[Non-arthrosic geodes in the femur head. Isolated or predominant geodes]

The isolated or predominant geodes of the femoral head without signs of coxarthritis or coxitis, seem to form in response to: osteochondritis dissecans in 9 cases where the sequester was only visible in profile films or oblique images for 5 cases, and only at time of operation in 2 cases; incipient necrosis in 3 adult cases, not evidenced in frontal films and only seen in profile films with the patient under axial traction; femoral head dysmorphia in 6 cases among which were 4 polyepiphyseal dysplasias and 2 coxa plana without radiographically apparent sequesters; induced increased pressure caused by congenital subluxation or a major disorder of posture and locomotion of lower limbs in 3 cases. In 2 cases no classification could be assigned to isolated or predominant geodes of the femoral head in spite of anatomic examination. The diagnosis of these isolated or predominant geodes of the head of the femur necessitates excellent films made from different angles of view (profile, "false" profile, usual profile, sometimes oblique shots, tomograms) and often enough a biopsy which must be obtained directly through the joint, not transcervically through the neck if a reliable specimen is desired. The surgical treatment indicated is voiding and packing to a maximum the geodes possibly correcting the former increased pressure discordance. But, in lots of cases the intensity of pain and discomfort remains moderate for years, so indication for surgery arises late after onset.