Bone marrow edema and associated pain in early stage osteonecrosis of the femoral head: Prospective study with serial MR images

Kyung Hoi Koo, In Oak Ahn, Rokho Kim, Hae Ryong Song, Soon Taek Jeong, Jae Boem Na, Yong Sik Kim, Se Hyun Cho

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

PURPOSE: To determine whether the marrow edema around focal osteonecrosis on magnetic resonance (MR) images is associated with clinical symptoms. MATERIALS AND METHODS: Thirty-three patients with 37 hips showing early stage osteonecrosis of the femoral head were followed up at 3-month intervals with clinical evaluation, conventional radiography, and serial MR imaging. RESULTS: Seven (50%) of 14 symptomatic hips showed marrow edema around focal osteonecrosis on initial MR images, whereas only one (4%) of 23 asymptomatic hips showed edema (P < .01). Six (86%) of seven hips that were moderately to severely painful were associated with surrounding marrow edema. All eight hips showing osteonecrosis with marrow edema at the initial MR examination had joint effusion and exhibited intense radionuclide uptake in the proximal femur, which corresponded to the extent of edema on MR images. In all eight hips, the marrow edema resolved on follow-up MR images, and the pain subsided with the resolution of edema. CONCLUSION: The results of this study suggest that the combination of marrow edema of the proximal femur and focal osteonecrosis of the femoral head are strongly associated with hip pain in early stage osteonecrosis, even prior to collapse. Pain improvement usually parallels the resolution of edema.

Original languageEnglish
Pages (from-to)715-722
Number of pages8
JournalRadiology
Volume213
Issue number3
DOIs
Publication statusPublished - 1999 Dec
Externally publishedYes

Keywords

  • Bone marrow, MR
  • Bone marrow, edema
  • Bone marrow, radionuclide studies
  • Femur, MR
  • Femur, necrosis
  • Femur, radionuclide studies
  • Hip, MR
  • Hip, necrosis
  • Hip, radionuclide studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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