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Erschienen in: Die Radiologie 7/2019

27.06.2019 | Magnetresonanztomografie | CME

Atraumatische und aseptische Osteonekrose großer Gelenke

verfasst von: Dr. T. Grieser

Erschienen in: Die Radiologie | Ausgabe 7/2019

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Zusammenfassung

Subchondrale Osteonekrosen stellen an den großen gewichtstragenden Gelenken (Hüfte, Knie) eine schwerwiegende und gelenkbedrohende Erkrankung dar. Bei den atraumatischen Osteonekrosen stehen als kausale Faktoren neben den idiopathischen Formen v. a. die Glukokortikoidmedikation und der Alkoholabusus im Vordergrund. Neben direkt zytotoxischen Faktoren führt letztlich eine kritisch verminderte Perfusion des subchondralen Knochenraums zu Ischämie und Nekrose. Dieses bereits irreversible, oft aber kaum symptomatische Stadium I kann in der Magnetresonanztomographie (MRT) als Doppellinienzeichen sichtbar gemacht werden und zeigt später auch röntgenologisch eine geographisch begrenzende Skleroselinie (Stadium II). Reparationsmechanismen des Knochens bleiben weitgehend frustran, und je nach Größe der Osteonekrose kommt es zum biomechanischen Versagen und schließlich zu subchondralen Insuffizienzfrakturen, die den Übergang zum Stadium III markieren (Gelenkflächenkollaps).
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Metadaten
Titel
Atraumatische und aseptische Osteonekrose großer Gelenke
verfasst von
Dr. T. Grieser
Publikationsdatum
27.06.2019
Verlag
Springer Medizin
Erschienen in
Die Radiologie / Ausgabe 7/2019
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-019-0560-3