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Metaphyser hyperactivity in femoral head osteonecrosis

Metaphyser hyperactivity as searched in 10 normals and 15 patients who had confirmed diagnosis of uniIateral femoral head osteonecrosis by core biopsies. 99m T c MDP bone SPECT study was performed in all cases. Using a standard ROI, counts per pixel were determined from coronary slices for both femoral heads and metaphysis. Femoral head activity ratio was calculated as; right femoral head/left femoral head in normals and involved femoral head/intact femoral head in patients. Metaphyser activity ratio was calculated as; right metaphysis Ieft metaphysis in normals and metaphisis of involved side metaphisis of intact side in patients. Mean femoral head activity ratio and metaphyser activity ratio was 0.99 ± 0.9, 1.1 0 ±0.11 in normals and 0.88 ± 0.50, 0.99 ± 0.33 in patients respectively. Femoral head activity ratio and metaphyser activity ratio were positively correlated (r: 0.64) in patients. Although photon deficient areas were identified by SPECT imaging in all patients, this correlation may be a useful parameter when the surrounding hyperactivity obscures the defect. Increased metaphyser activity may indicate the presence of femoral head osteonecrosis.