Magnetic resonance imaging in osteomalacic insufficiency fractures of the pelvis

Kanberoğlu, Kaya; Kantarcı, Fatih; Cebi, Deniz; Yılmaz, Mehmet; Kuruğoğlu, Sebuh; Bilici, A.; Koyuncu, Halil

doi:10.1016/j.crad.2004.04.021

Cited by 26 publications

(13 citation statements)

References 20 publications

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“…In the first 30 days postfracture, 70 complications occurred (in and out of the hospital) in 47 participants (average 0.39 AE 0.75 per participant). The most common complications were urinary tract infection (17 participants), pneumonia (8), delirium (8), urinary retention (6), decubitus ulcer (5), and atrial fibrillation (3); 10 participants died within the first 30 days. No significant correlation was found between fracture type and number of complications (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…In older adults, displaced pelvic fractures, which can be bilateral, usually occur in the pubic rami and often are accompanied by a nondisplaced posterior injury to the sacrum or sacroiliac joint. 8 Nondisplaced fractures may occur from low-energy trauma or from repetitive stress through bone weakened by osteoporosis 9 and can present in multiple patterns. For example, a lateral force may cause a nondisplaced fracture anteriorly in the pubic rami and posteriorly in the sacrum, and a vertical force may cause a sacral insufficiency fracture (SIF).…”

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confidence: 99%

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Outcomes of Displaced and Nondisplaced Pelvic and Sacral Fractures in Elderly Adults

Mears

Berry

2011

J American Geriatrics Society

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Outcomes of Displaced and Nondisplaced Pelvic and Sacral Fractures in Elderly Adults

Mears

Berry

2011

J American Geriatrics Society

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“…MR imFINFO (image file information) can determine the clinical activity and can monitor the response to the treatment of insufficiency fractures. 33 Diffusion-weighted MR imaging may be capable of differentiating malignant from benign lesions. 34…”

Section: Multidetector Computed Tomographymentioning

confidence: 99%

Imaging of Insufficiency Fractures

Krestan

Nemec

2011

Semin Musculoskelet Radiol

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This review article focuses on occurrence, imaging, and differential diagnosis of insufficiency fractures. Prevalence and the most common sites of insufficiency fractures and their clinical implications are discussed. Insufficiency fractures are due to normal stress exerted on weakened bone. Most commonly postmenopausal osteoporosis is the cause for insufficiency fractures. Additional conditions affecting bone turnover include osteomalacia, chronic renal failure, and high-dose corticosteroid therapy. It is a challenge for the radiologist to detect and diagnose insufficiency fractures as well as to differentiate them from malignant fractures. Radiographs are the basic modality used for screening of insufficiency fractures, yet depending on the location of the fractures, sensitivity is limited. Magnetic resonance imaging is a very sensitive tool to visualize bone marrow abnormalities associated with insufficiency fractures and allows differentiation of benign versus malignant fractures. Thin section multidetector computed tomography (CT) depicts subtle fracture lines allowing direct visualization of cortical and trabecular bone. Dedicated Mikro-CTs (Xtreme-CT) can detect subtle fractures reaching an in-plane resolution of 80 μm. Bone scintigraphy still plays a role in detecting fractures, with good sensitivity but unsatisfactory specificity. Positron emission tomography-CT with hybrid-scanners has been the upcoming modality for the differentiation of benign from malignant fractures. Bone densitometry and clinical fracture history may determine the future risk of possible insufficiency fractures.

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“…Thus, the two‐pool UTE‐MT technique has the potential to diagnose certain bone diseases associated with porosity variation such as osteoporosis. More importantly, for diseases affecting bone collagenous matrix and bone minerals differently, such as osteomalacia, the two‐pool UTE‐MT technique can provide information complementary to bone mineral density (BMD) measurements. Recently, the two‐pool UTE‐MT technique has been utilized to detect ex vivo fibular bone stress injury induced cyclic loading where the bone collagenous matrix is affected despite an unchanged BMD .…”

Section: Introductionmentioning

confidence: 99%

Collagen proton fraction from ultrashort echo time magnetization transfer (UTE‐MT) MRI modelling correlates significantly with cortical bone porosity measured with micro‐computed tomography (μCT)

Jerban

Wan

et al. 2018

NMR in Biomedicine

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Intracortical bone porosity is a key microstructural parameter that determines bone mechanical properties. While clinical MRI visualizes the cortical bone with a signal void, ultrashort echo time (UTE) MRI can acquire high signal from cortical bone, thus enabling quantitative assessments. Magnetization transfer (MT) imaging combined with UTE‐MRI can indirectly assess protons in the bone collagenous matrix, which are inversely related to porosity. This study aimed to examine UTE‐MT MRI techniques to evaluate intracortical bone porosity. Eighteen human cortical bone specimens from the tibial and fibular midshafts were scanned using UTE‐MT sequences on a clinical 3 T MRI scanner and on a high‐resolution micro‐computed tomography (μCT) scanner. A series of MT pulse saturation powers (500°, 1000°, 1500°) and frequency offsets (2, 5, 10, 20, 50 kHz) were used to measure the macromolecular fraction (MMF) and macromolecular T2 (T2MM) using a two‐pool MT model. The measurements were made on 136 different regions of interest (ROIs). ROIs were selected at three cortical bone layers (from endosteum to periosteum) and four anatomical sites (anterior, mid‐medial, mid‐lateral, and posterior) to provide a wide range of porosity. MMF showed moderate to strong correlations with intracortical bone porosity (R = −0.67 to −0.73, p < 0.01) and bone mineral density (BMD) (R = +0.46 to +0.70, p < 0.01). Comparing the average MMF between cortical bone layers revealed a significant increase from the endosteum towards the periosteum. Such a pattern was in agreement with porosity reduction and BMD increase towards the periosteum. These results suggest that the two‐pool UTE‐MT technique can potentially serve as a novel and accurate tool to assess intracortical bone porosity.

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Magnetic resonance imaging in osteomalacic insufficiency fractures of the pelvis

Cited by 26 publications

References 20 publications

Outcomes of Displaced and Nondisplaced Pelvic and Sacral Fractures in Elderly Adults

Outcomes of Displaced and Nondisplaced Pelvic and Sacral Fractures in Elderly Adults

Imaging of Insufficiency Fractures

Collagen proton fraction from ultrashort echo time magnetization transfer (UTE‐MT) MRI modelling correlates significantly with cortical bone porosity measured with micro‐computed tomography (μCT)

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