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Identification of avascular necrosis in the dysplastic proximal femoral epiphysis

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Abstract

Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the superimposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia.

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Author notes

  1. W. G. MacKenzie M.D.

    Present address: Department of Orthopedic Surgery, British Columbia Children's Hospital, Vancouver, Canada

  2. G. S. Bassett M.D.

    Present address: Division of Orthopaedics, 1300 North Vermont Avenue, Los Angeles, California

Authors and Affiliations

  1. Department of Orthopedics of the Alfred I. duPont Institute, Wilmington, Delaware, USA

    W. G. MacKenzie M.D. & G. S. Bassett M.D.

  2. Department of Genetics of the Alfred I. duPont Institute, Wilmington, Selaware, USA

    C. I. Scott Jr. M.D.

  3. Department of Radiology., Medical Center of Delaware, Newark, Delaware, USA

    J. S. Wills M.D.

  4. Department of Medical Imaging, Alfred I. duPont Instute, P.O. Box 269, 19899, Wilmington, DE, USA

    G. A. Mandell M.D. & H. T. Harcke M.D.

Authors
  1. G. A. Mandell M.D.
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  2. W. G. MacKenzie M.D.
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  3. C. I. Scott Jr. M.D.
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  4. H. T. Harcke M.D.
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  5. J. S. Wills M.D.
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  6. G. S. Bassett M.D.
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Mandell, G.A., MacKenzie, W.G., Scott, C.I. et al. Identification of avascular necrosis in the dysplastic proximal femoral epiphysis. Skeletal Radiol 18, 273–281 (1989). https://doi.org/10.1007/BF00361206

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  • DOI: https://doi.org/10.1007/BF00361206

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