Clinical and MRI features of bone marrow edema syndrome of femoral head
Duan Tao1, Ding Changqing2, Deng Bin3, Pan Ronglei1, Xie Bo1, Wang Wensheng2, Luo Hui2
1Department of Orthopedics, 2Department of Imaging, the People′s Hospital of Fengxian, Fengxian 221700, China； 3Department of Orthopedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China
Abstract：ObjectiveTo explore the clinical and MRI features of bone marrow edema syndrome (BMES) of femoral head. MethodsFrom October 2014 to July 2019, the data of 60 patients with BMES of femoral head diagnosed by MRI and confirmed by clinical follow-up in Orthopedics Departments of the People′s Hospital of Fengxian and the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. All patients underwent coronal T1WI, T2WI and fat suppression sequence scans of MRI, the MRI and clinical features were analyzed. The pain domain scores in the Harris hip scores system and the WHO quality of life (WHO-QOL) scores before and after treatment were compared. ResultsAll patients were unilateral hip involved, and the clinical manifestations were unilateral hip pain, claudication and limited lower limb movement. The articular surfaces of the affected femoral head were smooth and the femoral head, neck and trochanter were high signal on fat suppression sequence of all MRI. After one month of conservative treatment, both the Harris hip scores and the WHO-QOL scores ［（85.31±3.75）points, （93.48±6.91）points］ were significantly higher than those before treatments ［（61.08±4.29）points, （65.02±4.61）points］ (t=12.60，12.86, all P＜0.01). During the follow-up period from 2 months to 2 years, the pain disappeared from the time of 29 days to 14 months, with an average (5.72±1.25) months. For the 37 patients undergoing MRI re-examinations after treatment, the time of pain disappearance in the 35 cases was earlier than that of high signal disappearance on fat suppression sequence images. ConclusionBMES is different from the femoral head necrosis, is characterized by smooth articular surface of femoral head and flaky high signal in fat suppression sequence on MRI, and it can be cured by conservative treatment.
段涛 丁长青 邓斌 潘荣雷 谢波 王文生 罗慧 . 股骨头骨髓水肿综合征的临床及磁共振影像特征[J]. 中华诊断学电子杂志, 2020, 8(4): 237-241.
Duan Tao1, Ding Changqing2, Deng Bin3, Pan Ronglei1, Xie Bo1, Wang Wensheng2, Luo Hui2. Clinical and MRI features of bone marrow edema syndrome of femoral head. zhzdx, 2020, 8(4): 237-241.
