臨床整形外科53巻7号

2018年07月発行

Lecture

大腿骨頭軟骨下脆弱性骨折

著者： 池村聡¹ 本村悟朗¹ 福士純一¹ 濱井敏¹ 藤井政徳¹ 山本卓明² 中島康晴¹

所属機関： ¹九州大学整形外科学教室 ²福岡大学整形外科学教室

ページ範囲：P.621 - P.627

はじめに

　大腿骨頭軟骨下脆弱性骨折(subchondral insufficiency fracture of the femoral head：SIF［エス・アイ・エフ］)は1996年に提唱された疾患概念であり，発症機転としては，明らかな外傷歴のないことが多く，疫学的には，骨粗鬆症を有する高齢女性の片側に好発する，と報告されてきた^1-3)．疾患概念が浸透するに従って，高齢者のみでなく，腎移植後⁴⁾や，両側発生例⁴⁾，若年者⁵⁾にも起こり得ることがわかってきた．画像上，骨頭の圧潰をはじめ，多くの類似点を有することから，最も鑑別を要する疾患は大腿骨頭壊死症である⁶⁾．両疾患ともにMRI T1強調画像での低信号バンドを呈するが，その形状が鑑別に有用であると報告されている⁶⁾．

　本稿では，大腿骨頭壊死症との鑑別を中心とした，SIFの臨床的・画像的診断，治療，予後，最新の知見について述べる．

参考文献

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