HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khanna, A. J. Articles by Bluemke, D. A. Search for Related Content PubMed PubMed Citation Articles by Khanna, A. J. Articles by Bluemke, D. A.

Femoral Head Osteonecrosis: Detection and Grading by Using a Rapid MR Imaging Protocol¹

¹ From the Departments of Orthopaedic Surgery, Division of Arthritis Surgery (A.J.K., T.R.Y., M.A.M., D.S.H.) and Radiology and Radiological Science (D.A.B.) at Good Samaritan Hospital, The Johns Hopkins Medical Institutions, MRI 143, 600 N Wolfe St, Baltimore, MD 21287. Received January 8, 1999; revision requested February 18; final revision received January 12, 2000; accepted March 2. Address correspondence to D.A.B.

PURPOSE: To design and evaluate a limited magnetic resonance (MR) imaging examination that can be performed rapidly and potentially inexpensively in patients with clinical suspicion of osteonecrosis.

MATERIALS AND METHODS: Both a limited and a full hip MR examination were performed prospectively in 179 hips in 92 patients with clinical suspicion of femoral head osteonecrosis. The presence of osteonecrosis was determined by two radiologists. The percentage of involvement of the femoral head weight-bearing surface was evaluated subsequently for osteonecrosis-positive hips on both sets of images.

RESULTS: Both examinations were performed successfully in all cases. Agreement between the limited and full examinations for presence of osteonecrosis was 98.9% (177 of 179 cases; , 0.97). Forty-six (92%) of 50 patients with femoral head osteonecrosis at both examinations were placed in the appropriate quartile of percentage of femoral head weight-bearing surface involvement by both readers (weighted , 0.94). Incidental findings were made at the full examination that could not be made or were difficult to make at the limited examination.

CONCLUSION: There was excellent agreement between the full and screening MR examinations for both detection of and determining the extent of osteonecrosis. The time and potential cost reduction achieved with a limited examination may allow introduction of MR imaging earlier in the diagnosis of femoral head osteonecrosis, as well as its more widespread use in patient care.

Index terms: Bones, necrosis, 443.44 • Femur, MR, 443.121411, 443.121415 • Femur, necrosis, 443.44 • Magnetic resonance (MR), technology, 443.121411

This article has been cited by other articles:

				D. S. Levine, O. M. Navarro, G. Chaudry, J. J. Doyle, and S. I. Blaser Imaging the Complications of Bone Marrow Transplantation in Children RadioGraphics, March 1, 2007; 27(2): 307 - 324. [Abstract] [Full Text] [PDF]

				M. A. Mont, G. A. Marulanda, L. C. Jones, K. J. Saleh, N. Gordon, D. S. Hungerford, and M. E. Steinberg Systematic Analysis of Classification Systems for Osteonecrosis of the Femoral Head J. Bone Joint Surg. Am., November 1, 2006; 88(suppl_3): 16 - 26. [Abstract] [Full Text] [PDF]

				M. A. Mont, L. C. Jones, and D. S. Hungerford Nontraumatic Osteonecrosis of the Femoral Head: Ten Years Later J. Bone Joint Surg. Am., May 1, 2006; 88(5): 1117 - 1132. [Abstract] [Full Text] [PDF]

				J. F. Griffith, G. E. Antonio, S. M. Kumta, D. S. C. Hui, J. K. T. Wong, G. M. Joynt, A. K. L. Wu, A. Y. K. Cheung, K. H. Chiu, K. M. Chan, et al. Osteonecrosis of Hip and Knee in Patients with Severe Acute Respiratory Syndrome Treated with Steroids Radiology, April 1, 2005; 235(1): 168 - 175. [Abstract] [Full Text] [PDF]

				M. V. Relling, W. Yang, S. Das, E. H. Cook, G. L. Rosner, M. Neel, S. Howard, R. Ribeiro, J. T. Sandlund, C.-H. Pui, et al. Pharmacogenetic Risk Factors for Osteonecrosis of the Hip Among Children With Leukemia J. Clin. Oncol., October 1, 2004; 22(19): 3930 - 3936. [Abstract] [Full Text] [PDF]

				K. Stevens, C. Tao, S.-U. Lee, N. Salem, J. Vandevenne, C. Cheng, G. Neumann, A. Valentin-Opran, and P. Lang Subchondral Fractures in Osteonecrosis of the Femoral Head: Comparison of Radiography, CT, and MR Imaging Am. J. Roentgenol., February 1, 2003; 180(2): 363 - 368. [Abstract] [Full Text] [PDF]