CT analysis of proximal femoral trabecular pattern simulating skeletal pathology

The proximal femoral trabecular pattern was studied in 20 patients, six cadavers, and 20 macerated specimens using plain film radiography and CT. A distinctive pattern of increased radiodensity in the proximal femur is described in patients and specimens with osteoporosis and osteoarthritis. The appearance is similar to that of an enchondroma or bone infarct. This pattern may be explained by biomechanical principles and is created by unmasking or hypertrophy of preexistent, reinforcing trabeculae. Confusion with osseous pathology can be avoided if the radiologist is aware of this pattern.