Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: a longitudinal study by MR imaging
| Autor: | Bruno Vande Berg, Frédéric Lecouvet, Raphaël Gilon, Jacques Malghem, Frédéric Houssiau, G Depresseux |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.drug_class Population Femoral head Sex Factors Adrenal Cortex Hormones Bone Marrow Femur Head Necrosis medicine Humans Radiology Nuclear Medicine and imaging Femur Longitudinal Studies education Femoral neck Aged Observer Variation education.field_of_study medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine Middle Aged Magnetic Resonance Imaging Regimen medicine.anatomical_structure Adipose Tissue Coronal plane Corticosteroid Female Hip Joint Radiology business Follow-Up Studies |
| Zdroj: | European journal of radiology. 58(3) |
| ISSN: | 0720-048X |
| Popis: | OBJECTIVE: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. PATIENTS AND METHODS: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. RESULTS: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p=0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p=0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p=0.0298). CONCLUSION: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy. |
| Databáze: | OpenAIRE |
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