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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(02): 205-213
DOI: 10.4103/ijri.IJRI_185_17
Musculoskeletal Radiology

Idiopathic chondrolysis of hip in children: New proposal and implication for radiological staging

C Amarnath
Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
,
Priya Muthaiyan
Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
,
T Helen Mary
Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
,
Shilpa Mohanan
Department of Radiodiagnosis, Government Stanley Medical College, Chennai, Tamil Nadu, India
,
K Gopinathan
Department of Radiodiagnosis, Kilpauk Medical College, Chennai, Tamil Nadu, India
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Abstract

Purpose: Our objective was to evaluate the radiological appearances in different stages of idiopathic chondrolysis of hip (ICH) which will be helpful in the early diagnosis and guiding appropriate treatment for this condition to prevent progression of disease. Materials and Methods: We evaluated 14 patients of ICH in varying stages: Stage 1 (n = 9), Stage 2 (n = 3), Stage 3 (n = 2). Average age at presentation was 10–11 years. Plain radiograph and magnetic resonance imaging (MRI) was done in all these patients. Results: In the current study, we have attempted to stage ICH based on the radiological progression of the disease, where MRI was used as the primary tool. Stage 1 showed a wedge-shaped hyperintensity in T2 weighted (T2W) and hypointensity in T1 weighted (T1W) images involving the middle one-third of the femoral head and it is the earliest and characteristic finding in MRI. Associated findings like joint space narrowing, synovial hypertrophy with joint effusion may also be observed. Stage 2 showed acetabular edema in the affected hip in addition to the above-mentioned findings. Stage 3 showed more extensive involvement of femoral head and acetabulum, with collapse of the femoral head, degenerative changes in hip, early osteoporotic changes, and ultimately loss of joint space. Conclusion: Imaging-based staging system proves very useful in the early diagnosis, staging, and assessing the prognosis of ICH.

Keywords

Femoral head and acetabulum - idiopathic chondrolysis of hip - radiological staging


Publication History

Article published online:
26 July 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Waldenström H. On necrosis of the joint cartilage by epiphyseolysis capitis femoris. Acta Chir Scand 1930; 67: 936-46
    Google Scholar
  • 2 Wada Y, Higuchi F, Inoue A. Adult idiopathic chondrolysis of the hip report of 2 cases. Kurume Med J 1995; 42: 121-8
    CrossrefPubMedGoogle Scholar
  • 3 Goldman AB, Schneider R, Martel W. Acute chondrolysis complicating slipped capital femoral epiphysis. Am J Roentgenol 1978; 130: 945-50
    CrossrefPubMedGoogle Scholar
  • 4 Jones BS. Adolescent chondrolysis of the hip joint. S Afr Med J 1971; 45: 196-202
    PubMedGoogle Scholar
  • 5 Sparks LT, Dall G. Idiopathic chondrolysis of the hip joint in adolescents: Case reports. S Afr Med J 1982; 63: 883-6
    Google Scholar
  • 6 Duncan JW, Schrantz JL, Nasca RJ. The bizarre stiff hip: Possible idiopathic chondrolysis. JAMA 1975; 231: 382-5
    CrossrefPubMedGoogle Scholar
  • 7 Wenger DR, Mickelson MR, Ponseti IV. Idiopathic chondrolysis of the hip: Report of two cases. J Bone Joint Surg Am 1975; 57: 268-71
    CrossrefPubMedGoogle Scholar
  • 8 Laor T. Idiopathic chondrolysis of the hip in children: Early MRI findings. AJR Am J Roentgenol 2009; 192: 526-31
    CrossrefPubMedGoogle Scholar
  • 9 Smith EJ, Ninin DT, Keays AS. Idiopathic chondrolysis of the hip: A case report. SA Med J 1983; 63: 88-90
    Google Scholar
  • 10 Bleck EE. Idiopathic chondrolysis of the hip. J Bone Joint Surg Am 1983; 65: 1266-75
    CrossrefPubMedGoogle Scholar
  • 11 Bilski P, Snela S. Difficulties in treating chondrolysis and avascular necrosis of the hip in adolescent patients. Ortopedia, Traumatologia, Rehabilitacja 2006; 8: 34-40
    PubMedGoogle Scholar
  • 12 Korula RJ, Jebaraj I, David KS. Idiopathic chondrolysis of the hip: Medium- to long-term results. ANZ J Surg 2005; 75: 750-3
    CrossrefPubMedGoogle Scholar
  • 13 Appleyard DV, Schiller JR, Eberson CP, Ehrlich MG. Idiopathic chondrolysis treated with etanercept. Orthopedics 2009; 32: 214
    PubMedGoogle Scholar
  • 14 Roy DR, Crawford AH. Idiopathic chondrolysis of the hip: Management by subtotal capsulectomy and aggressive rehabilitation. J Pediatr Orthop 1988; 8: 203-7
    CrossrefPubMedGoogle Scholar
  • 15 Thacker MM, Feldman DS, Madan SS, Straight JJ, Scher DM. Hinged distraction of the adolescent arthritic hip. J Pediatr Orthop 2005; 25: 178-82
    CrossrefPubMedGoogle Scholar
  • 16 Patel AM, Raj PK. Bilateral idiopathic chondrolysis of hip – A case report. Indian J Orthop 2004; 38: 128-9
    Google Scholar
  • 17 Ippolito E, Bellocci M, Santori FS, Ghera S. Idiopathic chondrolysis of the hip: An ultrastructural study of the articular cartilage of the femoral head. Orthopedics 1986; 9: 1383-7
    CrossrefPubMedGoogle Scholar
  • 18 Mankin H, Sledge C, Rothschild S, Eisenstein A. Chondrolysis of the hip. In: Proceedings of the third open scientific meeting of The Hip Society. St. Louis, MO: C. V. Mosby; 1975: 127-35
    Google Scholar
  • 19 Herman JH, Herzig EB, Crissman JD, Dennis MV, Hess EV. Idiopathic chondrolysis: An immunopathologic study. J Rheumatol 1980; 7: 694-705
    Google Scholar
  • 20 François J, Mulier M. Idiopathic chondrolysis of the hip; A case report. Acta Orthop Belg 2007; 73: 653-7
    PubMedGoogle Scholar
  • 21 Gils-Morin VM, Graham TB, Blebea JS, Dardzinski BJ, Laor T, Johnson ND. et al. Knee in early juvenile rheumatoid arthritis: MR imaging findings. Radiology 2001; 220: 696-706
    CrossrefPubMedGoogle Scholar
  • 22 Rush BH, Bramson RT, Ogden JA. Legg-Calvé-Perthes disease: Detection of cartilaginous and synovial change with MR imaging. Radiology 1988; 167: 473-6
    CrossrefPubMedGoogle Scholar
  • 23 Rachinsky I, Boguslavsky L, Cohen E, Hertzanu Y, Lantsberg S. Bilateral idiopathic chondrolysis of the hip: A case report. Clin Nucl Med 2000; 25: 1007-9
    CrossrefPubMedGoogle Scholar
  • 24 Johnson K, Haigh SF, Ehtisham S, Ryder C, Gardner-Medwin J. Childhood idiopathic chondrolysis of the hip: MRI features. Pediatr Radiol 2003; 33: 194-9
    CrossrefPubMedGoogle Scholar
  • 25 Kozlowski K, Scougall J. Idiopathic chondrolysis: Diagnostic difficulties-report of four cases. Pediatr Radiol 1984; 14: 314-7
    CrossrefPubMedGoogle Scholar