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Fatty marrow conversion of the proximal femoral metaphysis in transient bone marrow edema syndrome

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Author(s)
민병우
Alternative Author(s)
Min, Byung Woo
Publication Year
2005
Abstract
Introduction In the proximal femoral metaphysis,
hematopoietic marrow is predominant during
the adult stage of life. The conversion of hematopoietic
marrow to fatty marrow in the proximal femoral metaphysis
has been suggested as an etiologic factor of
ischemia in the pathogenesis of femoral head osteonecrosis.
To determine whether the chronology of fatty
marrow conversion of the proximal femoral metaphysis
is related to transient bone marrow edema syndrome of
the hip, a case control study was conducted on 10 patients
with the disease. Materials and methods There
were 8 men and 2 women with a mean age of 33 years
(range 19–45 years). The 10 patients were matched with
20 controls for gender and age (5-year range). T1-
weighted MRI scans of their hips were reviewed. Marrow
of the greater trochanter becomes fatty before
puberty, and thus, the greater trochanter can be used as
a built-in control. The signal intensity of the proximal
femoral metaphysis was compared to that of the greater
trochanter. Results In all patients, the signal intensity of
the proximal femoral metaphysis was isointense (fatty
marrow) relative to that of the greater trochanter. In
control subjects, the signal intensity was isointense in 8
(40%) and hypointense (hematopoietic marrow) in 12
(60%) (p<0.05). Conclusion The current study shows
that the proximal femoral metaphysis is predominantly
fatty in transient bone marrow edema syndrome. The
conversion of hematopoietic to fatty marrow is known
to correlate with decreases in intramedullary blood flow.
Thus, the current study suggests that an ischemia of the
proximal femur secondary to fatty marrow conversion
of the proximal femoral metaphysis might be a cause of
transient bone marrow edema syndrome of the hip.
Keywords Hip Æ Proximal femoral metaphysis Æ
Bone marrow edema Æ MRI
Department
Dept. of Orthopedic Surgery (정형외과학)
Publisher
School of Medicine
Citation
Archives of Orthopaedic and Trauma Surgery, Vol.125(6) : 390-395, 2005
Type
Article
ISSN
0936-8051
DOI
10.1007/s00402-005-0824-4
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35080
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