Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology.
OBJECTIVE
To correlate the amount of bone marrow edema (BME) calculated by magnetic resonance imaging(MRI) with clinical findings, histopathology, and radiographic findings, in patients with advanced hip osteoarthritis(OA).


METHODS
The study was approved by The Institutional Human Subject Protection Committee. Coronal MRI of hips was acquired in 19 patients who underwent hip replacement. A spin echo (SE) sequence with four echoes and separate fast spin echo (FSE) proton density (PD)-weighted SE sequences of fat (F) and water (W) were acquired with water and fat suppression, respectively. T2 and water:fat ratio calculations were made for the outlined regions of interest. The calculated MRI values were correlated with the clinical, radiographic, and histopathologic findings.


RESULTS
Analyses of variance were done on the MRI data for W/(W + F) and for T2 values (total and focal values) for the symptomatic and contralateral hips. The values were significantly higher in the study group. Statistically significant correlations were found between pain and total W/(W + F), pain and focal T2 values, and the number of microfractures and calculated BME for the focal W/(W + F) in the proximal femora. Statistically significant correlations were found between the radiographic findings and MRI values for total W/(W + F), focal W/(W + F) and focal T2 and among the radiographic findings, pain, and hip movement. On histopathology, only a small amount of BME was seen in eight proximal femora.


CONCLUSIONS
The amount of BME in the OA hip, as measured by MRI, correlates with the severity of pain, radiographic findings, and number of microfractures.
Taljanovic
Mihra S
MS
Department of Radiology, The University of Arizona HSC, 1501 N. Campbell Ave, Tucson, AZ 85724, USA. mihrat@radiology.arizona.edu
Graham
Anna R
AR
Benjamin
James B
JB
Gmitro
Arthur F
AF
Krupinski
Elizabeth A
EA
Schwartz
Stephanie A
SA
Hunter
Tim B
TB
Resnick
Donald L
DL
D000368:Aged; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011859:Radiography; D016059:Range of Motion, Articular; D012720:Severity of Illness Index