Diagnostic criteria for non-traumatic osteonecrosis of the femoral head - A multicentre study
Diagnostic criteria for non-traumatic osteonecrosis of the femoral head - A multicentre study
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DOI：
10.1302/0301-620x.81b4.9393
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发表时间：
1999-07-01
影响因子：
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通讯作者：
Ninomiya, S
中科院分区：
文献类型：
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作者：
Sugano, N;Kubo, T;Ninomiya, S
日本股骨头坏死调查委员会（ONFH）制定了6个主要和7个次要诊断标准。我们进行了一项多中心研究来阐明这些问题，我们前瞻性地研究了来自6家医院的222例277髋有ONFH和其他髋关节病理学资料的患者，我们确定了5个具有高度特异性的标准：1）股骨头塌陷，没有关节间隙狭窄或X线片上髋臼异常，包括新月征; 2）在股骨头中区分硬化，没有变窄或髋臼异常; 3）骨扫描上的“热中冷”外观; 4）T1加权图像上的低强度带（带型）;和5）组织学检查上的小梁和骨髓坏死证据。任何两个这些标准的组合，诊断的敏感性和特异性分别为91%和99%。
Six major and seven minor diagnostic criteria have been developed by the Japanese Investigation Committee for osteonecrosis of the femoral head (ONFH). We have carried out a multicentre study to clarify these.We studied prospectively 277 hips in 222 patients, from six hospitals, who had ONFH and other hip pathology and from whom histological material was available, We identified five criteria with high specificity: 1) collapse of the femoral head without narrowing of the joint space or acetabular abnormality on radiographs, including the crescent sign; 2) demarcating sclerosis in the femoral head without narrowing or acetabular abnormality; 3) a 'cold-in-hot' appearance on the bone scan; 4) a low-intensity band on T1-weighted images (band pattern); and 5) evidence of trabecular and marrow necrosis on histological examination. With any combination of two of these criteria, the sensitivity and specificity of the diagnosis were 91% and 99%, respectively.