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Cost-effective analysis for the imaging diagnosis of early femoral head necrosis

JIN Lei;HU Kejia;WU Yongwei;RUI Yongjun;LU Yao;KONG Youyi;Department of Traumatic Orthopaedic,Wuxi No.9 People's Hospital Affiliated Soochow University;Department of Microsurgery,Huashan Hospital Affiliated Fudan University;  
Objective:To evaluate the cost-effective analysis of MRI,CT,SPECT and X-ray in the adult early femoral head necrosis,and investigate the more effective way for diagnosis.Methods:Eighty-two cases(129 hips) with early FHN in adult(ARCO stage Ⅰ~Ⅱ) proved by follow-up studies,pathology,or typical imageologic manifestations were analyzed.All the patients underwent MRI,CT,SPECT and X-ray in the same period.With cost-effective analysis,compare the cost of accurate diagnosis(CAD) of the 4 diagnosis.Results:There were statistical differences in diagnosing early FHN in adults by MRI,CT,SPECT and X-ray.The smallest cost for accurate diagnosis was X-ray.When X-ray made a certain or suspicious diagnosis,the diagnosis cost of MRI was nearly the same,CT had the smallest CAD.When X-ray diagnosed negative,MRI was the most sensitive and accurately way,also had the smallest CAD.Conclusion:X-ray can be used to screen early femoral head necrosis,MRI is the most sensitive and accurately way,especially the first choice of previous diagnosis when X-ray's result is negative.
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