Mikhael M A, Paige M L, Widen A L
Department of Diagnostic Radiology, Evanston Hospital-McGaw Medical Center, Northwestern University, IL 60201.
Comput Radiol. 1987 Jul-Aug;11(4):157-63. doi: 10.1016/0730-4862(87)90044-8.
Low back pain and/or pain radiating to one or both lower limbs can result from causes other than intervertebral disc disease. Recently three patients presented with low back pain radiating down the legs. When CT examination of the lumbar spine proved unrewarding, magnetic resonance imaging (MRI) was performed. Avascular necrosis (AVN) of the femoral head was diagnosed and subsequently treated before femoral head collapse occurred. In patients with unexplained low back pain, AVN of the hip should be considered and ruled out by MRI, even if conventional plain films, polytomes, and radionuclide scans are negative. The early diagnosis of AVN of the femoral head may be critical in determining whether a surgical revascularization procedure might be successful in treatment, or replacement with an endoprosthesis will be necessary, if femoral head collapse has already occurred.
下背部疼痛和/或疼痛放射至一侧或双侧下肢可能由椎间盘疾病以外的原因引起。最近有三名患者出现下背部疼痛并向下肢放射。当腰椎CT检查未发现异常时，进行了磁共振成像（MRI）检查。诊断为股骨头缺血性坏死（AVN），随后在股骨头塌陷前进行了治疗。对于原因不明的下背部疼痛患者，即使传统的平片、断层扫描和放射性核素扫描结果为阴性，也应考虑并通过MRI排除髋关节AVN。股骨头AVN的早期诊断对于确定手术血管重建程序是否可能成功治疗，或者如果已经发生股骨头塌陷是否有必要进行人工关节置换可能至关重要。
