57-year-old man
with right-sided hip pain. Anteroposterior radiograph obtained at onset of
symptoms shows moderate joint-space narrowing and subchondral sclerosis.
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Fig. 2B. —Rapidly destructive hip osteoarthritis in 57-year-old man
with right-sided hip pain. Anteroposterior radiograph obtained 3 months after
A reveals superior joint-space narrowing. Mild subchondral bone
sclerosis is seen with no osteophytes.
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Fig. 1C. —Rapidly destructive hip osteoarthritis in 68-year-old woman
with right-sided hip pain. Coronal (C) and sagittal (D)
fat-suppressed gadolinium-enhanced T1-weighted MR images (TR/TE, 720/20)
obtained 6 months after onset of symptoms show frank synovitis (curved
arrow). Note presence of cystlike subchondral defects (straight
arrows) at weight-bearing surfaces of femoral head and acetabulum.
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Fig. 1D. —Rapidly destructive hip osteoarthritis in 68-year-old woman
with right-sided hip pain. Coronal (C) and sagittal (D)
fat-suppressed gadolinium-enhanced T1-weighted MR images (TR/TE, 720/20)
obtained 6 months after onset of symptoms show frank synovitis (curved
arrow). Note presence of cystlike subchondral defects (straight
arrows) at weight-bearing surfaces of femoral head and acetabulum.
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Fig. 2C. —Rapidly destructive hip osteoarthritis in 57-year-old man
with right-sided hip pain. Coronal T1-weighted MR image (TR/TE, 552/14)
obtained 4 months after onset of symptoms shows ill-defined
low-signal-intensity area in femoral head and, to lesser degree, in
acetabulum.
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Fig. 2D. —Rapidly destructive hip osteoarthritis in 57-year-old man
with right-sided hip pain. Sagittal short tau inversion recovery MR image
(5216/60; inversion time, 150 msec) obtained 4 months after onset of symptoms
shows ill-defined high-signal-intensity area in femoral head.
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Fig. 3D. —Rapidly destructive hip osteoarthritis in 72-year-old woman
with left-sided hip pain. Coronal short tau inversion recovery MR image
(5216/60; inversion time, 150 msec) obtained 5 months after onset of symptoms
reveals markedly increased signal intensity in femoral head and neck and grade
3 amount of fluid in joint. Note low-signal-intensity line (arrows)
in upper pole of femoral head.
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Fig. 4C. —Rapidly destructive hip osteoarthritis in 73-year-old-woman
with right-sided hip pain. Sagittal short tau inversion recovery MR image
(TR/TE, 5216/60; inversion time, 150 msec) (C) and sagittal
fat-suppressed gadolinium-enhanced T1-weighted MR image (612/14) (D)
obtained 7 months after onset of symptoms show increased signal intensity in
femoral head and acetabulum with low-signal-intensity subchondral area
(arrowheads) in upper pole of femoral head.
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Fig. 4D. —Rapidly destructive hip osteoarthritis in 73-year-old-woman
with right-sided hip pain. Sagittal short tau inversion recovery MR image
(TR/TE, 5216/60; inversion time, 150 msec) (C) and sagittal
fat-suppressed gadolinium-enhanced T1-weighted MR image (612/14) (D)
obtained 7 months after onset of symptoms show increased signal intensity in
femoral head and acetabulum with low-signal-intensity subchondral area
(arrowheads) in upper pole of femoral head.
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Fig. 3E. —Rapidly destructive hip osteoarthritis in 72-year-old woman
with left-sided hip pain. Sagittal fat-suppressed gadolinium-enhanced
T1-weighted MR image (729/14) obtained 5 months after onset of symptoms shows
increased signal intensity in subchondral areas of femoral head and
acetabulum. Note low-signal-intensity line (arrows) in upper pole of
femoral head.
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Fig. 3A. —Rapidly destructive hip osteoarthritis in 72-year-old woman
with left-sided hip pain. Anteroposterior radiograph obtained at onset of
symptoms shows no significant joint-space narrowing and small lateral
acetabular osteophyte.
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Fig. 3B. —Rapidly destructive hip osteoarthritis in 72-year-old woman
with left-sided hip pain. Anteroposterior radiograph obtained 6 months after
A shows superior joint-space loss and small osteophytes on lateral
aspect of femoral head and acetabulum.
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Fig. 3C. —Rapidly destructive hip osteoarthritis in 72-year-old woman
with left-sided hip pain. Sagittal T1-weighted MR image (TR/TE, 480/14)
obtained 5 months after onset of symptoms shows abnormally low signal
intensity in superior parts of both femoral head and acetabulum. Note
joint-space narrowing.
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Fig. 5C. —Rapidly destructive hip osteoarthritis in 73-year-old-woman.
Coronal fat-suppressed gadolinium-enhanced T1-weighted MR image (TR/TE,
720/18) obtained 4 months after onset of symptoms shows high-intensity signal
in femoral neck and acetabulum. Note focal signal abnormalities
(arrows) of soft tissues.
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Fig. 1E. —Rapidly destructive hip osteoarthritis in 68-year-old woman
with right-sided hip pain. On moderate microscopic examination,
photomicrograph of histologic section shows prominent hypervascularity in
subchondral bone. Note presence of numerous capillaries (arrowheads)
and thinned trabeculae (arrows). (H and E, x40)
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Fig. 4A. —Rapidly destructive hip osteoarthritis in 73-year-old-woman
with right-sided hip pain. Anteroposterior radiograph obtained at onset of
symptoms shows moderate superior and lateral joint-space loss.
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Fig. 4B. —Rapidly destructive hip osteoarthritis in 73-year-old-woman
with right-sided hip pain. Anteroposterior radiograph obtained 7 months after
A shows major loss of joint space, moderate subchondral sclerosis, and
no significant osteophytosis.
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Fig. 5A. —Rapidly destructive hip osteoarthritis in 73-year-old-woman.
Anteroposterior radiograph obtained at onset of symptoms shows moderate
superolateral joint-space narrowing with small osteophytes along lateral
aspect of acetabulum.
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Fig. 5B. —Rapidly destructive hip osteoarthritis in 73-year-old-woman.
Anteroposterior radiograph obtained 4 months after A shows rapid
chondrolysis.
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Copyright © 2002 by the American Roentgen Ray Society.
