Pediatric Radiology

, Volume 20, Issue 1–2, pp 67–71

Magnetic resonance imaging in children with acute hip pain

  • G. Ranner
  • F. Ebner
  • R. Fotter
  • W. Linhart
  • E. Justich


45 children presenting with acute hip pain were prospectively evaluated with conventional radiography, radioisotope bone scan, and magnetic resonance imaging (MRI). The final diagnoses were transient synovitis (n=17), septic arthritis (n=2), Legg-Calve-Perthes disease (LCPD,n=13), epiphyseal dysplasia (n=2), other conditions (n=4), and normal findings (n=7). In the work-up MRI provided more morphologic information than other techniques and enlarged the diagnostic possibilities. It was the only imaging technique able to give an early indication of bone marrow involvement in systemic diseases. For the early diagnosis of LCPD, MRI was as sensitive as isotope bone scan and more precise than conventional radiography. In the follow-up of LCPD patients MRI was not able to indicate the start of revascularisation of the necrotic area, which bone scans showed reliably in six patients: but MRI provided excellent evaluation of the position, form and size of the femoral head and the surrounding soft tissues.


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  1. 1.
    Meradji M, Diepstraten AFM (1988) Coxitis fugax. Sonographisches und radiologisches Bild in 65 Fällen. Radiologe 28: 473PubMedGoogle Scholar
  2. 2.
    Landing LA, Danielsson LG, Wattsgard C (1987) Transient synovitis of the hip, J Bone Joint Surg [Br.] 69: 238Google Scholar
  3. 3.
    Lammer J, Nicoletti R, Fueger GF, Fink W (1982) Osteoscintimetry—a method of semiquantitative evaluation of skeletal scintigrams by use of profiles and a macro function for computer processing. Eur J Nucl Med 7: 364PubMedGoogle Scholar
  4. 4.
    Lammer J, Fueger GF, Fotter R, Nicoletti R (1982) Computermakrogramm zur Osteoszintimetrie mit Aktivitätsprofilen bei Morbus Perthes. Fortschr Röntgenstr 136: 14Google Scholar
  5. 5.
    Marry IPC (1980) Bone scanning in the child and young adult. Skeletal Radiol 5: 65PubMedGoogle Scholar
  6. 6.
    Fotter R, Lammer J, Ritter G (1982) Szintigraphische 5-Jahres-Studie bei Kindern mit M. Perthes. Fortschr Röntgenstr 137: 141Google Scholar
  7. 7.
    Daningelis JA, Fisher RL, Ozonoff MB, Sziklas J (1975) 99m-Tc-polyphosphate bone imaging in Legg-Calve-Perthes disease. Radiology 115: 407PubMedGoogle Scholar
  8. 8.
    Bensahel H, Bok B, Cavailloles F, Csukony Z (1983) Bone scintigraphy in Perthes disease. J Pediatr Orthop 3: 302PubMedGoogle Scholar
  9. 9.
    Carty H, Maxted M, Fiedling JA, Gulliford P, Owen R (1984) Isotope scanning in the “Irritable Hip Syndrome”. Skeletal Radiol 11: 32PubMedGoogle Scholar
  10. 10.
    Bower GD, Sprague P, Geijsel H, Holt K, Lovegrove FT (1985) Isotope bone scans in the assessment of children with hip pain or limp. Pediatr Radiol 15: 319PubMedGoogle Scholar
  11. 11.
    Rosenborg M, Mortensson W (1986) The validity of radiographic assessment of childhood transient synovitis of the hips. Acta Radiol [Diagn] (Stockh) 27: 85Google Scholar
  12. 12.
    Bauer R (1987) Osteochondrosis deformans coxae juvenilis. In: Hohmann G, Hackenbroch M, Lindemann K (Hrsg) Orthopädie in Klinik und Praxis, Band 7, Teil 1: Spezielle Orthopädie. Thieme, Stuttgart New YorkGoogle Scholar
