Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zürich, Switzerland.
Skeletal Radiol. 2021 Sep;50(9):1781-1790. doi: 10.1007/s00256-021-03730-x. Epub 2021 Feb 4.
To evaluate the prevalence, morphology, and clinical significance of a repeatedly observed yet not examined circumscript osseous defect at the anteroinferior aspect of the femoral head, termed femoral head defect.
Retrospective study with approval of the institutional review board. There was informed consent by all individuals. Magnetic resonance imaging (MRI) hip examinations of 970 individuals (age 15 to 55) were analyzed for femoral head defect. Patients with femoral head defect were matched for age and gender with patients without defect. Two readers independently assessed MRI images regarding presence, location, and morphology of the defect. MR images and radiographs were analyzed for findings of femoroacetabular impingement (FAI). Femoral torsion was measured. Independent t test and chi-square test were used for statistics.
Sixty-eight (7%) of 970 MRI examinations exhibited a femoral head defect in an anteroinferior location of the femoral head (29/400 men, 7.3%; 39/570 women, 6.8%; p = 0.8). The most frequent morphology of femoral head defect was type I, dent-like (34; 50%), followed by type II, crater-like (27; 40%), and III, cystic (7; 10%). Femoral head defect was slightly more common on the right hip (39 individuals; 57%) compared to left (29 individuals; 43%), non-significantly (p = 0.115). There was no association between FAI or its subtypes and the presence of femoral head defect (p = 0.890). Femoral antetorsion was reduced in patients with femoral head defect (12.9° ± 8.6) compared to patients without defect (15.2° ± 8.5), without statistical significance (p = 0.121).
The femoral head defect is a common finding in MRI examinations of the hip and is situated in the anteroinferior location. There was no association with FAI yet a non-significant trend towards lower femoral antetorsion in patients with femoral head defects.
评估一种在股骨头前下区域反复出现但尚未检查到的局限性骨缺损的发生率、形态学特征及其临床意义，将其命名为股骨头缺损。
本研究为回顾性研究，已获得机构审查委员会的批准，并获得所有参与者的知情同意。对 970 例（15 岁至 55 岁）的髋关节磁共振成像（MRI）检查进行分析，以评估股骨头缺损的存在情况。将有股骨头缺损的患者与无缺损的患者按照年龄和性别进行匹配。两位读者独立评估 MRI 图像中缺损的存在、位置和形态。对 MRI 图像和 X 线片进行分析，以评估股骨髋臼撞击症（FAI）的发现。测量股骨扭转。采用独立 t 检验和卡方检验进行统计学分析。
970 例 MRI 检查中，有 68 例（7%）在股骨头的前下区域出现股骨头缺损（400 例男性中有 29 例，7.3%；570 例女性中有 39 例，6.8%；p=0.8）。股骨头缺损最常见的形态为Ⅰ型，呈凹痕样（34 例，占 50%），其次为Ⅱ型，呈火山口样（27 例，占 40%），Ⅲ型，呈囊性（7 例，占 10%）。股骨头缺损在右侧髋关节（39 例，占 57%）比左侧（29 例，占 43%）更常见，但差异无统计学意义（p=0.115）。FAI 或其亚型与股骨头缺损之间无相关性（p=0.890）。与无股骨头缺损的患者相比，有股骨头缺损的患者的股骨前旋（12.9°±8.6）减少，但差异无统计学意义（p=0.121）。
股骨头缺损是髋关节 MRI 检查中的常见表现，位于前下区域。与股骨髋臼撞击症无相关性，但有股骨头缺损的患者的股骨前旋减小，趋势有统计学意义。
