A Case with Atypical Clinical Course Diagnosed as Osteoarthritis, Osteonecrosis, Subchondral Insufficiency Fracture, or Rapidly Destructive Coxopathy



Yukio Nakamura*, 1, Mikio Kamimura 2, Keijiro Mukaiyama 1, Shota Ikegami 1, Shigeharu Uchiyama 1, Hiroyuki Kato 1
1 Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan
2 Center of Osteoporosis and Spinal Disorders: Kamimura Orthopaedic Clinic, Matsumoto 399-0021, Japan


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© Nakamura et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390-8621, Japan; Tel: +81-263-37-2659; Fax: +81-263-35-8844; E-mail: yxn14@aol.jp


Abstract

Osteonecrosis (ON), subchondral insufficiency fracture (SIF), and rapidly destructive coxopathy (RDC) are considered to be clinically different disorders despite exhibiting several overlapping features. We encountered an elderly female patient with an atypical clinical course who was radiographically diagnosed as having osteoarthritis (OA), ON, SIF, and/or RDC over a long-term follow-up. In this case, radiographic diagnosis was apparently affected by the timing of imaging evaluation and was challenging because of radiographic overlap and atypical disease progression. The disorders of OA, SIF, ON, and RDC might share a similar pathophysiology.

Keywords: OA, ON, RDC, SIF..