  13. 13.
    Hall Rush B, Bramson RT, Ogden JA (1988) Legg-Calve-Perthes disease: detection of cartilaginous and synovial changes with MR imaging. Radiology 167: 473PubMedGoogle Scholar
  14. 14.
    Mayer J (1964) Dysplasia epiphysealis capitis femoris. Acta Orthop Scand 34: 183PubMedGoogle Scholar
  15. 15.
    Resnick D (1981) The osteochondroses. In: Resnick D, Niwayama G (eds) Diagnosis of bone and joint disorders, vol 3. Saunders, Philadelphia London Toronto, p 2874Google Scholar
  16. 16.
    Thickmann D, Axel L, Kressel HY, Steinberg M, Chen H, Velchick M, Fallon M, Dalinka M (1986) Magnetic resonance imaging of avascular necrosis of the femoral head. Skeletal Radiol 15: 133PubMedGoogle Scholar
  17. 17.
    Mitchel MD, Kundel HL, Steinberg ME, Kressel HY, Alavi A, Axel L (1986) Avascular necrosis of the hip: comparison of MR, CT and scintigraphy. AJR 147: 67PubMedGoogle Scholar
  18. 18.
    Mitchel DG, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Steinberg ME, Fallon M, Kressel HY (1987) Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 162: 709PubMedGoogle Scholar
  19. 19.
    Scoles PV, Yoon YS, Makley JT, Kalamchi A (1984) Nuclear magnetic resonance imaging in Legg-Calve-Perthes disease. J Bone Joint Surg [Am] 66: 1357Google Scholar
  20. 20.
    Heuck A, Lehner K, Schittich I, Reiser M (1988) Die Wertigkeit der MR für die Diagnostik, Differentialdiagnostik und Therapiekontrolle des Morbus Perthes. Fortschr Röntgenstr 149: 189Google Scholar
  21. 21.
    Toby EB, Koman LA, Bechtold RE (1985) Magnetic resonance imaging of pediatric hip disease. J Pediatr Orthop 5: 665PubMedGoogle Scholar
  22. 22.
    Bluemm RG, Falke THM, Ziedses des Plantes Jr. BG, Steiner M (1985) Early Legg-Perthes disease (ischemic necrosis of the femoral head) demonstrated by magnetic resonance imaging. Skeletal Radiol 14: 95PubMedGoogle Scholar
  23. 23.
    Heung SK, Sang HL, Yoon SL, et al. (1987) MR-imaging of the femoral heads in avascular necrosis. Poster, presented at the 73rd Scientific Assembly and Annual Meeting of the RSNA, ChicagoGoogle Scholar
  24. 24.
    Salter RB (1984) The present status of surgical treatment for Legg-Calve-Perthes disease. J Bone Joint Surg [Am] 66: 961Google Scholar
  25. 25.
    Cohen MD, Klatte EC, Baehner R, et al. (1984) Magnetic resonance imaging of bone marrow in children. Radiology 151: 715PubMedGoogle Scholar
  26. 26.
    Moore SG, Gooding CA, Brash RC, Ehman RL, et al. (1986) Bone marrow in children with acute lymphocytic leucemia: MR relaxation times. Radiology 160: 237PubMedGoogle Scholar
  27. 27.
    Reither M, Kaiser W, Imschweiler E, Lindner R, Zeitler E (1987) Bedeutung der Kernspintomographie für die Diagnostik von Knochenmarkserkrankungen im Kindesalter. Fortschr Röntgenstr 147: 647Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • G. Ranner
    • 1
  • F. Ebner
    • 1
  • R. Fotter
    • 1
  • W. Linhart
    • 2
  • E. Justich
    • 1
  1. 1.Department of RadiologyKarl Franzens University and Medical SchoolGrazAustria
  2. 2.Department of Pediatric SurgeryKarl Franzens University and Medical SchoolGrazAustria

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