Department of Radiology, Musculoskeletal division, University of Montreal Hospital Center, Hôpital Notre-Dame, 1560, rue Sherbrooke Est, Montréal, Quebec, H2L 4M1, Canada.
Skeletal Radiol. 2013 Aug;42(8):1089-95. doi: 10.1007/s00256-013-1622-7. Epub 2013 May 2.
To describe the imaging and clinical features of rapid osteolysis of the femoral neck in an attempt to better understand this uncommon pathology.
We retrospectively reviewed the files of 11 patients (six women and five men) aged 53-78 years diagnosed with rapid osteolysis of the femoral neck. Available imaging studies included radiographs, CT, MRI, and bone scintigraphy. Histopathological evaluations were available for seven cases.
All patients presented with complaints of hip pain, six of whom had acute symptoms, while the rest had progressive symptoms and impairment. All but one case were found to have bone deposition in adjacent hip muscles. CT confirmed bone deposition in adjacent tissues and true osteolysis of the femoral neck with relative sparing of the articular surfaces. Bone scintigraphy and MRI were useful to exclude underlying neoplastic disease.
Rapid osteolysis of the femoral neck tends to occur in patients with underlying comorbidities leading to bone fragility and may actually represent a peculiar form of spontaneous insufficiency fracture. Recognition of its imaging features and clinical risk factors may help distinguish this process from other more concerning disorders such as infection or neoplasm.
描述股骨颈快速溶骨的影像学和临床特征，以期更好地理解这种不常见的病理情况。
我们回顾性分析了 11 例（6 名女性，5 名男性）年龄 53-78 岁的被诊断为股骨颈快速溶骨的患者的资料。可利用的影像学研究包括 X 线片、CT、MRI 和骨扫描。7 例患者可进行组织病理学评估。
所有患者均表现为髋部疼痛，其中 6 例为急性症状，其余为逐渐出现的症状和功能障碍。除 1 例外，所有患者均发现邻近髋关节肌肉有骨沉积。CT 证实了邻近组织的骨沉积以及股骨颈的真性溶骨，关节面相对保留。骨扫描和 MRI 有助于排除潜在的肿瘤性疾病。
股骨颈快速溶骨倾向于发生在存在导致骨脆弱的合并症的患者中，实际上可能代表一种特殊形式的自发性骨衰竭骨折。认识其影像学特征和临床危险因素有助于将该过程与其他更令人担忧的疾病（如感染或肿瘤）区分开来。
