Lokmanya Tilak Municipal General Hospital = Subchondral Insufficiency Fractures of the Femoral Head

다국어 초록 (Multilingual Abstract)

A subchondral insufficiency fracture (SIF) of the femoral head is a recently proposed concept, which needs to be differentiated from osteonecrosis. Clinically, SIF has generally been observed in the osteoporotic elderly women or renal transplant recipients. Radiographical changes are not obvious in its early phase, however, some cases undergo subchondral collapse (crescent sign). On the T1-weighted magnetic resonance images, a low intensity band is one of the characteristic imaging appearances, which corresponds histologically to the fracture line and associated fracture repair tissue. Therefore, the shape of the low intensity band generally tends to be irregular, disconnected, and convex to the articular surface. The prognosis of SIF is not clearly established. Some cases show resolution of the symptoms by the conservative treatments, while other cases show rapid progression of the collapse such as rapidly progressive arthrosis of the hip.

참고문헌 (Reference)

1 Yamamoto T, "Transtrochanteric rotational osteotomy for a subchondral insufficiency fracture of the femoral head in young adults" 468 (468): 3181-3185, 2010

2 Vande Berg BC, "Transient epiphyseal lesions in renal transplant recipients:presumed insufficiency stress fractures" 191 (191): 403-407, 1994

3 Yamamoto T, "The role of subchondral insufficiency fracture in rapid destruction of the hip joint: a preliminary report" 43 (43): 2423-2427, 2000

4 Yamamoto T, "The prevalence and clinicopathological appearance of extension of osteonecrosis in the femoral head" 81 (81): 328-332, 1999

5 Cummings SR, "The future of hip fractures in the United States: numbers, costs, and potential effects of postmenopausal estrogen" (252) : 163-166, 1990

6 Tokuya S, "Subchondral insufficiency fracture of the humeral head and glenoid resulting in rapidly destructive arthrosis: a case report" 13 (13): 86-89, 2004

7 Yamamoto T, "Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI" 30 (30): 247-254, 2001

8 Yamamoto T, "Subchondral insufficiency fracture of the femoral head: a differential diagnosis in acute onset of coxarthrosis in the elderly" 42 (42): 2719-2723, 1999

9 Yamamoto T, "Subchondral insufficiency fracture of the femoral head resulting in rapid destruction of the hip joint: a sequential radiographic study" 178 (178): 435-437, 2002

10 Yamamoto T, "Subchondral insufficiency fracture of the femoral head in younger adults" 36 (36): S38-S42, 2007

11 Yamamoto T, "Subchondral insufficiency fracture of the femoral head in a patient with systemic lupus erythematosus" 65 (65): 837-838, 2006

12 Iwasaki K, "Subchondral insufficiency fracture of the femoral head after liver transplantation" 38 (38): 925-928, 2009

13 Bangil M, "Subchondral insufficiency fracture of the femoral head" 63 (63): 859-861, 1996

14 Visuri T, "Stress osteopathy of the femoral head: 10 military recruits followed for 5-11 years" 68 (68): 138-141, 1997

15 Yamamoto T, "Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture" 82 (82): 858-866, 2000

16 Iwasaki K, "Prognostic factors associated with a subchondral insufficiency fracture of the femoral head" 85 (85): 214-218, 2012

17 Fukushima W, "Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head" 468 (468): 2715-2724, 2010

18 Yamaguchi R, "MRI-detected double low-intensity bands in osteonecrosis of the femoral head" 16 (16): 471-475, 2011

19 Ikemura S, "MRI evaluation of collapsed femoral heads in patients 60 years old or older: differentiation of subchondral insufficiency fracture from osteonecrosis of the femoral head" 195 (195): W63-W68, 2010

20 Yamamoto T, "Insufficiency subchondral fracture of the femoral head" 24 (24): 464-468, 2000

21 Rafii M, "Insufficiency fracture of the femoral head: MR imaging in three patients" 168 (168): 159-163, 1997

22 Hagino H, "Insufficiency fracture of the femoral head in patients with severe osteoporosis: report of 2 cases" 70 (70): 87-89, 1999

23 Kubo T, "Initial MRI findings of non-traumatic osteonecrosis of the femoral head in renal allograft recipients" 15 (15): 1017-1023, 1997

24 Yamamoto T, "Histopathological prevalence of subchondral insufficiency fracture of the femoral head" 67 (67): 150-153, 2008

25 Mitchell DG, "Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings" 162 (162): 709-715, 1987

26 Pentecost RL, "Fatigue, insufficiency, and pathologic fractures" 187 : 1001-1004, 1964

27 Ikemura S, "Bilateral subchondral insufficiency fracture of the femoral head after renal transplantation: a case report" 52 (52): 1293-1296, 2005

28 Zhao G, "A histopathological evaluation of a concave-shaped low-intensity band on T1-weighted MR images in a subchondral insufficiency fracture of the femoral head" 39 (39): 185-188, 2010

29 Yamamoto T, "A clinicopathologic study of osteonecrosis in the osteoarthritic hip" 8 (8): 303-308, 2000