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Case Report
Rapid Acetabular Osteolysis Secondary to Subchondral Insufficiency Fracture
TAKUAKI YAMAMOTO, ROBERT SCHNEIDER, YUKIHIDE IWAMOTO, and PETER G. BULLOUGH ABSTRACT. A 93-year-old man presented with a one-month history of persistent left hip pain of sudden onset. At first visit, radiographs revealed a fracture line at the medial portion of the acetabulum with no displacement. Magnetic resonance imaging revealed bone marrow edema in the corresponding medial portion of the acetabulum. Radiographs obtained 2 months later showed rapid acetabular osteolysis with associated prominent migration of the femoral head into the acetabulum. Histology obtained from the hip joint was consistent with a subchondral insufficiency fracture with no evidence of massive chondrolysis. Our case was considered as a subchondral insufficiency fracture of the left acetabulum resulting in rapid acetabular osteolysis (protrusio acetabuli). (J Rheumatol 2007;34:592-5) Key Indexing Terms:
OSTEOLYSIS From the Department of Orthopaedic Pathology and Department of Radiology, Hospital for Special Surgery, New York, New York, USA. Supported in part by a Grant-in-Aid in Scientific Research (No. 18591665) from the Japan Society for the Promotion of Science and a grant from Konica Minolta Imaging Science Foundation. T. Yamamoto, MD, PhD; Y. Iwamoto, MD, PhD, Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan; R. Schneider, MD, Department of Radiology; P.G. Bullough, MB, ChB, Department of Laboratory Medicine, Hospital for Special Surgery. Address reprint requests to Dr. P.G. Bullough, Department of Laboratory Medicine, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail: bulloughp@hss.edu Accepted for publication November 8, 2006.
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