• Title/Summary/Keyword: 대퇴 골두

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Initial Plain Radiographs versus MR Imaging: Comparison of Prognostic Efficacy in Legg-Calve-Perthes Disease (초기의 단순 X선 촬영술 대 자기공명영상: 소아성 대퇴골두 무혈성 괴사증에서 예후 예측성 비교)

  • Lee, Sun-Jin;Jee, Won-Hee;Cho, Song-Mee;Jeong, Chang-Hoon;Ok, In-Young
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.153-160
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    • 2008
  • Purpose : To evaluate if at the time of diagnosis of Legg-Calve-Perthes disease, MR imaging is superior to radiographs for identifying patients with a favorable long term prognosis as determined by maintenance of a spherical configuration of the femoral head epiphysis on follow-up radiographs. Materials and Methods : We retrospectively analyzed plain radiographs and MR images of 48 femoral heads in 41 patients with Legg-Calve-Perthes disease at time of diagnosis. Femoral head involvement was estimated on initial plain radiographs and MR images using the Catterall classification. Prognosis as determined by maximum femoral head deformity was determined on follow-up radiographs evaluated according to Stulberg classification. Results: Catterall classification of greater than 1 at MR imaging had 100% sensitivity (14/14) for detecting patients with a poor prognosis as indicated by deformity of the femoral head on follow-up radiographs (Stulberg class > 2). Initial radiographs had a lower sensitivity of 57% (8/14) for detecting patients with poor prognosis. Specificity for MR imaging was 21% (7/34) which was not significantly different from 32% (11/34) specificity for initial radiographs. Conclusion: Catterall group 1 at initial MR imaging indicates favorable prognosis for Legg-Calve-Perthes disease. Patients with more extensive involvement of the femoral head can have a good outcome, however they are at risk for loss of spherical configuration of the femoral head and subsequent osteoarthritis in adulthood. MR imaging may be superior to radiographs for identifying a subgroup of patients with favorable prognosis.

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Total Hip Arthroplasty in Patients with Avascular Necrosis of the Entire Femur (전체 대퇴골에 발생한 골괴사 환자에서 인공 고관절 전치환술)

  • Yi, Seung Rim;Im, Se Hyuk;Park, Sang Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.281-286
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    • 2019
  • Avascular necrosis (AVN) is defined as the cellular death of bone and bone marrow components due to the loss of blood supply, and associated with post-traumatic or non-traumatic events. AVN usually involves the epiphysis of a long bone, such as the femoral and humeral heads, which are susceptible to osteonecrosis. Many studies have been conducted but they were restricted to investigations of femoral head avascular necrosis. The presence of osteonecrosis in the proximal femur may impair biological fixation after total hip arthroplasty. We report a 56-year-old male patient with avascular necrosis located not only at the femoral head, but also in the entire femur, including the medullary cavity, who underwent total hip arthroplasty 2 years earlier along with a review of the relevant literature.

Analysis of the Disposal Rate of Fresh Frozen Femoral Head in the Bone Bank of a Single Hospital (단일 병원 인체조직은행에서 채취한 신선 동결 대퇴골두의 폐기율 분석)

  • Lee, Jaeyoung;Lee, Donghun;Jeon, Jinhwa;Lee, Kee Haeng
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.305-309
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    • 2021
  • Purpose: This study analyzed the increase in disposal rate of femoral heads in the bone bank of a single hospital from medical disease and drug history, as assessed by the Korean health insurance review and assessment service. Materials and Methods: The disposal rate and cause of 340 femoral heads were analyzed according to the regulations of the bone bank based on the standard model of the Ministry of food and drug safety. Results: One hundred and seven (33%) of 323 femoral heads collected from 2009 to 2018, and 65 (46%) of 142 femoral heads collected from 2015 to 2018 were discarded. The most common causes were related to the history of dementia and the administration of radioisotope for nuclear medicine. Conclusion: The current methods and screening tools can lead to errors in disposing of the available tissues in a bone bank. Thus, improved standards and screening methods are needed.

Study of Deformity by the Involvement of the Femoral Head of the Proximal Femur in Polyostotic Fibrous Dysplasia (다발성 섬유성 이형성증에서 근위 대퇴골두 침범 여부에 따른 변형 정도)

  • Na, Bo Ram;Jung, Sung Taek;Cho, Yong Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.519-527
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    • 2019
  • Purpose: To evaluate the treatment result in polyostotic fibrous dysplasia classified according to the involvement of the femoral head. Materials and Methods: Twenty-three patients from March 1987 to March 2014 were reviewed retrospectively. Patients with no involvement of the physeal scar in the femoral head were classified as Type I, and those with involvement of the physeal scar were classified as Type II. A plain radiograph was used to measure the femoral neck shaft angle, articulo-trochanteric distance (ATD), and anterior bowing through the lateral view. A teleoroentgenogram of the lower limb was used to measure the leg length discrepancy and lower extremity mechanical axis. The pre- and postoperative femoral neck-shaft angle and ATD were compared to assess the degree of correction of the deformity. Results: Among a total of 46 cases (23 patients), 28 cases (23 patients) had lesions in the proximal femur. Type I were 16/28 cases (15/23 patients) and Type II were 12/28 cases (9/23 patients). The preoperative proximal femoral neck-shaft angle was 116.8° in Type I and 95.3° in Type II. The ATD was 12.08 mm in Type I and -5.54 mm in Type II. The deformity correction showed significant improvement immediately after surgery, the deformity correction was lost in Type II (neck shaft angle Type I: 133.8°-130.8°, Type II: 128.6°-116.9°, and ATD Type I: 17.66-15.72 mm, Type II: 7.44-4.16 mm). The extent of anterior bowing was 12.74° in Type I and 20.19° in Type II. The mean differences of 12 mm between the 9 patients who showed a leg length discrepancy and the lower extremity mechanical axis showed 4 cases of lateral deviation and 7 cases of medial deviation. Conclusion: In polyostotic fibrous dysplasia, when the femur head is involved, the femur neck shaft angle, ATD, and anterior bowing of the femur had more deformity, and the postoperative correction of deformity was lost, suggesting that the involvement of the femoral head was an important factor in the prognosis of the disease.

