Idiopathic Chondrolysis of Hip ( ICH) rare pediatric painful,
stiff hip of unknown etiology is characterized by rapidly progressive destruction of the articular cartilage of the femoral head and acetabulum with resultant joint space narrowing and restricted movement .
ICH can be diagnosed by typical MRI findings at an early,
reversible stage .Progression to irreversible stage can be prevented if treated at this stage.
A staging system for ICH has not been reported yet.
Aim and Objectives
i)To propose a staging of ICH,
Methods and Materials
14 children (9 to 12 years) who presented with complaints of hip pain with limp and fit in the diagnostic criteria of ICH were studied with 1.5T MRI in standard institutional MRI protocol,
from 2010 to 2014.
Radiograph were taken for all the patients and CT scans were taken for the two advanced cases.
Children having serology positive for Antinuclear antibodies ,
Rheumatoid factor ,
Culture from the joint fluid aspirate and other causes of chondrolysis were excluded .
Plain radiograph and MRI...
Nine cases were in stage I,
three were in stage II and two were in stage III. By using Fishers exact test analysis ,
three MRI criteria were statistically significant i) Geographic Rectangular Femoral head hyperintensity-(p=0.001), ii) hyperintensity in acetabulum-(p=0.004),
iii)flattening of femoral head-(p=0.011) . Findings with Significant p value in radiographic analysis were protrucio acetabuli [p=0.043] and degenerative changes [p=0.011].
Significant clinical improvement and disappearance of edema in femoral head was seen in stage I,
clinical improvement without radiological improvement was in II stage...
In the early stages,
the changes of ICH proved to be reversible with conservative treatment .
Early detection and treatment of ICH are imperative because they may prevent catastrophic joint destruction.
Radiologists should be aware of the various radiological findings including different stages of ICH.
Imaging based staging system in Idiopathic Chondrolysis of Hip is very useful in early diagnosis & prognostication .
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Adolescent chondrolysis of the hip joint.S Afr Med J1971; 45:196 –202
Dall G: Idiopathic chondrolysis of the hip joint in adolescents: Case reports. SA Med J 1982; 63(23):883-886.
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