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  • Open Access

Osteonecrosis of the femoral heads in patients with systemic onset juvenile idiopathic arthritis: comparison of the results of radiological and morphological methods

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Pediatric Rheumatology20119 (Suppl 1) :P134

  • Published:


  • Femoral Head
  • Trabecular Bone
  • Osteonecrosis
  • Bone Structure
  • Joint Space Narrowing


The destruction of the hip joints with the development of osteonecrosis (ON) - a common complication and a leading cause of functional impairment in patients with systemic onset juvenile idiopathic arthritis (soJIA).


A detailed study of the character of local disturbances and the structure of femoral heads (FH) in soJIA according to the comprehensive radiologic and morphological studies.


Four patients with similar clinical and demographic characteristics (female, age 17-20 years, soJIA, disease duration >10 years, the duration of hip damage > 5 years), underwent total hip replacement (5 hip joints), because of ON of the FH. Changes in the FH were investigated using a specially designed protocol with the use of radiologic (conventional radiography (Ro), computed tomography (CT), magnetic resonance imaging (MRI)) and morphological techniques.


Ro-, CT revealed pronounced joint space narrowing, the picture of osteonecrosis with FH deformation, realignment of bone structure, erosions. Zones with significant restructuring of the bone (detected by CT) and enhanced heterogeneous MRI signal (T1-, T2- weighted) were characterized by diverse damage in cartilaginous and bone tissues at morphologic examination (fissures in cartilage; cysts, sclerosis, necrosis of trabecular bone).
Figure 1
Figure 1

Figure 1


The results show that in patients soJIA with destructive hip damage similar changes of FH, interpreted by the radiological methods as ON, are characterized by a variety of histological disorders. Further in-depth comprehensive study of bone structure, damaged by ON of the FH will promote understanding of the pathogenetic nature of this complication.

Authors’ Affiliations

Research Institute of Rheumatology of Russian Academy of Medical Sciences, Moscow, Russian Federation


© Alexeev et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.