Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Skeletal Radiology
Erschienen in: Skeletal Radiology 7/2019

31.01.2019 | Review Article

Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb

verfasst von: Sangoh Lee, Asif Saifuddin

Erschienen in: Skeletal Radiology | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Subchondral insufficiency fracture (SIF) is a non-traumatic condition that has historically been associated with elderly, osteoporotic women and patients with systemic conditions. There has been much work done to determine the pathogenesis of SIF, which has previously been regarded as idiopathic, rapid-progressive osteoarthritis or osteonecrosis of the hip, spontaneous osteonecrosis of the knee (SONK), osteochondral defect (OCD) of the talus and adult-onset Freiberg infraction of the metatarsal head. Early diagnosis and management are crucial to prevent subchondral collapse, secondary osteonecrosis and early-onset osteoarthritis. Magnetic resonance imaging (MRI) plays an important role in the diagnosis of SIF, which is often inconspicuous on initial radiographs. In this article, the authors provide an update on the role of MRI in identifying key imaging features of SIF in various joints of the lower limb to aid in its correct diagnosis.
Literatur
1.
Bangil M, Soubrier M, Dubost JJ, Rami S, Carcanagues Y, Ristori JM, et al. Subchondral insufficiency fracture of the femoral head. Rev Rhum Engl Ed. 1996;63:859–61.PubMed
2.
Ikemura S, Yamamoto T, Nakashima Y, Shuto T, Jingushi S, Iwamoto Y. Bilateral subchondral insufficiency fracture of the femoral head after renal transplantation: a case report. Arthritis Rheum. 2005;52:1293–6.CrossRefPubMed
3.
Iwasaki K, Yamamoto T, Nakashima Y, Mawatari T, Motomura G, Ikemura S, et al. Subchondral insufficiency fracture of the femoral head after liver transplantation. Skeletal Radiol.2009;38:925–8.CrossRefPubMed
4.
Miyanishi K, Hara T, Hamada T, Maekawa M, Tsurusaki S, Moro-oka T, et al. Co-occurrence of subchondral insufficiency fracture of the femoral head and contralateral femoral neck fracture in a rheumatic patient receiving steroid treatment. Mod Rheumatol. 2008;18:619–22.CrossRefPubMed
5.
Depasquale R, Fotiadou A, Kumar DS, Lalam R, Tins B, Tyrrell PNM, et al. Subchondral impaction fractures of the non-weight-bearing portion of the lateral femoral condyle. Skeletal Radiol. 2013;42:177–85.CrossRefPubMed
6.
Nelson FR, Craig J, Francois H, Azuh O, Oyetakin-White P, King B. Subchondral insufficiency fractures and spontaneous osteonecrosis of the knee may not be related to osteoporosis. Arch Osteoporos. 2014;9:194.CrossRefPubMed
7.
8.
9.
Rafii M, Mitnick H, Klug J, Firooznia H. Insufficiency fracture of the femoral head: MR imaging in three patients. AJR Am J Roentgenol. 1997;168:159–63.CrossRefPubMed
10.
Song WS, Yoo JJ, Koo K-H, Yoon KS, Kim Y-M, Kim HJ. Subchondral fatigue fracture of the femoral head in military recruits. J Bone Joint Surg Am. 2004;86–A:1917–24.CrossRef
11.
Yamamoto T, Iwamoto Y, Schneider R, Bullough PG. Histopathological prevalence of subchondral insufficiency fracture of the femoral head. Ann Rheum Dis. 2008;67:150–3.CrossRefPubMed
12.
Miyanishi K, Hara T, Kaminomachi S, Maeda H, Watanabe H, Torisu T. Contrast-enhanced MR imaging of subchondral insufficiency fracture of the femoral head: a preliminary comparison with that of osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2009;129:583–9.CrossRefPubMed
13.
Viana SL, Machado BB, Mendlovitz PS. MRI of subchondral fractures: a review. Skeletal Radiol. 2014;43:1515–27.CrossRefPubMed
