MRI evaluation of steroid- or alcohol-related osteonecrosis of the femoral condyle

Sakai, Takashi; Sugano, Nobuhiko; Ohzono, Kenji; Matsui, Minoru; Hiroshima, Kazuo; Ochi, Takahiro

doi:10.3109/17453679808999263

Cited by 30 publications

(22 citation statements)

References 16 publications

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“…Although much of the available literature regarding rates of articular surface collapse about the knee describes spontaneous ON of the knee, some reports suggest that in adults with corticosteroid-induced knee ON the rates of collapse are lower than in our series [11,13]. For example, Sakai et al reported only a 10% collapse rate (four of 40) at 21 months of followup of the adult knees involved with ON, mostly secondary to steroid use [11]. At the time of last followup, all our patients with knee collapse were treated without arthroplasty.…”

Section: Discussioncontrasting

confidence: 75%

How Does Osteonecrosis About the Knee Progress in Young Patients with Leukemia?: A 2- to 7-year Study

Karimova¹,

Wozniak

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Osteonecrosis is a major treatment complication of pediatric leukemias owing to its potential to cause joint deterioration. Because of potential long-term effects of osteonecrosis on joints, information regarding its progression and collapse in different patients can be used to identify high-risk groups, advise the patients and parents of this complication, and potentially consider the risk for development of osteonecrosis in planning primary treatment. Questions/purposes We therefore determined: (1) the incidence of joint collapse and/or pain in young patients with hematologic malignancies diagnosed with ON of the knee; (2) risk factors associated with collapse; and (3) the relationship between size and location of osteonecrotic knee lesions and the likelihood of joint collapse. Patients and Methods We retrospectively reviewed 109 patients with hematologic malignancies and MRI-confirmed knee osteonecrosis. The median age was 11.5 years (range, 2.3-18.8 years) at primary diagnosis of hematologic malignancy and a median age of 13.4 years (range, 2.7-23.3 years) at diagnosis of osteonecrosis of the knee. For analyses, we used the first and last MR images. Minimum clinical followup was 2.3 years after diagnosis of knee osteonecrosis (median, 6 years; range, 2.3-7.17 years).

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Section: Discussioncontrasting

confidence: 75%

How Does Osteonecrosis About the Knee Progress in Young Patients with Leukemia?: A 2- to 7-year Study

Karimova¹,

Wozniak

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Osteonecrosis of the knee is often accompanied by nontraumatic osteonecrosis of the femoral head (LaPorte et al 1998, Sakai et al 1998, Mont et al 1999. Osteonecrosis of the patella tended to develop in patients with other necrotic lesions of the knee (Table 4).…”

Section: Discussionmentioning

confidence: 99%

“…To study the relationship between osteonecrosis of the patella and this condition elsewhere in the knee, we divided the knee into 7 sites: the medial and lateral femoral condyles, the distal femoral metaphysis, the medial and lateral tibial plateau, the proximal tibial metaphysis, and the patella. A normal fat intensity area, surrounded by a low-intensity band or diffuse low-intensity area on SPGR was judged a positive finding on MRI, according to MRI findings of osteonecrosis of the knee on T1 weighted images with spin echo sequence (Pollack et al 1987, Healy 1991, Sakai et al 1998.…”

Section: Methodsmentioning

confidence: 99%

Osteonecrosis of the patella in patients with nontraumatic osteonecrosis of the femoral head: MRI findings in 60 patients

Sakai¹,

Sugano²,

Nishii³

et al. 2000

Acta Orthopaedica Scandinavica

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“…However, accurate evaluation of a lesion on radiographs is difficult at best, and impossible in Stage 1 disease, which is not visualized by plain radiograph or CT scan [24]. MRI is superior to radiographs in the early detection of necrotic lesions as well as in evaluating the extent and location of lesions in hip and knee ON [22,25]. Early diagnosis and understanding of the natural history are important for treatment planning including core decompression [12], statin therapy [20], and alendronate therapy [18].…”

Section: Introductionmentioning

confidence: 99%

Extent of Osteonecrosis on MRI Predicts Humeral Head Collapse

Sakai

Sugano

Nishii

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Although MRI is useful for predicting progression of osteonecrosis (ON) of the femoral head or femoral condyle, predicting outcome of atraumatic osteonecrosis of the humeral head using MRI has not been previously examined. We asked whether the prognosis was related to the extent and location of necrotic lesions on MRI. We investigated 46 radiographically noncollapsed humeral heads in 27 patients, 24 steroid-related and three alcohol-related, using MRI and serial radiographs. The minimum followup was 24 months (mean, 84.9 months; range, 24-166 months). The necrotic lesion was typically located at the medial and superior aspect of the humeral head. The necrotic angle, which expressed the extent of the necrotic lesion, was measured on midoblique-coronal plane (range; 0 degrees -134.7 degrees ) and on midoblique-sagittal plane (range; 0 degrees -150.6 degrees ). Of the 46 lesions, 34 were less than 90 degrees and did not collapse, whereas 11 of the other 12 lesions of more than 90 degrees (92%) collapsed within 4 years. Of these 11 collapsed lesions, four of less than 100 degrees did not progress, followed by reparative reaction on plain radiographs, whereas the other seven of more than 100 degrees progressed to osteoarthritis. The extent of a necrotic lesion on MRI is useful to predict collapse of the humeral head.

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MRI evaluation of steroid- or alcohol-related osteonecrosis of the femoral condyle

Cited by 30 publications

References 16 publications

How Does Osteonecrosis About the Knee Progress in Young Patients with Leukemia?: A 2- to 7-year Study

How Does Osteonecrosis About the Knee Progress in Young Patients with Leukemia?: A 2- to 7-year Study

Osteonecrosis of the patella in patients with nontraumatic osteonecrosis of the femoral head: MRI findings in 60 patients

Extent of Osteonecrosis on MRI Predicts Humeral Head Collapse

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