Subchondral insufficiency fracture of the femoral head in young adults

Iwasaki, Kenyu; Yamamoto, Takuaki; Motomura, Goro; Mawatari, Taro; Nakashima, Yasuharu; Iwamoto, Yukihide

doi:10.1016/j.clinimag.2010.05.005

Cited by 31 publications

(41 citation statements)

References 15 publications

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“…2 (Tables 1 and 2) was a 43-yearold male patient with SIF in whom no evidence of osteoporosis, hyperparathyroidism or calcium/phosphate metabolism abnormalities other than the exception of BMD (t-score: 21.1 standard deviation) were observed. Although a recent study reported that subchondral insufficiency fracture of the femoral head occasionally occurs in healthy adults, 17 our case indicates that physicians should consider the possibility of subchondral insufficiency fractures in patients presenting with hip pain, even in young male patients.…”

mentioning

confidence: 86%

Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases

Ikemura¹,

Mawatari²,

Matsui³

et al. 2016

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mentioning

confidence: 86%

Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases

Ikemura¹,

Mawatari²,

Matsui³

et al. 2016

BJR

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“…Extensive BMEP was found in 86.3 % (44/51) with an average cross-sectional area of 885.7± 730.2 mm 2 , and roughly 37 % (19/51) of patients had a BMEP cross-sectional area greater than 1000 mm 2 (Fig. 2b).…”

Section: Baseline Mr Findingsmentioning

confidence: 99%

“…Previously thought to be a disease predominantly affecting elderly patients, SIF have since been reported in adults of varying ages and activity levels [2][3][4]. Though subchondral fractures do not necessarily comprise a separate disease process, SIF have been identified as a separate entity from osteonecrosis and trauma-related subchondral fractures through histopathologic evaluation [5,6].…”

Section: Introductionmentioning

confidence: 99%

Subchondral insufficiency fractures of the femoral head: associated imaging findings and predictors of clinical progression

et al. 2015

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Objectives To characterize the morphology and imaging findings of femoral head subchondral insufficiency fractures (SIF), and to investigate clinical outcomes in relation to imaging findings. Methods Fifty-one patients with hip/pelvis magnetic resonance (MR) images and typical SIF characteristics were identified and reviewed by two radiologists. Thirty-five patients had follow-up documentation allowing assessment of clinical outcome. Subgroup comparisons were performed using regression models adjusted for age and body mass index. Results SIF were frequently associated with cartilage loss (35/ 47, 74.5 %), effusion (33/42, 78.6 %), synovitis (29/44, 66 %), and bone marrow oedema pattern (BMEP) (average crosssectional area 885.7±730.2 mm 2 ). Total hip arthroplasty (THA) was required in 16/35 patients, at an average of 6 months post-MRI. Compared to the THA cohort, the non-THA group had significantly (p<0.05) smaller overlying cartilage defect size (10 mm vs. 29 mm), smaller band length ratio and fracture diameters, and greater incidence of parallel fracture morphology (p<0.05). Male gender and increased age were significantly associated with progression, p<0.05.Conclusions SIF were associated with synovitis, cartilage loss, effusion, and BMEP. Male gender and increased age had a significant association with progression to THA, as did band length ratio, fracture diameter, cartilage defect size, and fracture deformity/morphology.

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“…In addition, some cases show rapid progression of collapse, as seen in RDA. Although SIF generally occurs in osteoporotic elderly individuals, some reports demonstrated the occurrence of SIF in young adults without any history of overexertion or antecedent trauma [12,13]. In the current case, bone fragility was suggested by both DEXA and histological findings, probably due to SLE itself Fig.…”

Section: Discussionmentioning

confidence: 85%

Rapidly destructive arthrosis of the hip joint in a young adult with systemic lupus erythematosus

et al. 2015

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A 37-year-old female had been treated with corticosteroids for systemic lupus erythematosus clinically diagnosed at age 10. She suddenly had right hip pain without any antecedent trauma. Four months after the onset of pain, she visited her primary care physician. On magnetic resonance imaging, joint space narrowing at the weight-bearing area was already seen with bone marrow edematous lesions in both the femoral head and acetabulum. She was treated non-operatively; however, her pain continued to worsen in severity. Thirteen months after the onset of pain, she was referred to our hospital. A plain radiograph showed subluxation of the collapsed femoral head accompanied by destruction of the acetabular rim. Because of her severe intractable pain, she underwent total hip arthroplasty 1 month after her first visit. Histological examination of the resected femoral head revealed pseudogranulomatous lesions along with prominent callus formation, suggesting rapid destruction of the femoral head.

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Subchondral insufficiency fracture of the femoral head in young adults

Cited by 31 publications

References 15 publications

Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases

Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases

Subchondral insufficiency fractures of the femoral head: associated imaging findings and predictors of clinical progression

Rapidly destructive arthrosis of the hip joint in a young adult with systemic lupus erythematosus

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