14.
Lyons TJ, McClure SF, Stoddart RW, McClure J. The normal human chondro-osseous junctional region: evidence for contact of uncalcified cartilage with subchondral bone and marrow spaces. BMC Musculoskelet Disord. 2006;7:52.CrossRefPubMedPubMedCentral
15.
Lyons TJ, Stoddart RW, McClure SF, McClure J. The tidemark of the chondro-osseous junction of the normal human knee joint. J Mol Histol. 2005;36:207–15.CrossRefPubMed
16.
Oegema TRJ, Carpenter RJ, Hofmeister F, Thompson RCJ. The interaction of the zone of calcified cartilage and subchondral bone in osteoarthritis. Microsc Res Tech. 1997;37:324–32.CrossRefPubMed
17.
Madry H, van Dijk CN, Mueller-Gerbl M. The basic science of the subchondral bone. Knee Surg Sports Traumatol Arthrosc.2010;18:419–33.CrossRefPubMed
18.
Radin EL, Rose RM. Role of subchondral bone in the initiation and progression of cartilage damage. Clin Orthop Relat Res. 1986(213):34–40.
19.
Radin EL, Paul IL. Does cartilage compliance reduce skeletal impact loads? The relative force-attenuating properties of articular cartilage, synovial fluid, periarticular soft tissues and bone. Arthritis Rheum. 1970;13:139–44.CrossRefPubMed
20.
Layton MW, Goldstein SA, Goulet RW, Feldkamp LA, Kubinski DJ, Bole GG. Examination of subchondral bone architecture in experimental osteoarthritis by microscopic computed axial tomography. Arthritis Rheum. 1988;31:1400–5.CrossRefPubMed
21.
Simon WH. Scale effects in animal joints. II. Thickness and elasticity in the deformability of articular cartilage. Arthritis Rheum. 1971;14:493–502.CrossRefPubMed
22.
23.
Simon WH, Friedenberg S, Richardson S. Joint congruence. A correlation of joint congruence and thickness of articular cartilage in dogs. J Bone Joint Surg Am. 1973;55:1614–20.CrossRefPubMed
24.
Yoon PW, Kwak HS, Yoo JJ, Yoon KS, Kim HJ. Subchondral insufficiency fracture of the femoral head in elderly people. J Korean Med Sci 2014;29:593–8.CrossRefPubMedPubMedCentral
25.
Kubo T, Yamazoe S, Sugano N, Fujioka M, Naruse S, Yoshimura N, et al. Initial MRI findings of non-traumatic osteonecrosis of the femoral head in renal allograft recipients. Magn Reson Imaging. 1997;15:1017–23.CrossRefPubMed
26.
Ikemura S, Yamamoto T, Motomura G, Nakashima Y, Mawatari T, Iwamoto Y. MRI evaluation of collapsed femoral heads in patients 60 years old or older: differentiation of subchondral insufficiency fracture from osteonecrosis of the femoral head. AJR Am J Roentgenol. 2010;195:W63–8.CrossRefPubMed
27.
Sonoda K, Yamamoto T, Motomura G, Karasuyama K, Kubo Y, Iwamoto Y. Fat-suppressed T2-weighted MRI appearance of subchondral insufficiency fracture of the femoral head. Skeletal Radiol. 2016;45:1515–21.CrossRefPubMed
28.
Ikemura S, Mawatari T, Matsui G, Iguchi T, Mitsuyasu H. Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases. Br J Radiol. 2016;89:20150750.CrossRefPubMedPubMedCentral
29.
Yamamoto T, Schneider R, Bullough PG. Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI. Skeletal Radiol. 2001;30:247–54.CrossRefPubMed
30.
Gondim Teixeira PA, Savi de Tove K-M, Abou Arab W, Raymond A, Louis M, Polet Lefebvre K, et al. Subchondral linear hyperintensity of the femoral head: MR imaging findings and associations with femoro-acetabular joint pathology. Diagn Interv Imaging. 2017;98:245–52.CrossRefPubMed
31.
Iwasaki K, Yamamoto T, Motomura G, Karasuyama K, Sonoda K, Kubo Y, et al. Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging. Skeletal Radiol. 2016;45:105–13.
32.
