Superselektive intraarterielle DSA bei Hüftkopfnekrose und Schenkelhalsfraktur

Langer, Ruth; Scholz, Arne; Langer, M.; Astinet, F.; Schwetlick, G.; Ferstl, F. J.; Félix, R.

doi:10.1055/s-2008-1033192

Cited by 7 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another aggravating factor is that in 30-70% of the patients both hips are involved, with a peak incidence at 40 years of age [8]. In contrast to traumatic causes such as subcapital fracture or hip dislocation leading to vascular disruption and acutely deficient perfusion of the femoral head, the exact aetiology of AVN remains obscure [3,13]. A multifactorial genesis is discussed involving several underlying diseases, such as Gaucher's disease, ionizing radiation, steroid therapy, and risk factors such as alcoholic excess, hyperuricemia, pancreatitis and pregnancy [7,10].…”

Section: Introductionmentioning

confidence: 99%

Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications

Schmitt‐Sody¹,

Kirchhoff²,

Mayer³

et al. 2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

Diagnosis of avascular necrosis (AVN) of the femoral head depends on the combination of clinical symptoms and evaluation of radiographs and/or magnetic resonance imaging (MRI). To evaluate the evolution of AVN, the Ficat and the Association Research Circulation Osseous (ARCO) classification are commonly used to assess both imaging modalities. For comparison reasons, these classifications need to be reliable and reproducible to provide sufficient therapy options for the patient. Therefore, the aim of our study was to evaluate the interobserver reliability and the intraobserver reproducibility of these classifications. Patients with suspected AVN were examined using either radiographs or radiographs and MRI. The radiographs and/or MR images were reviewed initially and at 3 months by two general orthopaedic surgeons, two orthopaedic residents, and two general radiologists using the Ficat classification for radiographs and MR images as well as the ARCO classification for MR images only. In all, 38 patients (54 hips) were enrolled. There were 10 patients who presented with radiographs and 28 patients with radiographs and MR scans. Paired comparisons revealed a mean interobserver kappa reliability coefficient of 0.39 for the first and of 0.32 for the second review using the Ficat classification for radiographs, whereas for the MR images a mean of 0.39 in the first and of 0.34 in the second reading resulted. The MRI evaluation using the ARCO classification resulted in a mean interobserver reliability coefficient of 0.37 in the first and of 0.31 in the second reading. The mean kappa value for intraobserver reproducibility using the Ficat classification was 0.52 for radiographs and 0.50 for MR images, whereas a reproducibility of 0.43 resulted for the ARCO classification. This study showed poor interobserver reliability and fair intraobserver variability, diminishing any meaningful comparison of studies using the Ficat as well as the ARCO classification. Thus, the Ficat and ARCO staging systems are still not sufficient to reliably assess the status of AVN alone.Résumé Le diagnostic des nécroses vasculaires de la tête fémorale (AVN) dépend de l'analyse des signes cliniques et de l'évaluation des signes radiographiques ainsi que de l'IRM. Afin d'évaluer l'évolution de l'ostéonécrose de la hanche selon la classification de la Ficat et la classification ARCO, ces examens d'imagerie sont habituellement utilisés. Le but de notre étude est d'évaluer la fiabilité de ces différents paramètres inter et intra observateurs. Matériel et méthode : les patients suspects d'ostéonécrose de la hanche ont été examinés sur le plan radiographique et sur le plan IRM. Les radiographies et les images IRM ont été évaluées initialement trois mois après par deux chirurgiens orthopé-distes, deux résidents en orthopédie et deux radiologues en utilisant la classification du Ficat et la classification ARCO pour les images IRM. Résultats : 38 patients (54 hanches) ont été inclus dans cette étude. 10 patients n'ont bénéficié

show abstract

Section: Introductionmentioning

confidence: 99%

Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications

Schmitt‐Sody¹,

Kirchhoff²,

Mayer³

et al. 2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

show abstract

“…It is possible to analyse femoral blood flow relatively accurately, such as a super-selective angiography, intraosseous oxygen pressure Measurement and doppler-laser haemodynamic measurement, but it has a disadvantage of invasiveness. 9 – 11 Dynamic magnetic resonance imaging (MRI), which is seen as highly predictable, has the disadvantage of high cost, and when the technique is used after surgery, it is difficult to obtain accurate images due to interference from the instrument. 12 Efforts have been made to detect ONFH early using PET/CT and Bone SPECT/CT.…”

Section: Introductionmentioning

confidence: 99%

Prediction of femoral head avascular necrosis following femoral neck fracture: “pin-tract sign” of ^99mTc-HDP pinhole bone scan after metallic fixation

et al. 2019

View full text Add to dashboard Cite

Objective: To evaluate the predicting value of 99mTc-hydroxydiphosphonate (HDP) pinhole bone scan in development of osteonecrosis of femoral head (ONFH) in patients with femoral neck fracture after cannulated screw fixation. Methods: Pinhole bone scan of patients with metallically fixed femoral neck fracture from 2001 to 2015 were retrospectively reviewed. Initial pinhole bone scan was obtained within 2–3 weeks after surgery. Findings of initial pinhole bone scan were divided in to 4 groups. Group CU included cold defect in affected femoral head, group HU with no cold defect. Group PP with increased uptake along the inserted screws and group PN with no increased uptake along the inserted screws. More than 6 months of follow-up with pinhole bone scan and clinico-radiological evidence for ONFH was reviewed. Results: 72 patients (mean age 54.01 years, male 22, female 50) were included. 19 patients were in group CU, 53 in group HU. 60 patients were in group PP, 12 in group PN. During the follow-up, 13 patients were diagnosed as ONFH. 9 (47.36%) patients in group CU developed ONFH and 4 (7.5%) in group HU. 4 (6.66%) patients in group PP developed ONFH and 9 (75%) in group PN. Conclusions: To predict ONFH of femoral head followed by neck fracture, many imaging techniques with variable results were known. In this study, cold defect in early postoperative pinhole bone scans could predict ONFH, and loss of increased uptake along screw inserted site could be a strong indicative sign of ONFH. Further evaluation with a larger population is necessary.

show abstract

Hüftgelenk und proximaler Femur

Stübler¹

Handbuch Diagnostische Radiologie

View full text Add to dashboard Cite

Superselektive intraarterielle DSA bei Hüftkopfnekrose und Schenkelhalsfraktur

Cited by 7 publications

References 0 publications

Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications

Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications

Prediction of femoral head avascular necrosis following femoral neck fracture: “pin-tract sign” of ^99mTc-HDP pinhole bone scan after metallic fixation

Hüftgelenk und proximaler Femur

Contact Info

Product

Resources

About

Superselektive intraarterielle DSA bei Hüftkopfnekrose und Schenkelhalsfraktur

Cited by 7 publications

References 0 publications

Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications

Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications

Prediction of femoral head avascular necrosis following femoral neck fracture: “pin-tract sign” of 99mTc-HDP pinhole bone scan after metallic fixation

Hüftgelenk und proximaler Femur

Contact Info

Product

Resources

About

Prediction of femoral head avascular necrosis following femoral neck fracture: “pin-tract sign” of ^99mTc-HDP pinhole bone scan after metallic fixation