ArticleEuropean radiology2023
CT and MRI findings beyond the subchondral bone in osteonecrosis of the femoral head to distinguish between ARCO stages 2 and 3A.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Optimizing diagnosis and management of ONFH, FNSF, and SIF.EFORT open reviews · 2026Review
- Value of CT in quantitatively diagnosing and assessing collapse in patients with femoral head necrosis based on finite element mechanics analysis.BMC musculoskeletal disorders · 2026Article
- Intelligent Attention-Driven Deep Learning for Hip Disease Diagnosis: Fusing Multimodal Imaging and Clinical Text for Enhanced Precision and Early Detection.Medicina (Kaunas, Lithuania) · 2026Article
- A Novel Murine Model to Study the Early Biological Events of Corticosteroid-Associated Osteonecrosis of the Femoral Head.Bioengineering (Basel, Switzerland) · 2026Article
- Cystic lesions in osteoarthritis and osteonecrosis of the femoral head : a comparative analysis of 3D distribution, microstructure, and histology.Bone & joint research · 2025Article
- [Clinical study of double-channel core decompression combined with medullary cavity irrigation for non-traumatic osteonecrosis of femoral head].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- PTGS2 Is Involved in Osteonecrosis of the Femoral Head and Bone Marrow Edema.International journal of genomics · 2025Article
- Core decompression, allogenic fibula fixation, and pedicled fibula grafting are effective for osteonecrosis of femoral head.American journal of translational research · 2025Article
- Risk factors and prediction model for osteonecrosis of the femoral head in female systemic lupus erythematosus.Frontiers in immunology · 2024Article
- Subchondral fatigue fracture of the femoral head in young military recruits: Potential risk factors.World journal of clinical cases · 2023Article
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Abstract
objectivesTo determine the diagnostic values of deep changes beyond the subchondral bone in osteonecrosis of the femoral head (ONFH) to distinguish between Association Research Circulation Osseous (ARCO) stages 2 and 3A.
methodsThis retrospective study included 124 hips with ONFH of stages 2 (n = 49; 23 females; mean age, 50.7 years) and 3A (n = 75; 20 females; mean age, 53.2 years) from May 2017 to August 2022, who underwent CT (n = 124) and MRI (n = 85). Deep changes beyond subchondral bone were analyzed on CT (bone resorption area and cystic change) and on MRI (bone marrow edema [BME] and joint effusion). Diagnostic performance and multivariate analysis were evaluated for detecting stage 3A.
resultsStage 3A showed more frequent bone resorption area (72.0% vs. 4.1%), cystic change (52.0% vs. 0.0%), BME (93.5% vs. 43.6%), and joint effusion (76.0% vs. 24.5%) than stage 2 (p < 0.001, all). Bone resorption area and cystic change showed low sensitivities (52.0~72.0%) but high specificities (96.0~100.0%), while BME and joint effusion showed high sensitivities (76.0~93.0%) but low specificities (56.0~76.0%) for stage 3A. Predictors were in the order of bone resorption area, cystic change, and joint effusion (odds ratio: 32.952, 26.281, 9.603, respectively), and combined bone resorption area and cystic change had the best predictive value (AUC, 0.900) for stage 3A.
conclusionsAmong deep changes, bone resorption area and cystic changes were highly specific and BME and joint effusion were highly sensitive for stage 3A. Combined bone resorption area and cystic change had the best predictive value for predicting ARCO stage 3A. KEY POINTS: • The exact classification between ARCO stage 2 and 3A is essential but it is sometimes difficult to distinguish between ARCO stage 2 and 3A only by subchondral fracture, especially early post-collapse stage with preservation of femoral head contour. • The predictors of stage 3A were in the order of bone resorption area, cystic change, and joint effusion and combined bone resorption area and cystic change had the best predictive value for predicting stage 3A. • Analysis of deep changes beyond the subchondral bone may make it easier to distinguish between ARCO stage 2 and 3A.
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