The Journal of Bone and Joint Surgery, Vol 71, Issue 5 641-649, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
The diagnostic value of magnetic resonance imaging in non-traumatic osteonecrosis of the femoral head
JP Hauzeur, JL Pasteels, A Schoutens, M Hinsenkamp, T Appelboom, I Chochrad and N Perlmutter
Department of Rheumatology, Erasmus Hospital, University of Brussels, Belgium.
To assess the effectiveness of nuclear magnetic-resonance imaging in the
detection of osteonecrosis of the femoral head, we studied the cases of
twenty-five patients (forty-nine hips) in whom necrosis of the femoral head
was suspected on the basis of plain radiographs, computed tomographic
scans, radionuclide bone scans, and magnetic resonance-imaging scans. The
results of these investigations were compared, for all except one patient,
with the pathological findings of transtrochanteric core biopsies of the
femoral head and neck of both hips. Of the forty-nine hips, thirty-three
had histological proof of osteonecrosis. Twenty-two (67 per cent) of these
hips showed definite necrosis on the plain radiographs; eighteen (62 per
cent), on the twenty-nine available computed tomographic scans; twenty-four
(77 per cent), on the thirty-one available radionuclide bone scans; and all
of the hips, on the magnetic resonance-imaging studies. In six additional
hips, there were histological changes (marrow necrosis, edema, hemorrhage,
and fibrosis) in the medullary spaces without detectable osteonecrosis. The
plain radiographs and computed tomographic scans of these six hips were
normal except for the computed tomographic scan of one, and the
radionuclide uptake on bone-scanning was abnormal in four of the six, as
were the magnetic resonance-imaging studies. In the two hips that had
normal magnetic resonance-imaging studies, the biopsies showed only
destruction of fat cells in the medullary spaces, with no edema or
fibroblastic reaction.(ABSTRACT TRUNCATED AT 250 WORDS)
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