EURORAD ESR

Case 12652

Stress reaction of the femoral neck complicating contralateral transient synovitis

Author(s)
Vermaelen M1, Vanhoenacker FM1, 2, 3 Mulier E4.

1. Department of Radiology, AZ Sint-Maarten, Mechelen-Duffel, Belgium
2. Department of Radiology, University Hospital Ghent, Ghent, Belgium
3. Department of Radiology, University Hospital Antwerp, Edegem, Belgium
4. Department of Paediatric orthopaedics, AZ Sint-Maarten, Mechelen-Duffel, Belgium
 
Patient
male, 7 year(s)
 
 
  • Figure 1
    Ultrasound of the right hip

    Note a fluid collection in the right hip (A) and the slight thickening of the synovial lining (arrowheads) in the anterior recess of the right hip.

     
    Area of Interest: Musculoskeletal joint; Paediatric; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 2
    MRI Pelvis
     

    Coronal FS T2-WI. Increased signal at the medial aspect of the left femoral neck (arrow) in keeping with bone marrow oedema.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Paediatric; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Athletic injuries; Oedema;

    Coronal T1-WI. Note the presence of bone marrow oedema in the left femoral neck (arrow). There is absence of a clear fracture line. The imaging findings are indicative of a stress reaction grade 3.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Paediatric; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Athletic injuries; Oedema;
     
     
  • Figure 3
    Follow-up MRI Pelvis
     

    Coronal FS T2-WI. Follow-up MRI 6 weeks later. Almost complete resolution of increased signal at the left femoral neck (arrow). The patient was completely pain-free.

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Paediatric; Imaging Technique: MR; Procedure: Treatment effects; Special Focus: Oedema;

    Coronal T1-WI. Follow-up MRI 6 weeks later. Note complete resolution of signal changes in the left femoral neck (arrow).

     
    Area of Interest: Musculoskeletal bone; Musculoskeletal joint; Paediatric; Imaging Technique: MR; Procedure: Treatment effects; Special Focus: Oedema;
     
     
Note a fluid collection in the right hip (A) and the slight thickening of the synovial lining (arrowheads) in the anterior recess of the right hip.
 
Coronal FS T2-WI. Increased signal at the medial aspect of the left femoral neck (arrow) in keeping with bone marrow oedema.
 
Coronal T1-WI. Note the presence of bone marrow oedema in the left femoral neck (arrow). There is absence of a clear fracture line. The imaging findings are indicative of a stress reaction grade 3.
 
Coronal FS T2-WI. Follow-up MRI 6 weeks later. Almost complete resolution of increased signal at the left femoral neck (arrow). The patient was completely pain-free.
 
Coronal T1-WI. Follow-up MRI 6 weeks later. Note complete resolution of signal changes in the left femoral neck (arrow).
 
 
 
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