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Why is MRI important in the early diagnosis of occult proximal femoral fractures? MRI is the most sensitive and specific method for early diagnosis of radiographically occult fractures because its superior contrast resolution allows for visualization of the linear fracture signal abnormality and the associated bone marrow edema immediately after the fracture has occurred. If …

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What are the most common types of radiographically occult hip fractures? Acute nondisplaced femoral neck fractures as well as insufficiency and stress fractures are usually not visible on radiographs or CT. Insufficiency fractures occur in osteoporotic bone with physiologic stresses, whereas stress (or fatigue) fractures occur in normal bone from increased abnormal or repetitive stress …

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What is ITOH? This uncommon self-limited disease, also referred to as transient painful bone marrow edema, primarily affects middle-aged men as well as women in the third trimester of pregnancy. It is usually unilateral, resolves spontaneously in 6 to 8 months, and may recur in the same hip. Although the exact etiology is unknown, vascular …

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What is the role of MRI in the diagnosis of the femoral head AVN? MRI is the most sensitive imaging modality for detection of AVN in the early stages, allowing initiation of therapy before the onset of femoral head collapse. Delayed diagnosis and treatment can result in subchondral fracture with collapse of the femoral head, …

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What is the MRI appearance of hip osteonecrosis? The MRI appearance depends on the stage of disease. In the early stage, AVN presents on MRI as diffuse femoral head bone marrow edema, identical to that seen in ITOH, which can create a diagnostic challenge. Subsequently, the edema becomes more focal in the subchondral anterolateral femoral …

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When should intravenous contrast material be administered for hip MRI? In general, intravenous contrast material is not needed, except to differentiate solid from cystic soft tissue masses or to localize an abscess prior to drainage. Occasionally, it is used in cases of osteonecrosis to differentiate enhancing viable from nonenhancing necrotic bone. Intraarticular contrast for MR …

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What is AVN of the hip? AVN is a form of osteonecrosis that occurs in the epiphyseal or subchondral region, and in the hip typically involves the anterolateral aspect of the femoral head. Unilateral AVN can be a result of trauma, such as a displaced femoral neck fracture, while bilateral AVN occurs due to nontraumatic …

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