Comparison of Radiographic and Pathologic Diagnosis of Osteonecrosis of the Femoral Head

Crim, Julia R.; Layfield, Lester J.; Stensby, J. Derek; Schmidt, Robert L.

doi:10.2214/ajr.20.22930

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Histopathological examination is an important standard for the diagnosis of GIONFH ( Krenn et al, 2018 ; Crim et al, 2021 ). Based on the diagnostic criteria of GIONFH ( Yamamoto et al, 1997 ; Dong et al, 2015 ; Yan et al, 2020 ), we evaluated femoral head specimens of rabbits using H&E staining.…”

Section: Resultsmentioning

confidence: 99%

Metabolic Profiling Analysis of the Effect and Mechanism of Gushiling Capsule in Rabbits With Glucocorticoid-Induced Osteonecrosis of the Femoral Head

et al. 2022

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Gushiling capsule (GSLC) is an effective traditional Chinese medicine for the treatment of glucocorticoid-induced osteonecrosis of the femoral head (GIONFH). This study established the serum metabolite profiles of GSLC in rabbits and explored the metabolic mechanism and effect of GSLC on GIONFH. Seventy-five Japanese white rabbits were randomly divided into the control, model, and GSLC groups. The rabbits in the model group and the GSLC group received injection of prednisolone acetate. Meanwhile, rabbits in the GSLC group were treated by gavage at a therapeutic dose of GSLC once a day. The control group and the model group received the same volume of normal saline gavage. Three groups of serum samples were collected at different time points, and the changes in the metabolic spectrum were analyzed by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The resulting data set was analyzed using multivariate statistical analysis to identify potential biomarkers related to GSLC treatment. The metabolic pathway was analyzed by MetaboAnalyst 4.0 and a heatmap was constructed using the HEML1.0.3.7 software package. In addition, histopathological and radiography studies were carried out to verify the anti-GIONFH effects of GSLC. Principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) score plots revealed a significant separation trend between the control group and the model group and the GSLC group (1–3 weeks), but there were no significant differences in the GSLC group (4–6 weeks). Orthogonal PLS-DA (OPLS-DA) score plots also revealed an obvious difference between the model and the GSLC groups (4–6 weeks). Ten potential metabolite biomarkers, mainly phospholipids, were identified in rabbit serum samples and demonstrated to be associated with GIONFH. Hematoxylin and eosin staining and magnetic resonance imaging indicated that the pathological changes in femoral head necrosis in the GSLC group were less than in the model group, which was consistent with the improved serum metabolite spectrum. GSLC regulated the metabolic disorder of endogenous lipid components in GIONFH rabbits. GSLC may prevent and treat GIONFH mainly by regulating phospholipid metabolism in vivo.

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Section: Resultsmentioning

confidence: 99%

Metabolic Profiling Analysis of the Effect and Mechanism of Gushiling Capsule in Rabbits With Glucocorticoid-Induced Osteonecrosis of the Femoral Head

et al. 2022

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“…On the other hand, no statistically significant difference was found between the number of empty osteocytic lacunae and Ficat and Arlet stage for ONFH [ 20 ]. Although several studies have shown the link between imaging features and osteonecrosis severity [ 17 , 20 , 31 ], a direct relationship between the proportion of empty osteocytic lacunae and radiological staging has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

“…In the hips, a concordance rate of 81.2% in clinical diagnosis verified histologically has been reported [ 4 ]. According to the literature, in ONFH this concordance rate varies from 68% to 93% [ 4 , 27 , 31 , 32 ]. In the present study, histologic examination of the femoral head specimens confirmed clinico-radiological diagnosis of ONFH in 84% of the cases, hence showing correlation with previous reports.…”

Section: Discussionmentioning

confidence: 99%

Osteonecrosis of the Femoral Head: A Multidisciplinary Approach in Diagnostic Accuracy

et al. 2022

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Osteonecrosis of the Femoral Head (ONFH) is a disabling disease affecting up to 30,000 people yearly in the United States alone. Diagnosis and staging of this pathology are both technically and logistically challenging, usually relying on imaging studies. Even anatomopathological studies, considered the gold standard for identifying ONFH, are not exempt from problems. In addition, the diagnosis is often made by different healthcare specialists, including orthopedic surgeons and radiologists, using different imaging modes, macroscopic features, and stages. Therefore, it is not infrequent to find disagreements between different specialists. The aim of this paper is to clarify the association and accuracy of ONFH diagnosis between healthcare professionals. To this end, femoral head specimens from patients with a diagnosis of ONFH were collected from patients undergoing hip replacement surgery. These samples were later histologically analyzed to establish an ONFH diagnosis. We found that clinico-radiological diagnosis of ONFH evidences a high degree of histological confirmation, thus showing an acceptable diagnostic accuracy. However, when the diagnoses of radiologists and orthopedic surgeons are compared with each other, there is only a moderate agreement. Our results underscore the need to develop an effective diagnosis based on a multidisciplinary approach to enhance currently limited accuracy and reliability.

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Serum malondialdehyde and superoxide dismutase levels in patients with non-traumatic osteonecrosis of femoral head: a cross-sectional study

Zhu,

Zhao,

Zhang

et al. 2024

Mol. Cell. Toxicol.

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Comparison of Radiographic and Pathologic Diagnosis of Osteonecrosis of the Femoral Head

Cited by 4 publications

References 15 publications

Metabolic Profiling Analysis of the Effect and Mechanism of Gushiling Capsule in Rabbits With Glucocorticoid-Induced Osteonecrosis of the Femoral Head

Metabolic Profiling Analysis of the Effect and Mechanism of Gushiling Capsule in Rabbits With Glucocorticoid-Induced Osteonecrosis of the Femoral Head

Osteonecrosis of the Femoral Head: A Multidisciplinary Approach in Diagnostic Accuracy

Serum malondialdehyde and superoxide dismutase levels in patients with non-traumatic osteonecrosis of femoral head: a cross-sectional study

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