RATIONALE AND OBJECTIVES: The ability of biplane radiography and standard computed tomography (CT) imaging techniques to measure accurately the human femoral anteversion was evaluated and compared with an anatomic reference: the osteometric method. METHODS: Femoral anteversion of 10 normal adult cadaveric human femora were determined using a standardized anatomic measurement ...

A 39-year-old man who presented with right knee pain following trauma was found to have a radiographically-occult fracture of the lateral tibial condyle on magnetic resonance (MR) imaging. The intra-articular fracture was seen as a curvilinear area of hypointensity on both T1- and T2- weighted MR images, with surrounding bone ...

OBJECTIVE: The objective of this study was to describe the MR imaging features of osteochondritis dissecans of the femoral sulcus, which have not been described previously. CONCLUSION: Osteochondritis dissecans of the femoral sulcus has been recognized as a unique clinical and radiographic entity, warranting early diagnosis and appropriate treatment. Although ...

OBJECTIVE: Our objective was to compare the sensitivity of unenhanced radiography, CT, and MR imaging in revealing subchondral fractures. SUBJECTS AND METHODS: Forty-five subjects with stage I and stage II osteonecrosis of the femoral head were included in the study as part of a multicenter clinical trial to evaluate the ...

A 73-year-old woman who had previous mastectomy for breast carcinoma presented with persistent pain over the left hip area for two to three months. Pelvic radiograph showed an expanded osteolytic lesion involving the lesser trochanter of the left femur, with adjacent ill-defined destructive changes. She subsequently developed a displaced pathological ...

The history and physical examination are an essential component in the assessment of patients with lumbar spinal stenosis. The differential diagnosis is broad, and many conditions may be ruled out with a thorough office evaluation. Peripheral neuropathy, arteriovascular disease, and hip arthrosis are common entities with similar symptoms. Imaging studies ...

OBJECTIVE: To highlight the unusually indolent course of avascular necrosis in this patient, the risk factors of which chiropractors should be aware, the necessity of and means to an early diagnosis, the limitations of plain film radiographs, as well as the current medical treatments. CLINICAL FEATURES: A 27-year-old male professional ...

Three patients with osteonecrosis of the femoral head in whom the extent of necrosis increased by repeated episodes of osteonecrosis are described. In all cases the evidence of two attacks of osteonecrosis was detected clearly on magnetic resonance images. The significance of the recurrent attacks of osteonecrosis is not clear ...

PURPOSE: To assess the significance of ultrasonography (US) in detecting hip joint synovitis in patients with rheumatic diseases. MATERIAL AND METHODS: Forty patients with rheumatic disease and suspected hip joint synovitis underwent MRI and US of the hip joint. In addition to the throughout MRI evaluation, the anterior collum-capsule distance ...

After experimental and preclinical evaluation (HAP Paul Award 2001) of a CT-free image-guided surgical navigation system for acetabular cup placement, the system was introduced into clinical routine. The computation of the angular orientation of the cup is based on reference coordinates from the anterior pelvic plane (APP) concept. A hybrid ...

With the advent of magnetic resonance imaging and, subsequently, magnetic resonance arthrography, the imaging algorithm for hip pain has evolved considerably. Magnetic resonance imaging has supplanted bone scintigraphy as the first line imaging test after conventional radiographs in the setting of suspected occult fracture, transient marrow edema, and osteonecrosis. Computed ...

Avascular necrosis of the metacarpal head is a rare condition. Although the condition is associated with trauma, systemic lupus erythematosus, and steroid use, it can occur spontaneously without any obvious cause. Any metacarpal may be affected and the pathologic changes are similar to those described in other bones such as ...

The kinematic cup navigation procedure is a surgically simple technique for improving the precision of cup placement. Without CT scans, a reduction of cup malpositions is possible. The rate of desired cup inclination and anteversion angles is markedly increased as shown by the first results of 147 navigated cups. While ...

PURPOSE: 3D detection of centerpoints of prosthetic cup and head after total hip arthroplasty (THA) using CT. MATERIAL AND METHODS: Two CT examinations, 10 min apart, were obtained from each of 10 patients after THA. Two independent examiners placed landmarks in images of the prosthetic cup and head. All landmarking ...

In this prospective study of 18 hips we compared the efficacy of ultrasound with CT in determining the position of the femoral head in a spica cast after closed or open reduction in children with developmental dysplasia of the hip. Ultrasound was performed through the perineal opening of the cast. ...

Background. MRIs were obtained from 24 patients with suspicion of small pelvis pathology, with no indication of hip joint pathology.<br /> Results and Conclusions. Based on the normal descriptive and topographical anatomy of the hip joint and its vicinity, the authors identified on the MRIs the main bony, muscular, vascular ...

OBJECTIVE: To compare the intraobserver reliability and the sensitivity to change of 2 techniques evaluating the cartilage breakdown in hip osteoarthritis (OA). METHODS: Design: 3 year longitudinal study. Participants: patients with painful hip OA. Outcome: coxofemoral joint space width (JSW) at baseline and at 3 year followup was measured on ...

