C-reactive protein in femoral head necrosis

Serum concentrations of C-reactive protein (CRP), alpha 1-antitrypsin, orosomucoid, and haptoglobin were determined in 28 patients with a medial fracture of the femoral neck. The serum concentrations were compared with the result of hip scintigraphy with technetium-99m pyrophosphate, a method which can detect femoral head necrosis and predict the development of late segmental collapse. Serum concentrations of the four acute-phase proteins were measured immediately before osteosynthesis and at the time of hip scintigraphy 1 to 4, 8 to 13, and 37 to 47 days postoperatively. During the same period 15 patients had constantly normal, five varying abnormal/normal, and eight constantly abnormal scintigrams, the latter indicating femoral head necrosis. All four acute-phase proteins had a typical course of concentration changes, which were most pronounced for CRP. However, none of them were useful for the detection of femoral head necrosis or the prediction of late segmental collapse, since the observed serum concentrations could not be used to distinguish between the three scintigraphic groups.