• Arch Orthop Trauma Surg · May 2009

    Comparative Study

    Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head.

    • Keita Miyanishi, Toshihiko Hara, Shigekazu Kaminomachi, Hiroki Maeda, Hideyuki Watanabe, and Takehiko Torisu.
    • Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-3-1 Kuzuharatakamatsu, Kokuraminami-ku, Kitakyushu 800-0296, Japan. keitamiya@jcom.home.ne.jp
    • Arch Orthop Trauma Surg. 2009 May 1;129(5):583-9.

    IntroductionSubchondral insufficiency fracture of the femoral head (SIF) may be confused with osteonecrosis of the femoral head (ON) due to clinical and imaging similarities.Materials And MethodsContrast-enhanced MR images in patients with SIF (ten hips in ten patients) were retrospectively reviewed and compared with those from patients with ON (ten hips in six patients).ResultsLow-signal intensity bands on T1-weighted images were present within the femoral head in all hips examined. The segment proximal to the band was contrast-enhanced following IV gadolinium administration in nine of ten hips (90%) with SIF and in none of the 10 hips with ON.ConclusionThese results suggest that the presence of contrast enhancement in the segment proximal to the low-signal intensity band in the femoral head may serve as a supplemental diagnostic measure for the differentiation of SIF from ON.

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