Abstract
The proper diagnosis of ischemia and necrosis of bone is of primary practical importance because of the primacy of early diagnosis and the outcome of treatment, whatever it may be. Many authors, supporting core decompression, electrical stimulation, bone grafting or osteotomy have linked success to the stage at which the diagnosis is made (Steinberg et al., 1984; Hungerford et al., 1990). The purpose of this paper is to provide an overview of the issues and diagnosis, some of the obstacles and disputes, and finally to present our diagnostic algorithm as currently practiced in trying to arrive at the proper diagnosis for the patient presenting with a painful hip for evaluation.
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References
Camp, J.F., C.W. Colwell: Core decompression of the femoral head for osteonecrosis. JBJS 68-A: 1313–1319 (1986).
Cova, M., Y.S. Kang, H. Tsukomoto, L.C. Jones, E. McVeigh, B.L. Neff, C.J. Herold, W.W. Scott, D.S. Hungerford, E.A. Zerhouni: Bone marrow perfusion evaluated with gadolinium-enhanced dynamic fact MR imaging in a dog model. Radiology 179: 535–539 (19
D’Aubigne’, R.M., M. Postel, A. Mazabraud, P. Massias J. Gueguen: Idiopathic necrosis of the femoral head in adults. JBJS 47B: 612–633 (1965).
Hungerford, D.S., D.W. Lennox: Diagnosis and treatment of ischemic necrosis of the femoral head. In: C. McCollister Evarts (ed): Surgery of the Musculoskeletal System. 2nd ed. Churchill Livingstone Publ., New York 1990.
Jacobs, B.: Epidemiology of traumatic and non-traumatic osteonecrosis. Clin. Orthop. 130: 51–67 (1978).
Kerboul, M., J. Thomine, M. Postel, R.M. D’Aubigne’: The conservative surgical treatment of idiopathic aseptic necrosis of the femoral head. JBJS 56B: 291–296 (1974).
Kokubo, T., Y. Takatori, S. Ninomiya, T. Nakamura, M. Kamogawa: Magnetic resonance imaging and scintigraphy of avascular necrosis of the femoral head. Prediction of subsequent segmental collapse. Clin. Orthop. 277: 54–60 (1992).
Kulkarni, M.V., R.R. Tarr, E.E. Kim, C.B. McArdle, C.L. Partain: Potential pitfalls of magnetic resonance imaging in the diagnosis of avascular necrosis. J. Nucl. Med. 28: 1052–1054 (1987).
Matsuo, K., T. Hirohata, Y. Sugioka, M. Ikada, A. Fukuda: Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head. Clin. Orthop. 234: 115–123 (1988).
Mitchell, D.G., P.M. Joseph, M. Fallon, W. Hickey, H.Y. Kressel, V.M. Rao, M.E. Steinberg, M.K. Dalinka: Chemical shift MR imaging of the femoral head: An in vitro study of normal hips and hips with avascular necrosis. AJR 148: 1159–1164 (1987).
Mitchell, D.G., H.Y. Kressel, P.H. Arger, M.K. Dalinka, C.E. Spritzer, M.E. Steinberg: Avascular necrosis of the femoral head: morphologic assessment by MR imaging, with Cl correlation. Radiology 161: 739–742 (1986).
Mitchell, D.G., V.M. Rao, M.K. Dalinka, C.E. Spritzer, A. Alavi, M.E. Steinberg, M. Fallon, H.Y. Kressel: Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 162: 709–715 (1987).
Mitchell, D.G., V.M. Rao, M. Dalinka, C.E. Spritzer, L. Axel, W. Gefter, M. Kricum, M.E. Steinberg, H.Y. Kressel: Hematopoietic and fatty bone marrow distribution in the normal and ischemic hip: new observations with 1.5-TMR imaging. Radiology 161: 199–202 (1986).
Ropes, M.W., G.A. Bennett, S. Cobbs, R. Jacox, R.A. Jessar: Diagnostic criteria for rheumatoid arthritis, 958 revision. Ann. Rheum. Dis. 18: 49–53 (1959).
Rutishauser, E., A. Rohner, D. Held: Experimentelle Untersuchungen über die Wirkung der Ischämie auf den Knochen und das Mark. Virchows Arch. Path. Anat. 333: 101–118 (1960).
Steinberg, M.E., R.E. Bands, S. Parry, E. Hoffman, T. Chan, K.M. Hartman: Does lesion size affect outcome in avascular necrosis. 59th Annual Meeting of The Academy of Orthopaedic Surgeons. Final Program, pp. 176 (1992).
Steinberg, M.E., C.T. Brighton, D.R. Steinberg, S.E. Tooze, G.D. Heyken: Treatment of avascular necrosis of the femoral head by a combination of bone grafting, decompression, and electrical stimulation. Clin. Orthop. 186: 137–153 (1984).
Thickman, D., L. Axel, H.Y. Kressel, M. Steinberg, H. Chen, M. Velehick, M. Fallon, M.K. Dalinka: Magnetic resonance imaging of avascular necrosis of the femoral head. Skeletal Radiol. 15: 133–140 (1986).
Tsukamoto, H., Y.S. Kang, L.C. Jones, M. Cova, C.J. Herold, E. McVeigh, D.S. Hungerford, E.A. Zeraouni: Evaluation of marrow perfusion in the femoral head by dynamic magnetic resonance imaging: effect of venous occlusion in a dog model. Investigative Radiology 27: 265–281 (1992).
Zizic, T.M., C.G. Lew, C. Marcoux, D.S. Hungerford: The predictive valve of hemodynamic studies in preclinical ischemic necrosis of bone. J. Rheumatol. 16: 1559–1564 (1989).
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© 1993 Plenum Press, New York
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Hungerford, D.S., Jones, L.C. (1993). Diagnosis of Osteonecrosis of the Femoral Head. In: Schoutens, A., Arlet, J., Gardeniers, J.W.M., Hughes, S.P.F. (eds) Bone Circulation and Vascularization in Normal and Pathological Conditions. NATO ASI Series, vol 247. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-2838-8_29
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DOI: https://doi.org/10.1007/978-1-4615-2838-8_29
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