Analysis on Femoral Neck Fractures Using Morphological Variations (파라메트릭 형상모델을 이용한 근위 대퇴골의 경부 골절 영향 해석)

  • Lee, Ho-Sang;Park, Byoung-Keon;Chae, Je-Wook;Kim, Jay-Jung
    • Journal of the Korean Society for Nondestructive Testing
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    • v.31 no.5
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    • pp.459-465
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    • 2011
  • It has been reported that the femoral morphology has a major correlation to femoral neck fractures(FNF). Previous studies to analyze these correlations have relied on mechanical testing and finite element methods. However, these methods have not been widely applied to various femur samples and models. It is because of the availability of the samples from both patients and cadavers, and also of the geometric limitations in changing the shape of the models. In this study we analyzed femoral neck fractures using a parameterized femoral model that could provide flexibility in changing the geometry of the model for the wide applications of FNF analysis. With the parameterization a variety of models could be generated by changing four major dimensions: femoral head diameter(FHD), femoral neck diameter(FND), femoral neck length(FNL), and neck-shaft angle(NSA). We have performed FEA on the models to compute the stress distributions and reaction forces, and compare them with the data previously generated from mechanical testing. The analysis results indicate that the FND is significantly related with the FNF and the FHD is not significantly related with the FNF.

Pediatric Hip Disorders (소아 고관절 질환)

  • Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon;Seul Bi Lee;Yeon Jin Cho
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.531-548
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    • 2024
  • Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

The Early Result of Anterior Rotational Osteotomy in the Treatment of Osteonecrosis of the Femoral Head (대퇴골두 무혈성괴사의 치료에서 전방 회전 절골술의 조기 추시 결과)

  • Kim, Se-Dong;Shin, Duk-Seop;Jang, Woo-Seok
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.284-292
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    • 1994
  • In transtrochanteric rotational osteotomy to treat osteonecrosis of the femoral head, the necrotic superior anterior femoral head is rotated anteriorly around the longitudinal neck axis so that the weight bearing force is transferred to the intact posterior surface. The ratio of transposed intact articular surface of the femoral head to the weight-bearing surface of the acetabulum on postoperative anteroposterior view of the hip roentgenograph is the most important indicator of the prognosis. During the period from December 1992 to June 1994, we treated 31 hips in 28 patients who were indicated for the anterior rotational osteotomy among the patients of osteoncrosis of the femoral head. Among the patients, male were 27 and female was one. Age distribution was from 13 to 62 years old and mean age was 44.3. According to the Ficat and Arlet classification, II A was most in number as 16 II B was 7 and III was 8. As their etiolgic factors, alcohol was most in number as 18, steroid was 3, idiopathic was 5 and trauma was 2. The mean rate of the intact area of the posterior part of the femoral head to the total articular surface on the preoperative lateral view of the hip roentgenograph was 41.8%, The mean ratio of transposed intact articular surface of the femoral head to the weight bearing surface of the acetabulum was 53.8%, Fixation devices were screws or dynamic hip screw.

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Rapidly Destructive Coxarthrosis Mimicking a Malignant Bone Tumor - A Case Report - (악성 골 종양으로 오인된 급속 파괴형 고관절증 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.203-207
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    • 2008
  • Rapid destructive hip osteoarthritis is a rare subset of osteoarthritis with rapid destruction of the hip joint within months of the onset of symptoms. The entity simulates rheumatoid arthritis, septic arthritis, neuropathy or malignant bone tumor. We report a case of rapidly destructive coxarthrosis of the right hip joint initially misdiagnosed as a malignant bone tumor at outside hospital in a 80-year-old woman.

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Proteomic-determined Alteration of Synovial Fluid on Induced Model of Transected Ligament of Head of Femur (개의 대퇴골두인대 절단 모델에서 프로테오믹스로 관찰한 관절액의 변화)

  • Kim, Se-Hoon;Shin, Ki-Uk;Ji, Joong-Ryong;Shim, Kwan-Seob;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.679-685
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    • 2010
  • Many animal models of osteoarthritis (OA) have been developed, aimed at understanding the long-term progression of OA and difficulty of identifying patients in the initial stage of the disease. In canines, coxofemoral luxation and hip dysplasia are common orthopedic ailments related to OA in the hip joint. Transecting the ligament of the head of the femur (LHF) aids in diagnosis of coxofemoral joint OA. Presently, mobility of this joint was increased by transected LHF in 10 mature, 2-3-year-old (average $2.57{\pm}0.20$ years), healthy male beagles. The animals were normally gaited 1-week post-operatively. During the experimental period, examinations including X-ray, complete blood count and serum chemistry were unremarkable. Proteomic examination revealed protein alterations in synovial fluid, with significant increases in Vitamin D-binding protein precursor (ANOVA, p < 0.004) and Kinogen-1 (ANOVA, p < 0.039). Both proteins correlated with arthritis.