Accumulation of microdamage and low bone mass in the femoral head as a cause of subchondral insufficiency fracture in a patient with osteogenesis imperfecta

Iwata, Ken; Mashiba, Tasuku; Shimamura, Masashi; Miki, Takanori; Yamamoto, Toshiyuki

doi:10.1007/s00774-019-01006-y

Cited by 2 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Edematous changes and vascular-rich granulation tissue can be seen around this fracture lesion. 29 30) The histological findings of SIF are different from those of ONFH. In ONFH, a characteristic appearance is a zonal pattern comprising necrotic, repaired, and viable regions.…”

Section: Histopathological Manifestationsmentioning

confidence: 99%

Current Research on Subchondral Insufficiency Fracture of the Femoral Head

et al. 2022

View full text Add to dashboard Cite

Subchondral insufficiency fracture (SIF) of the femoral head is one of the predominant etiologies of rapidly progressive osteoarthritis of the hip (RPOH). SIF is a rare disease that causes acute pain in the hip joint. It is most frequently found in elderly women with osteoporosis. It is often underdiagnosed or misdiagnosed as osteonecrosis of the femoral head. SIF is currently a well-established cause of RPOH; however, the deeper etiology of SIF is not clear. Good clinical outcomes have been reported for hip preservation therapy and hip replacement. SIF is not obvious radiologically in the early stage, and a T1-weighted magnetic resonance imaging shows a discontinuous low-intensity band under the articular cartilage convex to the articular surface as its characteristic manifestation. Some patients will lose the opportunity to preserve the hip joint due to symptoms such as progressive joint space narrowing and subchondral collapse within a very short period. Patients with progressive hip space narrowing and subchondral collapse on X-ray should be converted to total hip arthroplasty. Based on the characteristics of the disease, surgeons need to master the clinical and radiological characteristics of SIF and strive for early diagnosis and treatment.

show abstract

Section: Histopathological Manifestationsmentioning

confidence: 99%

Current Research on Subchondral Insufficiency Fracture of the Femoral Head

et al. 2022

View full text Add to dashboard Cite

show abstract

A case of osteogenesis imperfecta diagnosed after subchondral insufficiency fracture of bilateral femoral heads

Okada,

Watarai,

Ozawa

et al. 2024

Modern Rheumatology Case Reports

View full text Add to dashboard Cite

Osteogenesis imperfecta (OI) is a heterogeneous disorder characterised by bone fragility. Herein, we report a case of OI diagnosed after subchondral insufficiency fracture (SIF) of bilateral femoral heads. A 37-year-old woman was referred to Saitama Medical University Hospital due to left hip pain without any trauma that lasted for 2 months. She was subsequently diagnosed with SIF of the left femoral head. After 3 months, she further developed SIF of the right hip without any trauma. Magnetic resonance imaging of the bilateral hips showed linear low-signal changes of the subchondral bone and bone marrow oedema of the femoral head on T2-weighted coronal and sagittal images, diagnosing of both SIFs. The bone mineral density was 0.851 g/cm2 (T-score, −1.3) at the lumbar spine, 0.578 g/cm2 (T-score, −1.9) at the right femoral neck, and 0.582 g/cm2 (T-score, −1.9) at the left femoral neck. Considering that the patient had multiple histories of fracture, blue sclera, and mild bilateral sensorineural hearing loss, she satisfied the diagnostic criteria for OI. Genetic testing revealed a mutation in COL1A1 (NM_000088.3, c.3806G>A: p. Trp1269*). After 7 months of conservative therapy, her symptoms improved. After 4 years, both hips were pain-free with no evidence of osteoarthritis progression. OI can result in insufficiency fractures due to bone fragility in adolescence and adulthood or later, and none of the cases of OI, except for the current case, were diagnosed as a result of bilateral SIF.

show abstract

Accumulation of microdamage and low bone mass in the femoral head as a cause of subchondral insufficiency fracture in a patient with osteogenesis imperfecta

Cited by 2 publications

References 17 publications

Current Research on Subchondral Insufficiency Fracture of the Femoral Head

Current Research on Subchondral Insufficiency Fracture of the Femoral Head

A case of osteogenesis imperfecta diagnosed after subchondral insufficiency fracture of bilateral femoral heads

Contact Info

Product

Resources

About