Kh. Koo et al., Bone marrow edema and associated pain in early stage osteonecrosis of the femoral head: Prospective study with serial MR images, RADIOLOGY, 213(3), 1999, pp. 715-722
Citations number
56
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To determine whether the marrow edema around focal osteonecrosis o
n magnetic resonance(MR) images is associated with clinical symptoms.
MATERIALS AND METHODS: Thirty-three patients with 37 hips showing early sta
ge osteonecrosis of the femoral head were followed up at 3-month intervals
with clinical evaluation, conventional radiography, and serial MR imaging.
RESULTS: Seven (50%) of 14 symptomatic hips showed marrow edema around foca
l osteonecrosis on initial MR images, whereas only one (4%) of 23 asymptoma
tic hips showed edema (P<.01). Six (86%) of seven hips that were moderately
to severely painful were associated with surrounding marrow edema. Ail eig
ht hips showing osteonecrosis with marrow edema at the initial MR examinati
on had joint effusion and exhibited intense radionuclide uptake in the prox
imal femur, which corresponded to the extent of edema on MR images. In all
eight hips, the marrow edema resolved on follow-up MR images, and the pain
subsided with the resolution of edema.
CONCLUSION: The results of this study suggest that the combination of marro
w edema of the proximal femur and focal osteonecrosis of the femoral head a
re strongly associated with hip pain in early stage osteonecrosis, even pri
or to collapse. Pain improvement usually parallels the resolution of edema.