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• W4381431486 abstract "Osteonecrosis of the femoral head (ONFH) is the leading cause of secondary hip OA in the young population. The occurrence of subchondral fracture is the determining step towards femoral head collapse and OA. Bone marrow edema-like (BME) signal intensity in the femoral head may be an indicator of early collapse in ONFH. To correlate the presence of BME of the femoral head at MRI with the presence of cortical and subchondral fracture at CT, and with the presence of pain. 76 patients with ONFH (mean age 45.9 years ±9.8 [standard deviation]; 60 male (79%)) underwent radiographs, MRI and CT of the hips with ONFH (n=83) within a short period of time (mean interval, 3.9 days ± 9.08 [standard deviation]). MRI protocol included large FOV coronal T1 and STIR of bilateral hips and small FOV sagittal T1 and FS-IW of the hip in question. Pain was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Staging of FHON was performed using MRI and radiographs by a consensus reading between two MSK radiologists according to the 2019 version of the ARCO classification. One radiologist assessed the presence of BME signal intensity of the proximal femur and synovitis/effusion of the hip joint on MRI. One radiologist, blinded to MRI findings and ARCO stage, analyzed CT images to look for the presence of cortical and trabecular fractures. Data was tabulated on Excel sheets and descriptive statistics were performed. Normality of the distribution was assessed using Shapiro-Wilk. Comparison was performed using Student's t-test. Mann-Whitney U-test or Chi-squared test when applicable. A p value of <0.05 was used for statistical significance for the abovementioned tests. There were 36 (43.4%) hips with BME at MRI (1 ARCO 1; 5 ARCO 2; 20 ARCO 3-A; 6 ARCO 3B and 4 ARCO 4), and 47/83 (56.6%) without BME (20 ARCO 1; 22 ARCO 2; 3 ARCO 3-A; 2 ARCO 3B and 0 ARCO 4). Among hips with BME on MRI, 26 (55.3%) showed fracture at CT (24 cortical and 25 trabecular fractures), while 10 (21.3%) of hips without BME showed fracture on CT (6 cortical and 10 trabecular fractures) (p=0.0015). The WOMAC-pain score was 30.8 ± 22.6 for hips without BME and 39.7 ± 21.4 for hips with BME (p=0.073) in ONFH, the presence of BME on MRI is associated with the presence of fracture on CT, but is not correlated to the severity of pain." @default.
• W4381431486 created "2023-06-21" @default.
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• W4381431486 date "2023-01-01" @default.
• W4381431486 modified "2023-09-23" @default.
• W4381431486 title "BONE MARROW EDEMA-LIKE IN FEMORAL HEAD OSTEONECROSIS: A SURROGATE OF EARLY COLLAPSE?" @default.
• W4381431486 doi "https://doi.org/10.1016/j.ostima.2023.100118" @default.
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