NECROSIS OF THE HEAD OF FEMUR AND BONE-MA RROW EDEMA SYNDROME IN PREGNANCY

MR examinations were performed in 9 patients suffering from severe pai n of the hip during the third trimenon without any relief after birth. Pathologic signal changes could be observed in 11 hips (oedema in the region of the femoral head and neck (n = 8); avascular necrosis of th e femoral head surrounded by bone marrow oedema (n = 3)). In 7 hips a relatively rapid decrease of the oedema following core decompression w as demonstrated. Focal necrosis, however, did not show any changes. In two patients, treated conservatively, markedly delayed healing was ev ident. MR imaging is the modality of choice for early diagnosis as wel l as follow-up of therapy of the bone marrow oedema syndrome or avascu lar necrosis and can be performed already during pregnancy.