J Korean Soc Magn Reson Med.
2009 Dec;13(2):177-182.
Comparison of Subchondral Fracture on Radiographs with MR Images in Evaluation of Osteonecrosis in LCP Patients
- Affiliations
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- 1Department of Radiology, Gyeongsang National University, College of Medicine, Korea. jbna@nongae.gsnu.ac.kr
- 2Department of Orthopedicsurgery, Gyeongsang National University, College of Medicine, Korea.
- 3Gyeongsang Institute of Health Science, Gyeongsang National University, College of Medicine, Korea.
- 4Department of Radiology, Hallym University, College of Medicine, Korea.
Abstract
- PURPOSE
To compare the subchondral fracture on plain radiography and MR image as a method for assessing osteonecrosis in Legg-Calve-Perthes(LCP) pateients.
MATERIALS AND METHODS
We retrospetively reviewed 15 hip joint MR images and plain radiography which visualized subchondral fracture. With basis of the Salter-Thompson classification, extent of necrosis was graded group A to B, as follows; Group A= <50%, B= >50%. On PACS workstation, necrotic area of each MR image was measured to calculate the volume of necrotic portion: volume = necrotic area x slice thickness. Necrotic areas on MR images were graded group A to B and results were compared with that measured in Salter-Thompson classification. On follow up, bone resorption was measured and the extent was compared with subchondral fracture representing necrotic area and that on MR volume method respectively.
RESULTS
In 9 joints of 15 hip joints (60%), the degree of necrosis in Salter-Thompson classification on plain radiographs was different from that on MR volume method. Based on plain radiographs by Salter-Thompson classification, the degree of necrosis was overestimated in 6 (67%) joints, and underestimated in 3(33%) joints compared with MR volume method. On follow up study, bone resorption was not correlated with necrotic extent of subchondral fracture and MR volume method.
CONCLUSION
The extent of femoral head necrosis measured by subchondral fracture was different from that measured by MR and was not correlated with bone resorption on follow up. Therefore, usefulness of subchondral fracture as a prognostic factor may be limited.
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