Imaging of Postoperative Avascular Necrosis of the Ankle and Foot

Buchan, Craig; Pearce, Dawn; Lau, Johnny; White, Lawrence M.

doi:10.1055/s-0032-1320060

Cited by 13 publications

(3 citation statements)

References 49 publications

(67 reference statements)

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“…Although gadolinium administration is not routinely performed in post-operative period unless there is the suspicion of infection, in case of VFG, it may add important prognosis informations. The presence of enhancement surrounding the graft and in the necrotic area means revascularization and is often associated with reduction of BME which stands for a favorable outcome (38,39). In summary, conventional MRI is considered the gold standard technique in the early stages when plain films are nega-tive and can be used as guidance and follow-up of FHAVN conservative and surgical treatments.…”

Section: Conventional Magnetic Resonance Imagingmentioning

confidence: 99%

The role of imaging in diagnosis and management of femoral head avascular necrosis

Manenti

Altobelli

Pugliese

et al. 2015

ccmbm

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SummaryThe aim of this paper is to critically review the literature documenting the imaging approach in adult Femoral Head Avascular Necrosis (FHAVN). For this purpose we described and evaluated different radiological techniques, such as X-ray, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Nuclear Medicine. Plain films are considered the first line imaging technique due to its ability to depict femoral head morphological changes, to its low costs and high availability. CT is not a routinely performed technique, but is useful to rule out the presence of a subchondral fracture when MRI is doubtful or contraindicated. MRI is unanimously considered the gold standard technique in the early stages, being capable to detect bone marrow changes such as edema and sclerosis. It may be useful also to guide treatment and, as CT, it is a validated technique in follow-up of patients with FHAVN. Nuclear medicine imaging is mostly applied in post-operative period to detect graft viability or infective complications. More advanced techniques may be useful in particular conditions but still need to be validated; thus new research trials are desirable. In conclusion, X-ray examination is the first line approach, but lacks of sensitivity in early stage whereas MRI is indicated. CT easily depicts late stage deformation and may decrease MRI false positive results in detecting the subchondral fracture. However, the role of both Nuclear Medicine Imaging and advanced MR techniques in FHAVN still need to be investigated.

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Section: Conventional Magnetic Resonance Imagingmentioning

confidence: 99%

The role of imaging in diagnosis and management of femoral head avascular necrosis

Manenti

Altobelli

Pugliese

et al. 2015

ccmbm

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“…An increase around the graft and necrotic area indicates revascularization. This is frequently linked to a decrease in BME, showing a positive result (Buchan et al, 2012;Elias et al, 2007). In conclusion, when plain films are harmful in the early stages, conventional MRI is regarded as the gold standard method and can guide and monitor FHAVN conservative and surgical treatments.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of X-Ray in Diagnosing Avascular Femoral Head, Keeping Magnetic Resonance Imaging (Mri) as Gold Standard

SHAKIR,

MELWAN,

MANSOOR

et al. 2024

Biol Clin Sci Res J

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Avascular necrosis of the femoral head is a common cause of musculoskeletal disability, and it presents a significant diagnostic and therapeutic challenge. Although patients are initially asymptomatic, avascular necrosis frequently leads to joint destruction, typically before the age of 50. Magnetic Resonance Imaging (MRI) is a non-invasive, rapid, and compassionate diagnostic tool commonly used by clinicians. This study aims to determine the diagnostic accuracy of X-rays in detecting avascular necrosis of the femoral head, using MRI as the gold standard. This Cross-Sectional Validation Study was conducted at the Department of Radiology, JPMC, Karachi, Pakistan. The study was conducted over six months after the synopsis approval, from November 6, 2021, to May 5, 2022. This study included all patients who met the inclusion criteria and visited the JPMC Hospital in Karachi. After explaining the procedure, risks, and benefits of the study, informed consent was obtained from all patients. All patients underwent X-rays, and those diagnosed with avascular necrosis of the femoral head underwent MRI. The collected data was entered into the attached proforma and used electronically for research. The mean age was 48.8±9.2, with 92 (63.0%) male and 54 (37.0%) female patients. The diagnostic accuracy of the X-ray was 82.88% in detecting avascular necrosis of the femoral head, with sensitivity and specificity of 82.05% and 83.82%, respectively. The positive predictive value (PPV) was 53.42%, and the negative predictive value (NPV) was 80.28%, using MRI findings as the gold standard. In conclusion, the use of X-ray in evaluating avascular necrosis of the femoral head was not helpful and comparable to MRI. Therefore, an MRI should be performed in every case of avascular necrosis of the femoral head to achieve an accurate diagnosis. More prospective and well-controlled trials are required to validate the current findings.

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“…The osteonecrosis of Navicular is not a common occurrence. Few of the reported literature supported the role of trauma with it [36,37] . Usually there is sclerosis of the bone along with marginal osteophyte formation and reduction of talonavicular joint space reduction on X ray and CT scan.…”

Section: Osteonecrosis Of Navicularmentioning

confidence: 99%

Radiological evaluation of avascular necrosis of bone with clinical correlation

Das¹,

Das²,

Gogoi³

et al. 2021

Int. J. Radiol. Diagn. Imaging

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Osteonecrosis of bone is a progressive disease affecting the areas with precarious blood supply like head of the femur, head of the humerus, Scaphoid, Talus, Navicular, Condyles of long bones etc. Causes are mostly unknown and few are related to Corticosteroids, Trauma, Alcoholism, and hematological disorders. In the present study, 45 symptomatic patients were evaluated for osteonecrosis using X Ray, CT Scan and MRI in a tertiary care hospital. The age of incidence, gender variability, laterality, involvement of the different bones were studied. The sensitivity of various imaging modalities according to the disease stages was also noted. In majority of the cases the cause was unknown and the head of the femur came out to be the most involved site. MRI was found to be the most sensitive imaging modality followed by CT and X ray. The common findings detected by X ray and CT were Sclerosis, Subchondral lucency, Altered morphology and associated degenerative changes. Bone marrow edema was the most common finding detected by MRI in very early stage. Joint effusion, Double line sign, subchondral collapse, degenerative changes of the joint were other significant findings. T1 hyposensitivity was the main finding in the osteonecrosis of Scaphoid, Navicular and Talus with no enhancement post contrast.

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Imaging of Postoperative Avascular Necrosis of the Ankle and Foot

Cited by 13 publications

References 49 publications

The role of imaging in diagnosis and management of femoral head avascular necrosis

The role of imaging in diagnosis and management of femoral head avascular necrosis

Diagnostic Accuracy of X-Ray in Diagnosing Avascular Femoral Head, Keeping Magnetic Resonance Imaging (Mri) as Gold Standard

Radiological evaluation of avascular necrosis of bone with clinical correlation

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