Femoral head osteonecrosis-imaging findings and differential diagnosis
Keywords:
Femoral head osteonecrosis, imaging findings , bone marrow edema, hip arthritis
Abstract
This review addresses the imaging features of femoral head osteonecrosis. Although the initial evaluation should include plain radiography in combination with thorough history and physical examination, MRI represents the method of choice for an early detection and correct diagnosis. It is also highlighted the imaging findings that enable differentiation of femoral head osteonecrosis from other pathological conditions including transient osteoporosis and arthritis.
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References
1. Mirzai R, Chang C, Greenspan A, Gershwin ME. Avascular necrosis. Comprehensive therapy 1998; 24: 251-5.
2. Assouline-Dayan Y, Chang C, Greenspan A, et al. Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 2002; 32(02): 94–124.
3. Murphey MD, Foreman KL, Klassen-Fischer MK, et al. From the radiologic pathology archives imaging of osteonecrosis: radiologic-pathologic correlation. Radiographics: a review publication of the Radiological Society of North America, Inc. 2014; 34: 1003-28.
4. Chang CC, Greenspan A, Gershwin ME. Osteonecrosis: Current perspectives on pathogenesis and treatment. Semin Arthritis Rheum 1993; 23(1): 47-69.
5. Mont MA, Pacheso IH, Hungerford DS. Non-traumatic osteonecrosis of the femoral head: part I. Demographics, pathogenesis, diagnosis and staging. Bombay Hospital Journal 1996;38.
6. Ohzono K, Saito M, Takaoka K, et al. Natural history of nontraumatic avascular necrosis of the femoral head. The Journal of bone and joint surgery. British volume 1991; 73: 68-72.
7. Seamon J, Keller T, Saleh J, Cui Q. The pathogenesis of nontraumatic osteonecrosis. Arthritis 2012; 2012: 601763.
8. Manaster BJ. From the RSNA Refresher Courses. Radiological Society of North America. Adult chronic hip pain: radiographic evaluation. Radiographics: a review publication of the Radiological Society of North America, Inc. 2000; 20 Spec No: S3-S25.
9. Mont M, Marulanda G, Jones LC, et al. Systematic analysis of classification systems for osteonecrosis of the femoral head. J Bone Joint Surg 2006; 88-A-(Supplement 3): 16–26.
10. Steinberg ME, Steinberg DR. Classification systems for osteonecrosis: an overview. Orthop Clin N Am2004; 35: 273–83.
11. Ficat RP. Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J Bone Joint Surg Br 1985; 67-B(1): 3–9.
12. ARCO (Association Research Circulation Osseous). Committee on terminology and classification. ARCO News 1992; 4: 41–46.
13. Zibis AH, Karantanas AH, Roidis NT, et al. The role of MR imaging in staging femoral head osteonecrosis. Eur J Radiol 2007; 63(01): 3–9.
14. Vassalou E, Spanakis K, Tsifountoudis I, Karantanas A. MR Imaging of the Hip: An Update on Bone Marrow Edema. Seminars in Musculoskeletal Radiology Vol. 23 No. 3/2019.
15. Karantanas AH. Accuracy and limitations of diagnostic methods for avascular necrosis of the hip. Expert opinion on medical diagnostics 2013; 7: 179-87.
16. Azzali E, Milanese GI, Martella I, et al. Imaging of osteonecrosis of the femoral head Acta Biomed 2016; Vol. 87, Supplement 3: 6-12.
17. Dasa V, Abdel-Nabi, Anders M, et al. F-18 fluoride positron emission tomography of the hip for osteonecrosis. Clin Orthop Relat Res 2008; 466: 1081–6.
18. Mitchell DG, Rao VM, Dalinka MK, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 1987; 162: 709–15.
19. Malizos KN, Karantanas AH, Varitimidis SE, et al. Osteonecrosis of the femoral head: Etiology, imaging and treatment. European Journal of Radiology 2007; 63: 16–28.
20. Kim YM, Oh HC, Kim HJ. The pattern of bone marrow oedema on MRI in osteonecrosis of the femoral head. J Bone Joint Surg Br 2000; 82B: 837–41.
21. Fujioka M, Kubo T, Nakamura F, et al. Initial changes of non-traumatic osteonecrosis of femoral head in fat suppression images: bone marrow edema was not found before the appearance of band patterns. Magn Reson Imaging 2001; 19: 985–91.