BACKGROUND: The reported prevalence of osteonecrosis of the femoral head in patients who have undergone a solid organ transplant has ranged from 3% to 41%. The wide variation is due to the retrospective nature of most studies and the inability to capture data on asymptomatic patients. The primary goals of ...

We are reporting three children and adolescents who presented with incongruous reduction of the hip following injury. In each case, the diagnosis was initially missed. None of the patients presented with a hip dislocation, but two gave a history consistent with transient hip subluxation or dislocation. Low-energy trauma was the ...

Tears and tendinopathy of the gluteus medius and minimus are potentially underrecognized clinical sources of hip pain. Magnetic resonance imaging is useful in diagnosing gluteal tears. This entity is frequently a result of predisposing conditions but may arise spontaneously. This clinical problem should be considered in the differential diagnosis of ...

MAK-VP-1/1, a proximal femur recovered from the Maka Sands (ca. 3.4 mya) of the Middle Awash, Ethiopia, and attributed to Australopithecus afarensis, is described in detail. It represents the oldest skeletal evidence of locomotion in this species, and is analyzed from a morphogenetic perspective. X-ray, CT, and metric data are ...

OBJECTIVE: To evaluate the radiographic and MR appearance of idiopathic synovial osteochondromatosis of the hip. MATERIALS AND METHODS: Radiographs and MR images of 15 patients with idiopathic synovial osteochondromatosis of the hip were assessed. The former were analysed in terms of the presence of 1) juxta-articular calcified and/ or ossified ...

PURPOSE: To develop a non-invasive method for detection of acetabular cup migration after total hip arthroplasty (THA) with a higher degree of accuracy than routine plain radiography. MATERIAL AND METHODS: Two CT examinations, 10 min apart, were obtained from each of 10 patients that had undergone THA. Using an in-house ...

Eleven hips of 10 patients with Legg-Calvé-Perthes disease (LCPD) were examined by arthrography and magnetic resonance (MR) imaging. Arthrogram and MR images were obtained with the hips in neutral position and in 20 degrees flexion-abduction and internal rotation. Modified arthrographic index (AI) was used for the evaluation of sphericity and ...

The authors investigated the deformity of the cartilaginous femoral head in 30 patients who had unilaterally affected Catterall groups III and IV Legg-Calvé-Perthes disease. The extent of collapse and the sphericity of cartilaginous head were determined using coronal and sagittal magnetic resonance images. The maximal femoral head collapse was larger ...

PURPOSE: To characterize osteonecrosis of the humeral head on coronal and axial MR images. METHODS: We retrospectively reviewed MR examinations in patients with humeral head osteonecrosis. The angle of the entire affected articular surface at three levels was measured and an angle subtended by the margins of osteonecrosis was also ...

OBJECTIVE: The aim of our study was to describe the MR imaging findings in patients with rapidly destructive osteoarthritis of the hip. CONCLUSION: The key MR imaging features of rapidly destructive hip osteoarthritis include joint effusion (100%), bone marrow edemalike pattern in the femoral head and neck (100%) or acetabulum ...

PURPOSE: To determine the frequency and distribution of the hyperintense stripe seen along the posterior surface of distal femoral and proximal tibial metaphyses at magnetic resonance (MR) imaging. MATERIALS AND METHODS: One hundred forty-two MR imaging studies obtained in 139 children and young adults were reviewed. The authors recorded the ...

OBJECTIVE: To evaluate the relationship between joint fluid, intramedullary pressure (IMP), bone marrow edema, and stages of osteonecrosis of the femoral head (ONFH). MATERIAL AND METHODS: We reviewed the magnetic resonance (MR) images of 28 patients with 40 documented ONFHs. IMP was measured in 16 symptomatic hips. The amount of ...

PURPOSE: To prospectively determine the accuracy of computed tomography (CT) in the detection of painful infection at the site of hip prosthesis before surgery. MATERIALS AND METHODS: Helical CT examinations of hip prostheses were prospectively performed before surgery after a standard clinical and radiologic examination of 65 patients. CT scans ...

BACKGROUND: It has been reported that MRI using a dynamic gadolinium-enhanced subtraction technique can allow the early identification of ischaemia and the pattern of revascularisation in Legg-Calvé-Perthes (LCP) disease with increased spatial and contrast resolution. Therefore, dynamic gadolinium-enhanced subtraction (DGS) MRI may be a possible non-ionising substitute for bone scintigraphy. ...

This paper describes an innovative surgical simulation software environment for the pre-operative planning of total hip replacement surgery. The software is a CT-based three-dimensional planning environment, with a user-friendly graphic user interface based on the multimodal display visualization paradigm. Although it relies on a fully three dimensional internal representation, this ...

Material and methods. To analyze morphology and endosteal anatomy of the proximal ends of the femur of 40 cadaver femora were x-rayed, dissected and measured. Various variables including trabecular pattern, calcar size, and cortical bone were measured and correlated. Observations were compared to literature concerns the various aspects of anatomy ...

