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Skeletal Radiol. 2001 May;30(5):247-54.

Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI.

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  • 1Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.

Abstract

OBJECTIVE:

To correlate the magnetic resonance imaging (MRI) features with the histopathologic findings in subchondral insufficiency fracture (SIF) of the femoral head.

DESIGN AND PATIENTS:

This study was based on a retrospective review of the MRI features and histopathologic findings in seven patients with SIF who had had total hip replacement. Results. In all seven cases, MRI showed a bone marrow edema pattern in the femoral head, and a focal low-intensity band beneath the articular cartilage on some slices (not all) on the T1-weighted images. The shape of the low-intensity band varied: it was irregular and serpentine in four cases, well-delineated, smooth, and a mirror image to the articular surface in two cases, and parallel to the articular surface in one case. On histologic examination, the low-intensity band on MRI corresponded to a fracture line and its associated repair tissue. In all but one case, the band was not visible on T2-weighted or fat suppression images, and the proximal subchondral portion of the lesion had a homogeneous high signal intensity. This region of high signal intensity corresponded histopathologically to viable bone and marrow tissue with associated callus, edema, and vascular granulation tissue.

CONCLUSIONS:

SIF of the femoral head characteristically demonstrates a low-intensity band on T1-weighted images that corresponds, histopathologically, to a linear subchondral fracture and its associated repair tissue. In most cases, the subchondral portion of the lesion appears on T2-weighted images as an area of homogeneously high signal intensity.

PMID:
11407715
[PubMed - indexed for MEDLINE]
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