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Proximal Femoral Focal Deficiency Workup

  • Author: Mark C Lee, MD; Chief Editor: William L Jaffe, MD  more...
 
Updated: Nov 07, 2014
 

Imaging Studies

The Aitken classification classifies proximal femoral focal deficiency (PFFD) into four categories based on radiographic appearance.[14] Remember that late ossification may occur, whereby the bone may be present but not visualized radiographically. Occasionally, push-pull comparison radiographs, as well as abduction-adduction views, are necessary to distinguish between Aitken class A and class B. Arthrography also can be helpful.[7, 9, 19, 20]

A study by Maldjian et al of the efficacy of magnetic resonance imaging (MRI) in classifying PFFD also compared MRI findings with radiographic classification.[19] The study, which used the Amstutz classification system, found that radiographic evaluation tends to overestimate the degree of deficiency and that MRI therefore is the better modality.

 
 
Contributor Information and Disclosures
Author

Mark C Lee, MD Assistant Professor, Department of Orthopedics, Connecticut Children’s Medical Center

Mark C Lee, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Connecticut State Medical Society, Scoliosis Research Society, Pediatric Orthopaedic Society of North America, Connecticut Orthopaedic Society

Disclosure: Received honoraria from Synthes-Depuy for speaking and teaching.

Coauthor(s)

Scott S Mallozzi, MD, MSc Resident Physician, Department of Orthopedic Surgery, University of Connecticut Health Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

B Sonny Bal, MD, JD, MBA Professor, Department of Orthopedic Surgery, University of Missouri-Columbia School of Medicine

B Sonny Bal, MD, JD, MBA is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Received none from Bonesmart.org for online orthopaedic marketing and information portal; Received none from OrthoMind for social networking for orthopaedic surgeons; Received stock options and compensation from Amedica Corporation for manufacturer of orthopaedic implants; Received ownership interest from BalBrenner LLC for employment; Received none from ConforMIS for consulting; Received none from Microport for consulting.

Chief Editor

William L Jaffe, MD Clinical Professor of Orthopedic Surgery, New York University School of Medicine; Vice Chairman, Department of Orthopedic Surgery, New York University Hospital for Joint Diseases

William L Jaffe, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American College of Surgeons, Eastern Orthopaedic Association, New York Academy of Medicine

Disclosure: Received consulting fee from Stryker Orthopaedics for speaking and teaching.

Additional Contributors

B Sonny Bal, MD, JD, MBA Professor, Department of Orthopedic Surgery, University of Missouri-Columbia School of Medicine

B Sonny Bal, MD, JD, MBA is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Received none from Bonesmart.org for online orthopaedic marketing and information portal; Received none from OrthoMind for social networking for orthopaedic surgeons; Received stock options and compensation from Amedica Corporation for manufacturer of orthopaedic implants; Received ownership interest from BalBrenner LLC for employment; Received none from ConforMIS for consulting; Received none from Microport for consulting.

Acknowledgements

Michael G Dennis, MD Consulting Surgeon, Orthopedic Care and Sports Medicine Center, Aventura Hospital and Medical Center

Michael G Dennis, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Medical Association

Disclosure: Nothing to disclose. James Hale, MD Staff Physician, Department of Orthopedic Surgery, Hospital for Joint Diseases

Disclosure: Nothing to disclose.

William L Jaffe, MD Clinical Professor of Orthopedic Surgery, New York University School of Medicine; Vice Chairman, Department of Orthopedic Surgery, New York University Hospital for Joint Diseases

William L Jaffe, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, Eastern Orthopaedic Association, and New York Academy of Medicine

Disclosure: Stryker Orthopaedics Consulting fee Speaking and teaching

David Scher, MD Clinical Instructor, Department of Orthopedic Surgery, Hospital for Joint Diseases, New York University

Disclosure: Nothing to disclose.

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