MR patterns of involvement of humeral head osteonecrosis

Abstract

Purpose: To characterize osteonecrosis of the humeral head on coronal and axial MR images.

Methods: We retrospectively reviewed MR examinations in patients with humeral head osteonecrosis. The angle of the entire affected articular surface at three levels was measured and an angle subtended by the margins of osteonecrosis was also measured.

Results: The appearance of osteonecrosis is identical to that in the femoral head with signal abnormality (13/13), double-line sign (7/13), and subchondral fractures (3/13). The superior aspect of the humeral head was the most common location of osteonecrosis. The MR staging resulted as follows: stage II (6/13), stage IIIA (1/13), stage IIIB (1/13), and stage IV (5/13). The maximum percentage of involvement of the articular surface demonstrated the following distribution: 0% to 25%, 0/11; 25% to 50%, 1/13; 50% to 75%, 5/13; and 75% to 100%, 7/13.

Conclusions: Quantitative analysis of the percentage of involvement of the humeral head was performed and indicates that in most cases, 75% to 100% of the articular surface at the levels measured was involved.