Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul 2;56(9):1491-1505.
doi: 10.1007/s43465-022-00684-7. eCollection 2022 Sep.

MRI Features and Treatment for Idiopathic Chondrolysis of the Hip (ICH) in Children: Outcomes of a Systematic Review

Sandeep Kumar Nema  1 , Premkumar Ramasubramani  2 , Jose Austine  1 , Govind Karunakaran  1 , Vendoti Nitheesha Reddy  3 , Vendoti Midhusha Reddy  3
Affiliations
Review

MRI Features and Treatment for Idiopathic Chondrolysis of the Hip (ICH) in Children: Outcomes of a Systematic Review

Sandeep Kumar Nema et al. Indian J Orthop. .

Abstract

Background: The purpose of this paper was to review the MRI features and treatment for idiopathic chondrolysis of the hip (ICH) in patients aged 18 years or less.

Methods: We included studies published in English up to August 2021. We accessed major electronic bibliographic databases on ICH that described MRI features, treatment, or both. We used the Joanna Briggs Institute (JBI) Critical appraisal checklist for case reports for Risk of bias assessment.

Results: We pooled 136 hips (125 participants) from 35 studies with 11.6 ± 3.4 years mean age. We had 46, 8, and 106 hips to assess ICH's MRI, pharmacological, and operative interventions. Geometric marrow edema (GME) (P < 0.01), diffuse marrow edema (DME) (P < 0.05), diffuse cartilage loss (DCL) (P < 0.05), and joint effusion (P < 0.05), were significantly associated with time in first MRI reviews. GME (P < 0.01) and focal cartilage loss (FCL) (P < 0.01) decreased significantly between two MRI reviews at median time of 1.75 (IQR 0.93-4.25) and 12.5 (IQR 3.75-19.5) months. Diffuse cartilage loss (P < 0.01) and degenerative changes (P < 0.01) increased significantly between the two MRI reviews. Etanercept, Methotrexate, and Botulinum Neurotoxin A drugs were used by 3, 3, and 1 report to treat ICH. Capsulectomies, total hip arthroplasty, arthrodiastasis, arthrodesis, arthroscopy operations treated 45, 18, 5, 5, and 2 hips.

Discussion: GME may be the most specific and early MRI feature in diagnosing ICH. GME and DME show an inverse relationship over time. So, it is with FCL and DCL. Despite reports on the efficacy of biologics, immunomodulators, and operations, early and late ICH management remains controversial due to poor quality studies.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-022-00684-7.

Keywords: Arthritis; Cartilage; Chondrolysis; Etanercept; Femoral head; Hip; Idiopathic; MRI; Pediatric; Subtotal capsulectomy.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Images of an 11-year-old female with 1-month history of right hip pain and limp. MRI showed geometric area of hypointensity (star) on coronal T1-weighted image (a), hyperintensity (star) on sagittal STIR (b) and coronal T2-weighted images in the mid-third of the right femoral head. There is mild joint effusion (c, arrow). Post-Gadolinium T1 VIBE coronal image (d) showed enhancing synovial thickening (arrow), femoral articular cartilage loss and joint space narrowing. Coronal section of color coded T2 articular cartilage map (e) showed irregularity and focal chondral defects in the right hip [40]
Fig. 2
Fig. 2
PRISMA flow diagram for the idiopathic chondrolysis of hip in children
See this image and copyright information in PMC

References

    1. Segaren N, Abdul-Jabar HB, Segaren N, Hashemi-Nejad A. Idiopathic chondrolysis of the hip: Presentation, natural history and treatment options. Journal of Pediatric Orthopedics Part B. 2014;23(2):112–116. doi: 10.1097/BPB.0000000000000019. - DOI - PubMed
    1. Yapp LZ, McClymont L, Beggs I, Gaston P, Salter DM. Adult-onset idiopathic chondrolysis of the hip. Skeletal Radiology. 2017;46(5):687–691. doi: 10.1007/s00256-017-2589-6. - DOI - PubMed
    1. Kumbhare DA, Harish S, Thomas J, Williams RA. Poster 140: Idiopathic chondrolysis of the hip in a young twin female with Blount’s disease: A case report and review of literature. PM&R. 2009;1:S164–S165. doi: 10.1016/j.pmrj.2009.08.160. - DOI
    1. Laor T, Crawford AH. Idiopathic chondrolysis of the hip in children: Early MRI findings. AJR. American Journal of Roentgenology. 2009;192(2):526–531. doi: 10.2214/AJR.08.1590. - DOI - PubMed
    1. Amarnath C, Muthaiyan P, Mary TH, Mohanan S, Gopinathan K. Idiopathic chondrolysis of hip in children: New proposal and implication for radiological staging. Indian Journal of Radiology Imaging. 2018;28(2):205–213. doi: 10.4103/ijri.IJRI_185_17. - DOI - PMC - PubMed

LinkOut - more resources