Yamamoto T, Bullough PG. Subchondral insufficiency fracture of the femoral head: a differential diagnosis in acute onset of coxarthrosis in the elderly. Arthritis Rheum. 1999;42:2719–23.CrossRefPubMed
33.
Ikemura S, Yamamoto T, Motomura G, Nakashima Y, Mawatari T, Iwamoto Y. The utility of clinical features for distinguishing subchondral insufficiency fracture from osteonecrosis of the femoral head. Arch Orthop Trauma Surg. 2013;133:1623–7.CrossRefPubMed
34.
Fukushima W, Fujioka M, Kubo T, Tamakoshi A, Nagai M, Hirota Y. Nationwide epidemiologic survey of idiopathic osteonecrosis of the femoral head. Clin Orthop Relat Res. 2010;468:2715–24.CrossRefPubMedPubMedCentral
35.
Ahlbäck S, Bauer GC, Bohne WH. Spontaneous osteonecrosis of the knee. Arthritis Rheum. 1968;11:705–33.CrossRefPubMed
36.
Kelman GJ, Williams GW, Colwell CWJ, Walker RH. Steroid-related osteonecrosis of the knee. Two case reports and a literature review. Clin Orthop Relat Res. 1990;(257):171–6.
37.
Yamamoto T, Bullough PG. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. J Bone Joint Surg Am. 2000;82:858–66.CrossRefPubMed
38.
Tanaka Y, Mima H, Yonetani Y, Shiozaki Y, Nakamura N, Horibe S. Histological evaluation of spontaneous osteonecrosis of the medial femoral condyle and short-term clinical results of osteochondral autografting: a case series. Knee. 2009;16:130–5.CrossRefPubMed
39.
Mears SC, McCarthy EF, Jones LC, Hungerford DS, Mont MA. Characterization and pathological characteristics of spontaneous osteonecrosis of the knee. Iowa Orthop J. 2009;29:38–42.PubMedPubMedCentral
40.
Higuchi H, Kobayashi Y, Kobayashi A, Hatayama K, Kimura M. Histologic analysis of postmeniscectomy osteonecrosis. Am J Orthop (Belle Mead NJ). 2013;42:220–2.
41.
Wilmot AS, Ruutiainen AT, Bakhru PT, Schweitzer ME, Shabshin N. Subchondral insufficiency fracture of the knee: a recognizable associated soft tissue edema pattern and a similar distribution among men and women. Eur J Radiol. 2016;85:2096–103.CrossRefPubMed
42.
43.
Narvaez JA, Narvaez J, De Lama E, Sanchez A. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. Eur Radiol. 2003;13:1843–8.CrossRefPubMed
44.
Sokoloff RM, Farooki S, Resnick D. Spontaneous osteonecrosis of the knee associated with ipsilateral tibial plateau stress fracture: report of two patients and review of the literature. Skeletal Radiol. 2001;30:53–6.CrossRefPubMed
45.
Ohdera T, Miyagi S, Tokunaga M, Yoshimoto E, Matsuda S, Ikari H. Spontaneous osteonecrosis of the lateral femoral condyle of the knee: a report of 11 cases. Arch Orthop Trauma Surg. 2008;128:825–31.CrossRefPubMed
46.
Lotke PA, Nelson CL, Lonner JH. Spontaneous osteonecrosis of the knee: tibial plateaus. Orthop Clin N Am. 2004;35:365–70.CrossRef
47.
Kon E, Ronga M, Filardo G, Farr J, Madry H, Milano G, et al. Bone marrow lesions and subchondral bone pathology of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24:1797–814.CrossRefPubMed
48.
Jose J, Pasquotti G, Smith MK, Gupta A, Lesniak BP, Kaplan LD. Subchondral insufficiency fractures of the knee: review of imaging findings. Acta Radiol. 2015;56:714–9.CrossRefPubMed
49.
Mayerhoefer ME, Kramer J, Breitenseher MJ, Norden C, Vakil-Adli A, Hofmann S, et al. MRI-demonstrated outcome of subchondral stress fractures of the knee after treatment with iloprost or tramadol: observations in 14 patients. Clin J Sport Med. 2008;18:358–62.CrossRefPubMed
50.
Karim AR, Cherian JJ, Jauregui JJ, Pierce T, Mont MA. Osteonecrosis of the knee: review. Ann Transl Med. 2015;3:6.PubMedPubMedCentral
