Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis.
OBJECTIVE
The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).


METHODS
28 young-adult subjects (32 hips) with a mean age of 23.8 ± 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1=subjects with normal femoral head-neck offset (alpha-angle <50°), group 2=subjects with mild offset decrease (alpha-angle 50°-60°), and group 3=subjects with severe offset decrease (alpha-angle >60°).


RESULTS
There was statistically significant difference noted for the T1(Gd) values, lateral and central, between group 1 and group 3 (p-values=0.038 and 0.041). The T1(Gd) values measured within the lateral portion were slightly lower compared with the T1(Gd) values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference.


CONCLUSIONS
By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.
Department of Orthopaedics, Heinrich-Heine University Medical School, Duesseldorf, Germany. Christoph.Zilkens@med.uni-duesseldorf.de
Christoph
C
Zilkens
Falk
F
Miese
Bernd
B
Bittersohl
Marcus
M
Jäger
Johannes
J
Schultz
Arne
A
Holstein
Young-Jo
YJ
Kim
Michael B
MB
Millis
Tallal C
TC
Mamisch
Rüdiger
R
Krauspe
D000293:Adolescent; D000328:Adult; D002358:Cartilage, Articular / Q000503:physiopathology*; D003287:Contrast Media / Q000008:administration & dosage; D004185:Disability Evaluation; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D060048:Slipped Capital Femoral Epiphyses / Q000378:metabolism / Q000503:physiopathology*
D003287:Contrast Media; D006025:Glycosaminoglycans; D019786:Gadolinium DTPA