Skip to content
2000
  1. Home
  2. A-Z Publications
  3. Current Medical Imaging
  4. Volume 20, Issue 1
  5. Article
Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
file format pdf download PDF
side by side viewer icon HTML

Abstract

Objective:

The study aimed to evaluate whether the measurement of Femoral Neck Shaft Angle (FNSA) can be helpful in differentiating femoral head Stress Fracture (SF) from Avascular Necrosis (AVN).

Methods:

From September 2019 to April 2022, sixty-four patients [median age 32.0 years, interquartile range (IQR) 23.0–39.0 years] who underwent both hip radiograph and Magnetic Resonance Imaging (MRI) and diagnosed as femoral head SF or AVN were included in our retrospective study. Patients were divided into as having either femoral head SF (n = 34) or AVN (n = 30). The FNSA was measured in anteroposterior hip radiography. Continuous values were compared using the Mann-Whitney U test. The assessment of the predictive value of FNSA for femoral head SF was performed by Receiver Operating Characteristic (ROC) analysis.

Results:

The FNSA was significantly higher in patients with SF (median 133.5°, IQR 128.0–136.7°) than those with AVN (median 127.5°, IQR 124.0–132.0°) ( = 0.001). In addition, the FNSA was significantly higher in SF femurs (median 134.8°, IQR 129.2–137.4°) than in contralateral normal femurs (median 127.1°, IQR 124.3–132.5°) in patients with unilateral femoral head SF (n = 30) ( < 0.001). In ROC analysis, the sensitivity, specificity, and Area Under the Curve (AUC) for predicting the femoral head SF were 77.3%, 63.3%, and 0.785 (95% confidence interval: 0.666–0.905), respectively, at a cutoff of 130.2°.

Conclusion:

Increased FNSA was associated with femoral head SF; thus, measurement of FNSA could be helpful for differentiating femoral head SF from AVN.

© 2024 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Loading

Article metrics loading...

/content/journals/cmir/10.2174/0115734056277516240220065728
2024-04-30
2025-06-27

  • From This Site

    /content/journals/cmir/10.2174/0115734056277516240220065728
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
The full text of this item is not currently available.

