What question did this study set out to answer?

To differentiate between osteochondritis dissecans and early avascular necrosis in a young patient.

April 24, 2026Orthopedics & Traumatology0 citationsOpen Access

若年者の早期における離断性骨軟骨炎と上腕骨頭壊死の鑑別を要した1例

Key Points

To differentiate between osteochondritis dissecans and early avascular necrosis in a young patient.
Case report of an 18-year-old male athlete presenting with right shoulder pain.
Utilization of MRI for imaging, including T1-weighted and STIR sequences, and CT scans for bone assessment.
Functional blood flow evaluation using Gadobutrol-enhanced MRI.
MRI indicated distinct low-signal regions with slight bone sclerosis observed on CT scans.
Blood flow assessment confirmed no significant obstruction, leaning towards osteochondritis dissecans as the diagnosis.
Treatment led to improvement in MRI findings after six months, suggesting effective management.

Abstract

若年者に発生した早期の離断性骨軟骨炎と早期の上腕骨頭壊死の鑑別を要した症例を経験したので報告する．症例は18歳男性．高校球児．主訴，半年程度継続する右肩痛．MRI T1強調画像では上腕骨頭後上方に境界明瞭な低信号域で囲まれ，内部はほぼ均一な冠状陰影を認め，STIRではその周囲に高信号域を認めた．CTでは同部位に淡い骨硬化像を認めた．これらの検査のみでは上腕骨頭壊死Cruess分類stageⅡと離断性骨軟骨炎Nelson分類GradeⅡが鑑別に上がるが，形態的区別は困難であった．Gd造影MRIによる血流の機能的評価により，正常な組織と比較しても血流の流入と流出に差はなく，血流閉塞はないと判断した．離断性骨軟骨炎の可能性が高いと考え，保存加療を選択した．治療経過は半年後のMRIでは冠状陰影は不明瞭となった．骨壊死を鑑別に要す病変において，造影MRIによる血流評価は病態の把握に有用であり，診断や治療方針の決定に役立つ可能性がある．

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Cite This Study

阿南 et al. (2026) studied this question.

synapsesocial.com/papers/69eb0899553a5433e34b38ba https://doi.org/10.5035/nishiseisai.75.181

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April 24, 2026Orthopedics & Traumatology0 citationsOpen Access

若年者の早期における離断性骨軟骨炎と上腕骨頭壊死の鑑別を要した1例

凛阿凛香阿南歳北歳男北村敦阿敦子阿南

Key Points

To differentiate between osteochondritis dissecans and early avascular necrosis in a young patient.
Case report of an 18-year-old male athlete presenting with right shoulder pain.
Utilization of MRI for imaging, including T1-weighted and STIR sequences, and CT scans for bone assessment.
Functional blood flow evaluation using Gadobutrol-enhanced MRI.
MRI indicated distinct low-signal regions with slight bone sclerosis observed on CT scans.
Blood flow assessment confirmed no significant obstruction, leaning towards osteochondritis dissecans as the diagnosis.
Treatment led to improvement in MRI findings after six months, suggesting effective management.

Abstract

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Cite This Study

阿南 et al. (2026) studied this question.

synapsesocial.com/papers/69eb0899553a5433e34b38ba https://doi.org/10.5035/nishiseisai.75.181

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