Osteochondritis dissecans of the hip

Acta Radiol. 2003 Jan;44(1):67-71.

Abstract

Purpose: To investigate the clinical and radiological characteristics of osteochondritis dissecans (OD) of the hip and the outcome of this condition after treatment.

Material and methods: Twelve male and 3 female patients with OD were retrospectively studied. Six patients had a history of Legg-Calvé-Perthes disease (LCPD) and among them 2 also had had a trauma to the hip. A further 5 had had trauma and 1 a developmental dislocation of the hip (DDH). The remaining 3 patients had no history of previous hip disease or trauma. All patients were examined with plain radiography, 7 with MR, 3 with CT and 2 with hip arthrography.

Results: All OD lesions were detected at plain radiography, and most of them were located near the fovea. At MR the lesions had low signal intensity at T1-weighted sequences, and 6/7 had edema or fluid collection in or adjacent to the lesion on T2-weighted sequences. The early treatment in 7 patients was surgery, 2 had had conservative treatment and 6 no treatment. At follow-up 12 years after radiological diagnosis, 5 patients had hip arthrosis, 4 of whom were treated with arthroplasty. All but 3 had reduced hip rotation and all but 2 (with arthroplasty) had load pain. Three of the patients with earlier surgery had not developed arthrosis.

Conclusions: OD lesions are usually well seen with plain radiography. There is a great risk of developing early arthrosis and it seems that early surgery is connected with arthrosis development. Thus only symptomatic treatment is recommended.

MeSH terms

  • Adolescent
  • Adult
  • Arthrography
  • Child
  • Child, Preschool
  • Female
  • Hip Joint / diagnostic imaging*
  • Hip Joint / pathology
  • Hip Joint / surgery
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Osteochondritis Dissecans / diagnostic imaging*
  • Osteochondritis Dissecans / pathology
  • Osteochondritis Dissecans / surgery
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tomography, X-Ray Computed