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Related Experiment Videos

Radiographically negative avascular necrosis: detection with MR imaging.

B G Coleman1, H Y Kressel, M K Dalinka

  • 1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.

Radiology
|August 1, 1988
PubMed
Summary

Magnetic resonance (MR) imaging effectively detects early avascular necrosis (AVN) of the femoral head, even when X-rays show no abnormalities. This early detection allows for timely treatment, preventing disease progression in most cases.

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Area of Science:

  • Orthopedics
  • Radiology
  • Medical Imaging

Background:

  • Avascular necrosis (AVN) of the femoral head can be challenging to diagnose in its early stages.
  • Radiography is often insensitive to early, radiographically negative AVN.
  • Advanced imaging techniques are crucial for early detection and management.

Purpose of the Study:

  • To correlate magnetic resonance (MR) imaging findings of radiographically negative avascular necrosis (AVN) of the femoral head with computed tomographic (CT) and radionuclide scans.
  • To evaluate the efficacy of MR imaging in diagnosing early-stage AVN.
  • To assess the progression of AVN after core decompression treatment.

Main Methods:

  • Retrospective review of radiographic and clinical records of 24 patients with suspected AVN.

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  • Serial MR imaging including T1-weighted and T2-weighted sequences.
  • Staging of AVN based on MR signal intensity characteristics.
  • Comparison of MR findings with CT and radionuclide scans.
  • Evaluation of treatment outcomes after core decompression.

    • Main Results:

    • MR imaging identified AVN in 31 hips, with 27 staged based on signal intensity.
    • Core decompression was performed on 18 hips, with only one showing disease progression.
    • Fourteen of 16 asymptomatic patients (88%) had early-stage focal lesions detected by MR.
    • CT and radionuclide scans failed to detect abnormalities in hips with distinctly abnormal MR findings.

    Conclusions:

    • MR imaging is highly sensitive for detecting early, radiographically negative avascular necrosis of the femoral head.
    • Early-stage AVN lesions identified by MR appear nonprogressive after core decompression treatment.
    • MR imaging offers superior diagnostic capability compared to CT and radionuclide scans for early AVN detection.