Is the femoral head dead or alive before surgery of slipped capital femoral epiphysis? Interest of perfusion Magnetic Resonance Imaging

Técnica de Dunn modificada no escorregamento da epífise femoral proximal com instabilidade: Experiência unicêntrica de médio prazo

“… 30 There is still doubt as to whether the femoral head might be avascular before the operation. A French study 31 using perfusion magnetic resonance imaging (MRI) showed that avascular heads before capital realignment can revascularize after the operation. Superselective angiogram of the medial circumflex artery has also identified the revascularization with surgery; therefore, using a technique that enables the safe reorientation of the femoral epiphysis instead of pinning unstable slips in situ is important.…”

“… 30 Há alguns questionamentos quanto à possível avascularidade da cabeça femoral antes da cirurgia. Um estudo francês 31 com ressonância magnética (RM) de perfusão mostrou que cabeças avasculares antes do realinhamento podem sofrer revascularização após o procedimento cirúrgico. A angiografia superseletiva da artéria circunflexa medial também identificou a revascularização pela cirurgia; assim, é importante utilizar uma técnica capaz de proporcionar reorientação segura da epífise femoral em vez de fixar escorregamentos instáveis in situ .…”

Diagnosis and Management of Unstable Slipped Capital Femoral Epiphysis

“…While radiographs should serve as the initial imaging modality, the role of magnetic resonance imaging (MRI) is evolving 80 . Recent interest has been directed at perfusion MRI to evaluate the vascularity and viability of the femoral head prior to pursuing surgical treatment and utilizing these preoperative findings as a predictor for osteonecrosis 81 . However, additional study is needed since the sensitivity of perfusion imaging and its relationship to clinical osteonecrosis are unclear.…”