Early Avascular Necrosis of the Femoral Head: Relationship of the Findings of Preoperative MRI and the Long-Term Results of Core Decompression

PURPOSE: To evaluate potential correlation between the extent and site of avascular necrosis (AVN), as determined by preoperative magnetic resonance (MR) imaging, and the development of femoral head collapse. MATERIALS AND METHODS: Using clinical, radiographic and MR imaging criteria, twenty hips in 15 patients were selected for core decompression. Preoperative MR results were classified into three categories: group A, less than 15% involvement of the weight-bearing portion of the femoral head; group B, 15%-30% involvement; group C, more than 30% involvement, according to ARCO staging. We also established three groups according to site of involvement of the femoral head, namely medial, middle and lateral. RESULTS: Of 20 cases, three were stage Ia; two, Ib; four, Ic; three, IIa; two, IIb; and 6, IIc. Ten cases of Ia, Ib, IIa or IIb showed no femoral head collapse during follow-up of at least 24 months, while ten cases of Ic or IIc showed femoral head collapse. CONCLUSION: The prognosis of core decompression in patients with early AVN is related to the area of lesion in the femoral head.

Drip Infusion Pyelography / 대한비뇨기과학회지

Drip infusion pyelography by Schencker technique was carried out on total of 20 cases, 7 normal and 13 abnormal. Of 13 abnormal cases, definite diagnosis could be obtained in 1 cases in which conventional urography had not been helpful in establishment of diagnosis, and significant information could be obtained in 6 cases. This is the first report on drip infusion pyelography in this country and no complication was observed during the examination. Drip infusion pyelography was found valuable in cases with the following problems; 1) When valuable information can not be obtained through the conventional urography. 2) When renal function is poor. 3) When delineation of anatomical details is desirable. 4) When retrograde pyelography is contraindicated. Drip infusion pyelography is a safe, new and widely accepted diagnostic procedure in urographic study.