References

  1. KarasuyamaK. YamamotoT. MotomuraG. SonodaK. KuboY. IwamotoY. The role of sclerotic changes in the starting mechanisms of collapse: A histomorphometric and FEM study on the femoral head of osteonecrosis.Bone20158164464810.1016/j.bone.2015.09.00926408039
     [Google Scholar]
  2. KawanoK. MotomuraG. IkemuraS. YamaguchiR. BabaS. XuM. NakashimaY. Differences in the microarchitectural features of the lateral collapsed lesion between osteonecrosis and subchondral insufficiency fracture of the femoral head.Bone202014111558510.1016/j.bone.2020.11558532795680
     [Google Scholar]
  3. TsaiH.L. ChangJ.W. LuJ.H. LiuC.S. Epidemiology and risk factors associated with avascular necrosis in patients with autoimmune diseases: A nationwide study.Korean J. Intern. Med.202237486487610.3904/kjim.2020.09835236014
     [Google Scholar]
  4. IkemuraS. YamamotoT. MotomuraG. NakashimaY. MawatariT. IwamotoY. MRI evaluation of collapsed femoral heads in patients 60 years old or older: Differentiation of subchondral insufficiency fracture from osteonecrosis of the femoral head.AJR Am. J. Roentgenol.20101951W63W6810.2214/AJR.09.327120566783
     [Google Scholar]
  5. LeeS. SaifuddinA. Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb.Skeletal Radiol.20194871011102110.1007/s00256‑019‑3160‑430706108
     [Google Scholar]
  6. MuellerD. SchaeffelerC. BaumT. WalterF. RechlH. RummenyE.J. WoertlerK. Magnetic resonance perfusion and diffusion imaging characteristics of transient bone marrow edema, avascular necrosis and subchondral insufficiency fractures of the proximal femur.Eur. J. Radiol.201483101862186910.1016/j.ejrad.2014.07.01725129825
     [Google Scholar]
  7. KimD.K. KimT.H. Femoral neck shaft angle in relation to the location of femoral stress fracture in young military recruits: Femoral head versus femoral neck stress fracture.Skeletal Radiol.20215061163116810.1007/s00256‑020‑03661‑z33145605
     [Google Scholar]
  8. ChalupaR.L. RiveraJ.C. TennentD.J. JohnsonA.E. Correlation between femoral neck shaft angle and surgical management in trainees with femoral neck stress fractures.U.S. Army Med. Dep. J.201620161526874089
     [Google Scholar]
  9. MarmorM. NystuenC. EhemerN. McClellanR.T. MatityahuA. Accuracy of in situ neck-shaft angle and shortening measurements of the anatomically reduced, varus malreduced and shortened proximal femur: Can we believe what we see on the postoperative films?Injury201243684684910.1016/j.injury.2011.10.01022040694
     [Google Scholar]
  10. ReikeråsO. HøisethA. RegstadA. FönstelienE. Femoral neck angles: A specimen study with special regard to bilateral differences.Acta Orthop. Scand.198253577577910.3109/174536782089922917136588
     [Google Scholar]
  11. LandisJ.R. KochG.G. An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers.Biometrics197733236337410.2307/2529786884196
     [Google Scholar]
  12. BlandM.J. AltmanD. Statistical methods for assessing agreement between two methods of clinical measurement.Lancet1986327847630731010.1016/S0140‑6736(86)90837‑82868172
     [Google Scholar]
  13. Kim DK LeeK-C KimJK KimT Assessment of imaging factors associated with Baker’s cyst rupture on knee MRI.J Belg Soc Radiol202310717710.5334/jbsr.3258
     [Google Scholar]
  14. MaraghelliD. BrandiM.L. CerinicM.M. PeiredA.J. ColagrandeS. Edema-like marrow signal intensity: A narrative review with a pictorial essay.Skeletal Radiol.202150464566310.1007/s00256‑020‑03632‑433029648
     [Google Scholar]
  15. AsadipooyaK. GravesL. GreeneL.W. Transient osteoporosis of the hip: review of the literature.Osteoporos. Int.20172861805181610.1007/s00198‑017‑3952‑028314897
     [Google Scholar]
  16. MurpheyM.D. ForemanK.L. Klassen-FischerM.K. FoxM.G. ChungE.M. KransdorfM.J. From the radiologic pathology archives imaging of osteonecrosis: radiologic-pathologic correlation.Radiographics20143441003102810.1148/rg.34414001925019438
     [Google Scholar]
  17. GlicksteinM.F. BurkD.L.Jr SchieblerM.L. CohenE.K. DalinkaM.K. SteinbergM.E. KresselH.Y. Avascular necrosis versus other diseases of the hip: Sensitivity of MR imaging.Radiology1988169121321510.1148/radiology.169.1.34202603420260
     [Google Scholar]
  18. CarpinteroP. LeonF. ZafraM. TrenasS.J.A. RománM. Stress fractures of the femoral neck and coxa vara.Arch. Orthop. Trauma Surg.2003123627327710.1007/s00402‑003‑0514‑z12756588
     [Google Scholar]
  19. BenlidayiC.I. GuzelR. BasaranS. AksungurE.H. SeydaogluG. Is coxa valga a predictor for the severity of knee osteoarthritis? A cross-sectional study.Surg. Radiol. Anat.201537436937610.1007/s00276‑014‑1359‑625113012
     [Google Scholar]
  20. BjørdalF. BjørgulK. The role of femoral offset and abductor lever arm in total hip arthroplasty.J. Orthop. Traumatol.201516432533010.1007/s10195‑015‑0358‑726068583
     [Google Scholar]
  21. HendersonE.R. MarulandaG.A. CheongD. TempleH.T. LetsonG.D. Hip abductor moment arm - A mathematical analysis for proximal femoral replacement.J. Orthop. Surg. Res.201161610.1186/1749‑799X‑6‑621266066
     [Google Scholar]
/content/journals/cmir/10.2174/0115734056277516240220065728
Loading
Femoral Neck Shaft Angle Measurement for Differentiating Femoral Head Stress Fracture from Avascular Necrosis
Curr. Med. Imaging 20, e15734056277516 (2024); https://doi.org/10.2174/0115734056277516240220065728
/content/journals/cmir/10.2174/0115734056277516240220065728
/content/journals/cmir/10.2174/0115734056277516240220065728
Loading

Data & Media loading...


  • Article Type:     Research Article
Keyword(s): Avascular necrosis; Differentiation; Femoral head; Femoral neck shaft angle; Radiography; Stress fracture

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test