22. Ito H, Matsuno T, Minami A. Relationship between bone marrow edema and development of symptoms in patients with osteonecrosis of the femoral head. AJR 2006; 186: 1761–70.
23. Hines J.T. Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment. J Korean Med Sci. 2021; 36(24): e177.
24. Steinberg ME, Brighton CT, Steinberg DR, et al. Treatment of avascular necrosis of the femoral head by a combination of bone grafting, decompression, and electrical stimulation. Clin Orthop Relat Res 1984; (186): 137-53.
25. Nishii T, Sugano N, Ohzono K, Sakai T, Sato Y, Yoshikawa H. Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head: a new three-dimensional quantification using magnetic resonance imaging. J Orthop Res 2002; 20(1): 130-6.
26. Kerboul M, Thomine J, Postel M, Merle d’Aubigné R. The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. J Bone Joint Surg Br 1974; 56-B(2): 291-6.
27. Ha YC, Kim HJ, Kim SY, et al. Effects of age and body mass index on the results of transtrochanteric rotational osteotomy for femoral head osteonecrosis. J Bone Joint Surg Am 2010; 92(2): 314-21.
28. Jackson SM, Major MN. Pathologic conditions mimicking osteonecrosis. Orthop Clin N Am 2004; 35(3): 315-20.
29. Nokes SR, Vogler JB, Spritzer CE, et al. Herniation pits of the femoral neck: appearance at MR imaging. Radiology 1989; 172: 231–4.
30. Vande Berg BC, Malghem JJ, Lecouvet FE, et al. Idiopathic bone marrow edema lesions of the femoral head: predictive value of MR imaging findings. Radiology- 1999; 212(2): 527-35.
31. Khurana B, Okanobo H, Ossiani M, et al. Abbreviated MRI for patients presenting to the emergency department with hip pain. AJR Am J Roentgenol 2012; 198(06): W581-8.
32. Karchevsky M, Schweitzer ME, Morrison WB, Parellada JA. MRI findings of septic arthritis and associated osteomyelitis in adults. AJR Am J Roentgenol 2004; 182(01): 119–22.
33. McQueen FM. The use of MRI in early RA. Rheumatology (Oxford) 2008; 47(11): 1597–99.
34. Vander Cruyssen B, Muñoz-Gomariz E, Font P, et al; ASPECTREGISPONSER-RESPONDIA working group. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology (Oxford) 2010; 49(01): 73–81.
2. Assouline-Dayan Y, Chang C, Greenspan A, et al. Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 2002; 32(02): 94–124.
3. Murphey MD, Foreman KL, Klassen-Fischer MK, et al. From the radiologic pathology archives imaging of osteonecrosis: radiologic-pathologic correlation. Radiographics: a review publication of the Radiological Society of North America, Inc. 2014; 34: 1003-28.
4. Chang CC, Greenspan A, Gershwin ME. Osteonecrosis: Current perspectives on pathogenesis and treatment. Semin Arthritis Rheum 1993; 23(1): 47-69.
5. Mont MA, Pacheso IH, Hungerford DS. Non-traumatic osteonecrosis of the femoral head: part I. Demographics, pathogenesis, diagnosis and staging. Bombay Hospital Journal 1996;38.
6. Ohzono K, Saito M, Takaoka K, et al. Natural history of nontraumatic avascular necrosis of the femoral head. The Journal of bone and joint surgery. British volume 1991; 73: 68-72.
7. Seamon J, Keller T, Saleh J, Cui Q. The pathogenesis of nontraumatic osteonecrosis. Arthritis 2012; 2012: 601763.
8. Manaster BJ. From the RSNA Refresher Courses. Radiological Society of North America. Adult chronic hip pain: radiographic evaluation. Radiographics: a review publication of the Radiological Society of North America, Inc. 2000; 20 Spec No: S3-S25.
9. Mont M, Marulanda G, Jones LC, et al. Systematic analysis of classification systems for osteonecrosis of the femoral head. J Bone Joint Surg 2006; 88-A-(Supplement 3): 16–26.
10. Steinberg ME, Steinberg DR. Classification systems for osteonecrosis: an overview. Orthop Clin N Am2004; 35: 273–83.
11. Ficat RP. Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J Bone Joint Surg Br 1985; 67-B(1): 3–9.
12. ARCO (Association Research Circulation Osseous). Committee on terminology and classification. ARCO News 1992; 4: 41–46.
