Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System
Background: The 2019 Revised Association Research Circulation Osseous (ARCO) Staging Criteria for Osteonecrosis of the Femoral Head (ONFH) only requires plain radiographs and magnetic resonance imaging (MRI) to diagnose and stage ONFH; however, the effectiveness of the 2019 ARCO criteria in the abse...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123001498 |
| _version_ | 1797377851198013440 |
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| author | Eric Jordan, BS Nathan H. Varady, SB Shayan Hosseinzadeh, MD Stacy Smith, MD Antonia F. Chen, MD, MBA Michael Mont, MD Richard Iorio, MD |
| author_facet | Eric Jordan, BS Nathan H. Varady, SB Shayan Hosseinzadeh, MD Stacy Smith, MD Antonia F. Chen, MD, MBA Michael Mont, MD Richard Iorio, MD |
| author_sort | Eric Jordan, BS |
| collection | DOAJ |
| description | Background: The 2019 Revised Association Research Circulation Osseous (ARCO) Staging Criteria for Osteonecrosis of the Femoral Head (ONFH) only requires plain radiographs and magnetic resonance imaging (MRI) to diagnose and stage ONFH; however, the effectiveness of the 2019 ARCO criteria in the absence of computed tomography (CT) scans has not been investigated. Therefore, the purpose of this study was to evaluate whether CT scanning is a necessary modality for diagnosing/staging ONFH using the ARCO staging system. More specifically, do CT scans help differentiate pre- and post-collapse lesions more than MRI scans? Methods: A study was conducted on 228 ONFH patients diagnosed between January 1, 2008, and December 31, 2018, at a single academic medical center. CT and MRI scans were reviewed by the senior author and other contributors. The ONFH classification was compared between the 2 scans to determine if CT scans were able to further differentiate staging of collapsed lesions vs MRI scans. Results: A diagnosis of ONFH was made by MRI first in 57% (129/228) while 21% (48/228) used MRI and CT simultaneously. Only 22% (51/228) of cases were diagnosed by CT scans first. There were no cases where collapse was found by a CT scan that were not diagnosed by standard x-rays and/or MRIs. Conclusions: CT scans are not a useful adjunct for diagnosing or treating ONFH and are not necessary if MRI is ordered when using the Revised ARCO Staging System for ONFH diagnosis. |
| first_indexed | 2024-03-08T19:59:17Z |
| format | Article |
| id | doaj.art-8fe5a3f96a6848c6bdce52e03daf0033 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-03-08T19:59:17Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-8fe5a3f96a6848c6bdce52e03daf00332023-12-24T04:45:43ZengElsevierArthroplasty Today2352-34412023-12-0124101244Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging SystemEric Jordan, BS0Nathan H. Varady, SB1Shayan Hosseinzadeh, MD2Stacy Smith, MD3Antonia F. Chen, MD, MBA4Michael Mont, MD5Richard Iorio, MD6Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USADepartment of Radiology, Brigham and Women’s Hospital, Boston, MA, USADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USADepartment of Orthopaedic Surgery, Rubin Institute for Advanced Ortho, Baltimore, MD, USADepartment of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, MA, USA; Corresponding author. Richard D. Scott, MD, Harvard Medical School, Department of Orthopaedics, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. Tel.: +1 617 732 7238.Background: The 2019 Revised Association Research Circulation Osseous (ARCO) Staging Criteria for Osteonecrosis of the Femoral Head (ONFH) only requires plain radiographs and magnetic resonance imaging (MRI) to diagnose and stage ONFH; however, the effectiveness of the 2019 ARCO criteria in the absence of computed tomography (CT) scans has not been investigated. Therefore, the purpose of this study was to evaluate whether CT scanning is a necessary modality for diagnosing/staging ONFH using the ARCO staging system. More specifically, do CT scans help differentiate pre- and post-collapse lesions more than MRI scans? Methods: A study was conducted on 228 ONFH patients diagnosed between January 1, 2008, and December 31, 2018, at a single academic medical center. CT and MRI scans were reviewed by the senior author and other contributors. The ONFH classification was compared between the 2 scans to determine if CT scans were able to further differentiate staging of collapsed lesions vs MRI scans. Results: A diagnosis of ONFH was made by MRI first in 57% (129/228) while 21% (48/228) used MRI and CT simultaneously. Only 22% (51/228) of cases were diagnosed by CT scans first. There were no cases where collapse was found by a CT scan that were not diagnosed by standard x-rays and/or MRIs. Conclusions: CT scans are not a useful adjunct for diagnosing or treating ONFH and are not necessary if MRI is ordered when using the Revised ARCO Staging System for ONFH diagnosis.http://www.sciencedirect.com/science/article/pii/S2352344123001498OsteonecrosisARCO stagingHipFemoral headMRICT |
| spellingShingle | Eric Jordan, BS Nathan H. Varady, SB Shayan Hosseinzadeh, MD Stacy Smith, MD Antonia F. Chen, MD, MBA Michael Mont, MD Richard Iorio, MD Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System Arthroplasty Today Osteonecrosis ARCO staging Hip Femoral head MRI CT |
| title | Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System |
| title_full | Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System |
| title_fullStr | Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System |
| title_full_unstemmed | Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System |
| title_short | Femoral Head Osteonecrosis: Computed Tomography Not Needed to Identify Collapse When Using the Association Research Circulation Osseous Staging System |
| title_sort | femoral head osteonecrosis computed tomography not needed to identify collapse when using the association research circulation osseous staging system |
| topic | Osteonecrosis ARCO staging Hip Femoral head MRI CT |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123001498 |
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