51.
Aglietti P, Insall JN, Buzzi R, Deschamps G. Idiopathic osteonecrosis of the knee. Aetiology, prognosis and treatment. J Bone Joint Surg Br. 1983;65:588–97.CrossRefPubMed
52.
Rios AM, Rosenberg ZS, Bencardino JT, Rodrigo SP, Theran SG. Bone marrow edema patterns in the ankle and hindfoot: distinguishing MRI features. AJR Am J Roentgenol. 2011;197:W720–9.CrossRefPubMed
53.
Long NM, Zoga AC, Kier R, Kavanagh EC. Insufficiency and nondisplaced fractures of the talar head: MRI appearances. AJR Am J Roentgenol. 2012;199:W613–7.CrossRefPubMed
54.
Roemer FW, Frobell R, Hunter DJ, Crema MD, Fischer W, Bohndorf K, et al. MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. Osteoarthritis Cartilage. 2009;17:1115–31.CrossRefPubMed
55.
Berndt AL, Harty M. Transchondral fractures (osteochondritis dissecans) of the talus. J Bone Joint Surg Am. 1959;41–A:988–1020.CrossRefPubMed
56.
Bruns J, Rosenbach B. Osteochondrosis dissecans of the talus. Comparison of results of surgical treatment in adolescents and adults. Arch Orthop Trauma Surg. 1992;112:23–7.CrossRefPubMed
57.
Freiberg AH. Infarction of the second metatarsal bone. Surg Gynecol Obstet. 1914;19:191–3.
58.
Brukner P, Bennell K. Stress fractures in female athletes. Diagnosis, management and rehabilitation. Sports Med. 1997;24:419–29.CrossRefPubMed
59.
Tsujii M, Hasegawa M, Hirata H, Uchida A. Subchondral insufficiency fracture of the second metatarsal head in an elderly woman treated with autologous osteochondral transplantation. Arch Orthop Trauma Surg. 2008;128:689–93.CrossRefPubMed
60.
Gauthier G, Elbaz R. Freiberg’s infraction: a subchondral bone fatigue fracture. A new surgical treatment. Clin Orthop Relat Res. 1979;(142):93–5.
61.
Young MC, Fornasier VL, Cameron HU. Osteochondral disruption of the second metatarsal: a variant of Freiberg’s infraction? Foot Ankle. 1987;8:103–9.CrossRefPubMed
62.
Torriani M, Thomas BJ, Bredella MA, Ouellette H. MRI of metatarsal head subchondral fractures in patients with forefoot pain. AJR Am J Roentgenol. 2008;190:570–5.CrossRefPubMed
Metadaten
Titel
Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb
verfasst von
Sangoh Lee
Asif Saifuddin
Publikationsdatum
31.01.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 7/2019
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-019-3160-4

Weitere Artikel der Ausgabe 7/2019

Skeletal Radiology 7/2019 Zur Ausgabe

Perspective

Three approaches to full-spine radiograph measurement reporting

Scientific Article

Preliminary validation of the Simplified Psoriatic Arthritis Radiographic Score (SPARS)

Case Report

Ulnar hemimelia: a report of four cases

Scientific Article

Assessing the effects of long-term osteoporosis treatment by using conventional spine radiographs: results from a pilot study in a sub-cohort of a large randomized controlled trial

Technical Report

Optimizing methods to quantify intramuscular fat in rotator cuff tears with normalization

Browser's Notes

Browser’s Notes

Neu im Fachgebiet Radiologie

18.04.2024 | Pädiatrische Notfallmedizin | Nachrichten

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

13.04.2024 | Klinik aktuell | Kongressbericht | Nachrichten

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

08.04.2024 | Andrologie | Nachrichten

Wie toxische Männlichkeit der Gesundheit von Männern schadet

29.03.2024 | Diagnostische Radiologie | Nachrichten

Studie bestätigt Potenzial von KI in der Radiologie
weitere anzeigen

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen