Archives of Orthopaedic and Trauma Surgery
Volume 129, Number 5, 583-589, DOI: 10.1007/s00402-008-0642-6

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German Speaking Arthroscopy Association

Orthopaedic Surgery

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

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Abstract

Introduction  

Subchondral 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 methods  

Contrast-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).

Results  

Low-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.

Conclusion  

These 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.

Keywords  Femoral head - Insufficiency fracture - Avascular necrosis - MRI

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