OBJECTIVE: To document the imaging findings observed in patients with an unusual pattern of abnormality of the femoral head, most likely representing osteonecrosis. DESIGN AND PATIENTS: The imaging findings in 11 patients (10 men, 1 woman; age range 32-55 years) with a distinct lesion of the femoral head were reviewed ...

BACKGROUND: The majority of patients who undergo a reconstructive pelvic osteotomy because of symptomatic hip dysplasia are young women of childbearing potential. The purpose of this paper was to evaluate the effect of periacetabular osteotomy on the dimensions of the pelvic inlet and outlet in these patients. METHODS: The dimensions ...

OBJECTIVE: This study describes the MR imaging findings of focal osteochondral lesions found in the hips of 11 athletes with persistent pain and normal findings on radiographs. CONCLUSION: Osteochondral lesions of the femoral head are seen on MR imaging as focal, medial areas of high T2-weighted and low T1-weighted signals ...

Two cases of bacterial adductor myositis that presented as painful hips in boys aged 4 and 9 years are reported. Clinically, there was severe pain and a high pyrexia, a raised C-reactive protein and positive blood cultures but a negative hip ultrasound. Urgent magnetic resonance imaging demonstrated changes throughout the ...

The authors used magnetic resonance imaging to evaluate the hip joint in patients with diastrophic dysplasia. T1- and T2-weighted images were obtained from 35 patients (25 female patients, 10 male patients) of different ages (1-39 years). The status of the joint and paraarticular soft tissues was evaluated. Hip joint congruity ...

PURPOSE: To establish if 3D MR imaging could be used for measurements of acetabular inclination and anteversion in infants specimens. MATERIAL AND METHODS: 3D MR data of 3 pelvic preparations of 6-week- to 10-month-old infant specimens was gathered. MR imaging in transaxial and frontal planes was carried out to measure ...

Normal hip joint function is fundamental in running-, jumping-, and kicking-based sporting activities. Hip disorders do not account for a large portion of exercise-related injuries, but they can pose a clinical dilemma since symptoms tend to be non-specific. Conventional radiographs may demonstrate some causes of hip pain, such as stress ...

AIM: To determine the minimum clinically important difference (MCID) in joint space width (JSW) progression in patients with hip osteoarthritis (OA), based upon evaluation by a panel of clinical experts as a gold standard. METHODS: A sample of 298 patients with hip OA was selected from a multicentre, prospective, longitudinal, ...

The 2001 revised criteria for the diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head were proposed in June 2001, by the working group of the Specific Disease Investigation Committee under the auspices of the Japanese Ministry of Health, Labor and Welfare, to establish criteria for diagnosis and ...

This study evaluated the internal rotation limit prior to bony impingement of the proximal femur on the pelvis after total hip arthroplasty (THA). Reconstructed computed tomography (CT) images of 90 degrees hip flexion were used to simulate the internal rotation limit against safety limits measured intraoperatively. Ninety joints in 86 ...

Magnetic resonance imaging (MRI) was performed on 73 hips in 59 children aged 3 to 16 months after surgical reduction of developmental dislocation of the hip. Twenty-seven hips in 22 children had repeat MRI 6 weeks after reduction, and 20 hips in 16 patients had further MRI at least 1 ...

A 4-month-old Japanese girl with a developmental dislocation of the right hip was treated with manual reduction under general anesthesia followed by cast immobilization. Serial magnetic resonance imaging (MRI) revealed that a large interposition of fat tissue in the acetabulum, observed immediately after cast immobilization, became remarkably small in size ...

OBJECTIVE: To give an overview of genetic, clinical and radiological aspects in two families over four generations with known hereditary multiple exostoses (HME). METHODS AND MATERIAL: After linkage analysis in both families to localize the defective gene, mutation analysis was performed in these genes to identify the underlying mutation. In ...

This study examined the hypothesis that labral lesions contribute to early degenerative hip disease. Between 1993 and 1999, 436 consecutive hip arthroscopies were performed by the senior author (J.C.M.). In addition, 54 acetabula were harvested from human adult cadavers and 10 hips underwent microangiography to determine labral blood supply. Of ...

We present the case of a 14-year-old male with melorhesotosis and severe iliotibial band tightness which was associated with femoral shortening, severe external rotational deformity of the femur, genu valgum and patellar dislocation in the right lower extremity. Skeletal survey revealed irregular radiodense streaks involving the pelvis, femoral head, femoral ...

Avascular necrosis of the femoral head (ANFH) is a common clinical disorder in the orthopedic field. Traditional approaches to study the extent of ANFH rely primarily on manual segmentation of clinical magnetic resonance images (MRI). However, manual segmentation is insufficient for quantitative evaluation and staging of ANFH. This paper presents ...

PURPOSE: To evaluate trochanteric anatomy with magnetic resonance (MR) imaging, bursography, MR bursography, and anatomic analysis. MATERIALS AND METHODS: T1-weighted and fat-saturated T2-weighted (transverse, sagittal, coronal, and coronal oblique planes) MR imaging of the greater trochanter was performed in 10 cadaveric hips and 12 hips of asymptomatic volunteers. Three bursae ...