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1、MRIEvaluationofCollapsed FemoralHeadsinPatients 60YearsOldorOlder: DifferentiationofSubchondralInsufficiencyFractureFromOsteonecrosisoftheFemoralHead2011.4.17FromAJR:195,July2010WordsSubchondralInsufficiencyFracture：软骨下不全骨折OsteonecrosisoftheFemoralHead：股骨头坏死Convex凸nc
2、avity凹软骨下不全骨折（Subchondralinsufficiencyfracture,简称SIFs）1、软骨下机能不全性骨折是非外伤性的一种骨折。2、最常见的病因：骨质疏松，不常见的病因是骨质软化症或骨不全症、甲状旁腺功能亢进和类风湿性关节炎等。3、发病原理：正常软骨可忍受正常的生物机械应力，当由于上述病因变得软弱时，可出现软骨下骨折，并发展为软骨下萎陷，为此需认识此病作出早期诊断，多数患者经保守治疗后可自愈。OBJECTIVEThepurposeofthisarticleistoverifythehypothesist
3、hatosteonecrosisandsubchondralinsufficiencyfractureofthefemoralheadcanbedifferentiatedonthebasisoftheirappearanceonMRI.SUBJECTSANDMETHODS1BetweenMay1998andFebruary2009,wereviewed30consecutivehipsin30patients,60yearsoldorolderatthetimeofonsetofhippain,withradiologicev
4、idenceofsubchondralcollapseofthefemoralheadandwithbothMRimagesandhistologicresultsavailable.SUBJECTSANDMETHODS2Thepatientsweredividedintotwogroupaccordingtotheshapeoflow-intensitybandsonT1-weightedimages.Thefirstgroupshowedconcavityofthearticularsurface,whichischarac
5、teristicofosteonecrosis,andthesecondgroupshowedanirregularconvexityofthearticularsurface,whichischaracteristicofsubchondralinsufficiencyfracture.AInosteonecrosis,low-intensitybandissmooth,concavetoarticularsurface,andcircumscribesallofnecroticsegments.BInsubchondrali
6、nsufficiencyfracture,low-intensitybandisirregular,convextoarticularsurface,anddiscontinuous.RESULTSSixteenhips(53.3%)showedevidenceofosteonecrosis,and14(46.7%)showedevidenceofsubchondralinsufficiencyfracture,whichwasconsistentwiththecorrespondinghistopathologicdiagno
7、ses.Inallcasesofosteonecrosis,thepatienthadahistoryofeithercorticosteroidintakeoralcoholabuse.Amongpatientswithsubchondralinsufficiencyfracture,theproportionofwomenwassignificantlyhigherthanthatamongpatientswithosteonecrosis.Acrescentsign(subchondralfracture)wasprese
8、ntradiographicallyinabouthalfofallcasesinbothgroups.TABLE1:ClinicalCharacteristicsofPatientsWithOsteonecrosisorSubchondralInsuffici
