Loose Bodies In

Cure Arthritis Naturally

Cure Arthritis Naturally

Get Instant Access

The hip is a ball-and-socket joint that permits multiaxial movement. It is surrounded by a dense, strong, fibrous capsule. Along with the knee, the hip joint is the most typical site of os-teoarthritis. Clinical symptoms are rotation or extension difficulty and pain that may be referred to the buttock, thigh, groin, greater tro-chanteric region, and knee.

The radiographic features, as in all other joints, include articular narrowing, osteoscle-rosis, osteophytosis, subchondral cystic change, and ankylosis (Fig. 9.9). Rarely, osteochondral or loose bodies may be present. The articular narrowing is accompanied by asymmetrical migration of the femoral head with respect to the acetabulum. On anterior radiographs the migration is mostly superolateral or superome-

Hip Loose Bodies

Fig. 9.12A, B Scintigraphic demonstration of the marginal osteophytes in osteoarthritis in the hip. A Anterior pinhole scintigraph of the left hip in a 33-year-old man with osteoarthritis secondary to dislocation reveals several beaded areas of increased tracer uptake along the ac-etabular brim as well as an eccentric, patchy uptake in the medial edge (lower arrow). Beaded lesions represent sta-lactic osteophytes; those at the lateral and medial edges are imaged in profile (arrows) and those at the anterior and posterior edges en face (arrowheads). The eccentricity of the patchy tracer uptake is characteristic of osteoar-thritis. B Anteroposterior radiograph shows the stalactic bony excrescences along the acetabular brim (arrows)

Fig. 9.12A, B Scintigraphic demonstration of the marginal osteophytes in osteoarthritis in the hip. A Anterior pinhole scintigraph of the left hip in a 33-year-old man with osteoarthritis secondary to dislocation reveals several beaded areas of increased tracer uptake along the ac-etabular brim as well as an eccentric, patchy uptake in the medial edge (lower arrow). Beaded lesions represent sta-lactic osteophytes; those at the lateral and medial edges are imaged in profile (arrows) and those at the anterior and posterior edges en face (arrowheads). The eccentricity of the patchy tracer uptake is characteristic of osteoar-thritis. B Anteroposterior radiograph shows the stalactic bony excrescences along the acetabular brim (arrows)

dial, and infrequently axial or central. The finding contrasts with the concentric migration of the femoral head in infective arthritis (Fig 8.12) and rheumatoid arthritis (see Chap. 10).

Ordinary scintigraphy may show marked tracer uptake in the affected hip without topographic detail. In contrast, pinhole scintigra-phy shows tracer uptake that is eccentric in location either in the uppermost (Fig. 9.10) or innermost aspect of the acetabulum, reflecting cranial or medial migration, respectively. On occasion, moderate uptake may also be observed in the medial aspect of the femoral neck due to buttressing (Fig. 9.10). It is important to note that the tracer uptake in the acetabular side of the joint is usually less intense than that in the femoral head unless the disease is advanced. The joint space becomes extinct when sealed by ankylosis (Fig. 9.11). Osteophytes may be indicated by ovoid tracer uptake hanging from the acetabulum like a necklace (Fig. 9.12). As mentioned above, differentiation from pyogenic arthritis or rheumatoid arthritis is possible by noting concentric narrowing of the joint space in these conditions. As elsewhere, the preradiographic or early change can be indicated by subtle uptake in the femoral head. The sign is reliable especially when it is eccentric in location. Frequently, such a small uptake may pass undetected on ordinary scin-tigraphs.

Was this article helpful?

0 0
Arthritis Relief Now

Arthritis Relief Now

When you hear the word arthritis, images of painful hands and joints comes into play. Few people fully understand arthritis and this guide is dedicated to anyone suffering with this chronic condition and wants relief now.

Get My Free Ebook


Post a comment