• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.281-286
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• 2019

Avascular necrosis (AVN) is defined as the cellular death of bone and bone marrow components due to the loss of blood supply, and associated with post-traumatic or non-traumatic events. AVN usually involves the epiphysis of a long bone, such as the femoral and humeral heads, which are susceptible to osteonecrosis. Many studies have been conducted but they were restricted to investigations of femoral head avascular necrosis. The presence of osteonecrosis in the proximal femur may impair biological fixation after total hip arthroplasty. We report a 56-year-old male patient with avascular necrosis located not only at the femoral head, but also in the entire femur, including the medullary cavity, who underwent total hip arthroplasty 2 years earlier along with a review of the relevant literature.

• Journal of KIISE:Software and Applications
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• v.27 no.8
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• pp.846-854
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• 2000

In this paper, we propose effecient methods to extract the femoral head region in MR images. The femoral head area in MRI is approximated using Hough transform and the anatomical features of the femoral heads. Then, modified region growing method is applied to extract the femoral head region. We measured the parameters for the diagnosis of the avascular necrosis of the femoral heads from the segmented femoral head region. The proposed methods are proved very effective to extract the femoral head of healthy volunteer and of the patient having heavy avascular necrosis. The measured parameters can be used very efficiently for the quantitative analysis and the diagnosis of the avascular necrosis of the femoral heads.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.206-213
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• 1994

We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.

• Journal of Korean Foot and Ankle Society
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• v.4 no.1
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• pp.44-47
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• 2000

Freiberg's infarction involving the fifth metatarsal head is very rare condition. The authors experienced a case of avascular necrosis of the fifth metatarsal head and base of the proximal phalanx in a 27-year-old female patient. Involved bones were excised and internally fixed with 2 K-wires after autogenous cancellous bone grafting. Pain was relieved, and an excellent clinical result was obtained at the follow-up examination six months after the surgery.

• Radiation Oncology Journal
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• v.26 no.2
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• pp.126-130
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• 2008

Avascular necrosis(AVN) is a disease characterized by the temporary or permanent loss of the blood supply to the bones, resulting from many possible causes, including radiation therapy. The femoral head is known to be the most common site of AVN. The authors encountered two cases of AVN of the femoral head among 557 patients with cervical cancer treated with whole pelvic radiation therapy at the Samsung Medical Center. AVN of the femoral head was presented with a sclerotic density change in a plain roentgenography and a decreased signal intensity lesion on the T1 and T2 weighted phases of a magnetic resonance image(MRI). Although it is a very rare complication after whole pelvic radiation therapy, AVN of the femoral head should be considered when characteristic imaging findings appear on follow-up examinations.

• 대한미세수술학회:학술대회논문집
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• 1998.11a
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• pp.192-192
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• 1998

• Journal of radiological science and technology
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• v.27 no.3
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• pp.19-24
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• 2004

MRI imaging is one of the imaging techniques showing anatomical structures of human body for medical diagnosis, and has been researched in order to provide better quality of anatomical information. In this study, we propose a very useful method to extract an interest areas and how to diagnose necrolysis of femoral neck disease automatically. Regions of femoral neck is set using anatomical features and Hough transform and advantages of both region extension and histogram-based region segmentation method are combined for better region segmentation. As a result of the proposed method, good imaging quality was obtained for femoral neck with both normal and severe necrosis as well as for femoral neck in early stage of necrolysis.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.117-120
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• 1992

Non traumatic aseptic necrosis of the head of the femur is well documented with respect to its clinical roentgenographic and pathological aspect, but not with respect to etiology. A number of reports have associated various diseases and conditions with necrosis of the femoral head. Prominent among these are alcoholism, steroid therapy and hemostatic disorder. The increased incidence of avascular necrosis of bone associated with long-term corticosteroid therapy has aroused much interest. The pathogenesis of cortisone-induced avascular necrosis is as yet unproved. But cortisone-induced fatty liver with hyperlipidemia, leading to systemic embolization of fat and avascular necrosis of bone has much experimental support. We present a case of bilateral avascular necrosis of the femur head following several epidural steroid injections in a 30 year old male patient who had low back pain with radiation to both legs for 1 year and who had Cushinoid appearance for several months. One week later, he had a total replacement of both hip operation.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.1-9
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• 1999

Avascular necrosis of the femoral head is a debilitating disease that leads to destruction of tho hip joint in patients who are in the third, fourth, or fifth decade of life. The total societal cost is so high because these patients are generally young, hold jobs, and have a considerable life expectancy. Therefore, we have to delay or eliminate the need for total hip replacement as possible as we can. The purpose of this review is to provide a current perspective of avascular necrosis of the femoral head.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.1-9
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• 2009

There has been recent interest in radiation-induced bone injury in clinical conditions, especially for pelvic insufficiency fracture (PIF). A PIF is caused by the effect of normal or physiological stress on bone with demineralization and decreased elastic resistance. Pelvic radiotherapy (RT) can also contribute to the development of a PIF. A PIF has been regarded as a rare complication with the use of megavoltage equipment. However, recent studies have reported the incidence of PIFs as $8.2{\sim}20%$ after pelvic RT in gynecological patients, an incidence that was higher than previously believed. The importance of understanding a PIF lies in the potential for misdiagnosis as a bony metastasis. If patients complain of pelvic pain after whole-pelvis radiation therapy, the presence of a PIF must be considered in the differential diagnosis. The use of multibeam arrangements and conformal RT to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture. In addition to a PIF, osteonecrosis and avascular necrosis of the femoral head can develop after radiation therapy. Osteoradionecrosis of the pelvic bone is a clinical diagnostic challenge that must be differentiated from an osseous metastasis. A post-radiation bone sarcoma can result as a long-term sequela of pelvic irradiation for uterine cervical cancer.