MR Imaging of Bone Marrow Edema and Joint Effusion in Patients with Osteonecrosis of the Femoral Head: Relationship to Pain
Guo-Shu Huang1,
Wing P. Chan2,3,
Yue-Cune Chang4,
Cheng-Yen Chang5,
Cheng-Yu Chen1 and
Joseph S. Yu6
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.
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Fig. 1. —Stage III [17]
osteonecrosis of femoral head in 28-year-old man with right-hip pain. Coronal
MR image (TR/TE, 2800/40; inversion recovery, 125) shows crescent area
(solid arrow) of low signal intensity at weight-bearing portion of
femoral head. Note grade 3 joint fluid (open arrow) that distended
capsular recess.
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Fig. 2. —Stage II [17]
osteonecrosis of femoral head in 54-year-old man with symptom-free left hip.
Coronal intermediate-weighted MR image (TR/TE, 1800/20) shows bandlike pattern
(arrow) in bone marrow corresponding to sclerotic change in left
femoral head seen on radiograph (not shown).
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Fig. 3A. —Stage III (left hip, A) and stage IV (right hip, B and
C) [17] osteonecrosis
of femoral head in 44-year-old man with bilateral hip pain. Coronal
intermediate-weighted MR image (TR/TE, 1800/20) shows ringlike pattern
(arrow) in subchondral marrow of left femoral head.
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Fig. 3B. —Stage III (left hip, A) and stage IV (right hip, B and
C) [17] osteonecrosis
of femoral head in 44-year-old man with bilateral hip pain. Coronal
intermediate-weighted MR image (1800/20) shows diffuse low-signal-intensity
bone marrow edema (arrows) in femoral neck and intertrochanteric area
and collapse of right femoral head.
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Fig. 3C. —Stage III (left hip, A) and stage IV (right hip, B and
C) [17] osteonecrosis
of femoral head in 44-year-old man with bilateral hip pain. T2-weighted MR
image (1800/80) shows that bone marrow edema (arrows) turns to high
signal intensity in femoral neck and intertrochanteric area.
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Fig. 4. —Osteonecrosis of femoral head with bone marrow edema in 20-year-old
man with left hip pain. Coronal T2-weighted MR image (TR/TE, 2200/80) shows
low-signal-intensity area with dark band (open arrow) in left femoral
head. Note high-signal-intensity bone marrow edema (curved arrows)
extending to neck and intertrochanter of proximal femur and grade 2 fluid
(solid straight arrows) surrounding femoral neck.
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Copyright © 2003 by the American Roentgen Ray Society.