13. Zibis AH, Karantanas AH, Roidis NT, et al. The role of MR imaging in staging femoral head osteonecrosis. Eur J Radiol 2007; 63(01): 3–9.
14. Vassalou E, Spanakis K, Tsifountoudis I, Karantanas A. MR Imaging of the Hip: An Update on Bone Marrow Edema. Seminars in Musculoskeletal Radiology Vol. 23 No. 3/2019.
15. Karantanas AH. Accuracy and limitations of diagnostic methods for avascular necrosis of the hip. Expert opinion on medical diagnostics 2013; 7: 179-87.
16. Azzali E, Milanese GI, Martella I, et al. Imaging of osteonecrosis of the femoral head Acta Biomed 2016; Vol. 87, Supplement 3: 6-12.
17. Dasa V, Abdel-Nabi, Anders M, et al. F-18 fluoride positron emission tomography of the hip for osteonecrosis. Clin Orthop Relat Res 2008; 466: 1081–6.
18. Mitchell DG, Rao VM, Dalinka MK, et al. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 1987; 162: 709–15.
19. Malizos KN, Karantanas AH, Varitimidis SE, et al. Osteonecrosis of the femoral head: Etiology, imaging and treatment. European Journal of Radiology 2007; 63: 16–28.
20. Kim YM, Oh HC, Kim HJ. The pattern of bone marrow oedema on MRI in osteonecrosis of the femoral head. J Bone Joint Surg Br 2000; 82B: 837–41.
21. Fujioka M, Kubo T, Nakamura F, et al. Initial changes of non-traumatic osteonecrosis of femoral head in fat suppression images: bone marrow edema was not found before the appearance of band patterns. Magn Reson Imaging 2001; 19: 985–91.
22. Ito H, Matsuno T, Minami A. Relationship between bone marrow edema and development of symptoms in patients with osteonecrosis of the femoral head. AJR 2006; 186: 1761–70.
23. Hines J.T. Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis, Staging and Treatment. J Korean Med Sci. 2021; 36(24): e177.
24. Steinberg ME, Brighton CT, Steinberg DR, et al. Treatment of avascular necrosis of the femoral head by a combination of bone grafting, decompression, and electrical stimulation. Clin Orthop Relat Res 1984; (186): 137-53.
25. Nishii T, Sugano N, Ohzono K, Sakai T, Sato Y, Yoshikawa H. Significance of lesion size and location in the prediction of collapse of osteonecrosis of the femoral head: a new three-dimensional quantification using magnetic resonance imaging. J Orthop Res 2002; 20(1): 130-6.
26. Kerboul M, Thomine J, Postel M, Merle d’Aubigné R. The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. J Bone Joint Surg Br 1974; 56-B(2): 291-6.
27. Ha YC, Kim HJ, Kim SY, et al. Effects of age and body mass index on the results of transtrochanteric rotational osteotomy for femoral head osteonecrosis. J Bone Joint Surg Am 2010; 92(2): 314-21.
28. Jackson SM, Major MN. Pathologic conditions mimicking osteonecrosis. Orthop Clin N Am 2004; 35(3): 315-20.
29. Nokes SR, Vogler JB, Spritzer CE, et al. Herniation pits of the femoral neck: appearance at MR imaging. Radiology 1989; 172: 231–4.
30. Vande Berg BC, Malghem JJ, Lecouvet FE, et al. Idiopathic bone marrow edema lesions of the femoral head: predictive value of MR imaging findings. Radiology- 1999; 212(2): 527-35.
31. Khurana B, Okanobo H, Ossiani M, et al. Abbreviated MRI for patients presenting to the emergency department with hip pain. AJR Am J Roentgenol 2012; 198(06): W581-8.
32. Karchevsky M, Schweitzer ME, Morrison WB, Parellada JA. MRI findings of septic arthritis and associated osteomyelitis in adults. AJR Am J Roentgenol 2004; 182(01): 119–22.
33. McQueen FM. The use of MRI in early RA. Rheumatology (Oxford) 2008; 47(11): 1597–99.
34. Vander Cruyssen B, Muñoz-Gomariz E, Font P, et al; ASPECTREGISPONSER-RESPONDIA working group. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Rheumatology (Oxford) 2010; 49(01): 73–81.
Published
2023-12-28
Section
Review
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