Contiguous development of idiopathic osteonecrosis and osteoarthrosis in ischemia of a femoral head (radiological and morphological study).
In a 67 year-old man, an aseptic necrosis of the right hip joint developed side by side with an early oteoarthrosis characterized by an extensive narrowing of the upper interlinear space. The histological study revealed a diffuse ischemia which had evolved differently in the various regions of the femoral head. A well-limited necrosis appeared in a part of the weight-bearing zone, and osteoarthrosis developed in another one. In contrast with classical osteoarthrosis secondary to malformation, the osteoarthrotic lesions of the weight-bearing zone were caused by the ischemic angio-fibrosis of the bone marrow. At the beginning there was a resorption by the subjacent fibro-vascular tissue of the end-plate and of the deep layer of the cartilage. The osteosclerosis of this zone, in particular the eburnated plate, was formed mostly of fibre bone which rapidly became necrotic. Outside the weight-bearing zone, the subchondral angio-fibrosis and the non-inflammatory vascular pannus modified the articular surface.
D000368:Aged; D001168:Arthritis / Q000209:etiology / Q000473:pathology*; D005271:Femur Head Necrosis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008297:Male