2007 Volume 56 Issue 1 Pages 12-21
Subchondral insufficiency fracture (SIF) of the femoral head seems to be an important preliminary event in the development of rapidly destructive arthrosis (RDA) of the hip. However, in some cases, it can be cured conservatively only by rest. Although not all SIFs do not destroy the hip progressively, it is important to predict prognosis by early diagnosis. We proposed magnetic resonance imaging (MRI) of SIF or RDA for prognostic judgment. The subject was on 80-year-old woman suffering fall injury of AO31-A1. NTX114.3. X-ray indicated flattened femoral head at injury time. MRI examination showed a small low signal band at the subchondral area, and STIR image showed a diffused marrow edema in the femoral head and acetabulum. No remarkable abnormal changes were found in the T2 emphasis image. Partial load started after osteosynthesis (CHS) in four weeks, resulting in complete load in ten weeks. No collapse of the femoral head was found later. The T1 emphasis image and STIR image in MRI were effective for diagnosis reflecting bone edema but the only showed slight emphasis. These results suggest that T2 emphasis images are suitable prediction of later bone collapse.
