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BACKGROUND: Ischiofemoral impingement (IFI) syndrome has attracted more and more attention, but there is little report on IFI because of its low incidence. Moreover, its imaging characters have not yet been fully understood.OBJECTIVE: To discuss the MRI diagnostic criteria for IFI, thus understanding the imaging characters of IFI revealed on MRI.METHODS: Sixteen cases (21 hips) of suspected IFI were selected as experimental group, and 25 healthy volunteers as control group. The bilateral ischiofemoral space (IFS, the shortest distance between the ischial tuberosity and lesser trochanter of femur) and quadratus femoris space (QFS, distance between the lesser trochanter of femur and hamstring tendon insertion) were measured on MRI axial image. The signal and morphology of the quadratus femoris were observed. The differences in QFS and IFS were compared between two groups.RESULTS AND CONCLUSION: (1) Among 16 patients, there were 13 females, and 3 males, and 5 female cases of bilateral IFI. (2) In the experimental group, the IFS ((13.65±3.87) mm versus (22.17±5.75) mm) and QFS ((7.15±3.50) mm versus (12.89±3.13) mm) showed significant differences between affected and opposite sides (P 0.05). (4) Compared with the control group, there were significant differences in IFS and QFS of the affected side in the experimental group, and no significant differences in IFS and QFS of the opposite side. (5) In the experimental group, quadratus femoris appeared with deformation, edema and atrophy. (6) To conclude, the incidence of IFI in females is significantly higher than that in males, and bilateral hips are usually affected. MRI diagnostic criteria for IFI are IFS ≤ 11.46 mm, QFS ≤ 5.53 mm of the affected side, and quadratus femoris present edema and deformation, which are more sensitive on axial fat-suppressed MRI imaging.
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Objective:To analyze imaging diagnosis and differential diagnosis of upper femur aneurysmal bone cyst.Methods: The pre-operation imaging appearances about digital radiography(DR), computerized tomography (CT) and magnetic resonance imaging (MRI) of 46 aneurysmal bone cyst cases confirmed by operation and pathology were retrospectively analyzed, and then these special imaging appearances were gained and analyzed.Results:①CT plain scans showed the irregular expansile lucency shadow in the upper femur with the uneven bone septum image; the complete or incomplete osteosclerosis edge can be found in some parts of lesions; some lesions extend to adjacent soft tissue, and the liquid-liquid level can be found in lesion of 8 cases, and their edge and separated intensity strengthening were visible after signals were enhanced.②MRI plain scans revealed that most lesions showed long T1, T2 signals, the periphery of lesions showed long T1, short T2 signal shadows, and septum image was visible within lesions, and the liquid-liquid level can be found in lesion of 8 cases; some lesions extend to adjacent soft tissue, and their edge and separated intensity strengthening were visible after signals were enhanced.Conclusion: Through combined examination of DR, CT and MRI, the specialty and diagnostic accuracy of aneurysmal bone cyst could be improved, and it was helpful in the differential diagnosis of other upper femur bone tumors.
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bone fracture, mild col apse of the articular surface;femoral head deformation, bone fracture, articular surface col apse, hip degeneration. MRI of four categories of avascular necroses appeared as phase Ⅰ:line-like low signal of weight-bearing area of femoral head on T1WI, high signal on T2WI as the main change. Phase Ⅱ:clear boundary crescent-shaped uneven signal on T1WI, T2WI displayed moderately higher, uneven slightly lower signal around, showing a typical two-line sign. Phase Ⅲ:femoral head deformation, subchondral fracture, col apse, crescent formation, zonal low signal on T1WI, medium or high signal on T2WI. Phase Ⅳ, Ⅴ:complete destruction of articular cartilage, joint space narrowing, significant col apse and deformation of the femoral head, non-specific secondary osteoarthritis of the acetabulum, such as sclerosis, cystic degeneration and marginal osteophyte. The X-ray, CT, MRI performances of four types of avascular necroses at the same period were basical y the same.
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Objective To study the application of spiral CT three-dimensional reconstruction in diagnosing intra-articular and other bone fractures in the earthquake of Wenchuan.Methods 25 cases with joint and other bone fractures in Wenchuan earthquake underwent multi-slice spiral CT volume scanning,the images were dealed with three-dimensional reconstruction at workstation including multiplanar reconstruction (MPR) and surface shaded display(SSD) to observe the fractures.Results 36 fractures in 25 cases were found by three-dimensional reconstruction(MPR and SSD),which included knee joint bone fracture in 6,one case was avulsion fracture of the point attached to the tibia by posterior cruciate ligament and missed by X-ray;ankle fracture in 3,1 case was Pilon fracture;shoulder fracture in 5,one case with glenoid anterior labrum missed by radiography;elbow fracture in 3;spinal fractures including cervical vertebra in 2,thoracic vertebra in 4 and lumbar vertebra in 5,2 cases were burst fracture accompanied with the articular process fracture; pelvis bone fracture in 8,1 case was sacroiliac fracture accompanied with sacroiliac separation.There were open bone fractures in 4 cases,fractures with dislocation in 6 cases,soft tissue swelling in different degree around the fractures in 25 cases.Conclusion Spiral CT three-dimensional reconstruction of bone can directly and really show the fractures that will provide in-formations for the clinical diagnosis and treatment .