Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head.
BACKGROUND
Subchondral insufficiency fracture of the femoral head (SIF) may be confused with osteonecrosis of the femoral head (ON) due to clinical and imaging similarities.


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.


CONCLUSIONS
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.
Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-3-1 Kuzuharatakamatsu, Kokuraminami-ku, Kitakyushu 800-0296, Japan. keitamiya@jcom.home.ne.jp
Keita
K
Miyanishi
Toshihiko
T
Hara
Shigekazu
S
Kaminomachi
Hiroki
H
Maeda
Hideyuki
H
Watanabe
Takehiko
T
Torisu
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003937:Diagnosis, Differential; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000293:injuries*; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015775:Fractures, Stress / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006620:Hip Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies