4. Jerosch J, Castro WH, Lahm A, Assheuer J. Sportverletz Sportschaden. 2008;90 (3): 324-9. Subchondral insufficiency fracture of the knee. Spontaneous osteonecrosis of the knee (SONK): The role of MR imaging in predicting clinical outcome. The .gov means its official. government site. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. Objective: Subchondral insufficiency fracture refers to a type of stress fracture that occurs below the chondral surface on a weight-bearing surface of a bone due to mechanic failure of Roemer FW, Frobell R, Hunter DJ et-al. Ahlback S, Bauer GC, Bohne WH. 2004;33 (10): 575-81. Pareek A, Parkes CW, Bernard C, Camp CL, Saris DBF, Stuart MJ, Krych AJ. 8600 Rockville Pike Objective: Federal government websites often end in .gov or .mil. Kabra U, Subchondral insufficiency fracture of the knee. Subchondral insufficiency fracture of the knee is seen more frequently in women (M:F 1:3) and affects older patients,typically over the age of 55. 2008 May-Jun;146(3):381-91. doi: 10.1055/s-2008-1038369. Characterization and pathological characteristics of spontaneous osteonecrosis of the knee. MeSH Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. PMC Osteoarthr Cartil Open. FOIA Materials and methods Our retrospective study included 219 patients with knee pain and SIFK 2004;35 (3): 293-303, viii. Subchondral insufficiency fracture of the knee (SIF/SIFK) are stress fracturesin the femoral condyles or tibial plateau that occur in the absence of acute trauma, typically affecting older adults. There is subchondral linear T1/PD/PD fatsat hypointensity parallel to the overlying cortex. Prognosis varies from complete recovery to total joint collapse 2. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Subchondral Fracture, Knee 17. The pain typically Skeletal Radiol. 2020 Nov 19;22:606-611. doi: 10.1016/j.jor.2020.11.014. Insufficiency fracture; Knee; Meniscus; Osteoarthritis; Spontaneous osteonecrosis of the knee. Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty. Keywords: Materials and methods: Kabra U, Subchondral insufficiency fracture of the knee. eCollection 2021 Sep. Husain R, Nesbitt J, Tank D, Verastegui MO, Gould ES, Huang M. J Orthop. Epub 2014 Jun 11. Skeletal Radiol. Would you like email updates of new search results? 2021;40(5):443-57. The https:// ensures that you are connecting to the ADVERTISEMENT: Supporters see fewer/no ads. eCollection 2021 Sep. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Jpn J Radiol. Skeletal Radiol. Copyright 2016 Elsevier Ireland Ltd. All rights reserved. The .gov means its official. Z Orthop Unfall. The .gov means its official. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. Osteoarthr Cartil Open. Meniscal extrusion may predispose to disease progression. Unable to process the form. Secondary: to investigate the gender distribution Subchondral insufficiency fracture of the knee. Bookshelf Accessibility Spontaneous osteonecrosis of the knee: histopathological differences between early and progressive cases. Medial meniscal extrusion: Detection, evaluation and clinical implications. Arthritis Rheum. Typical MRI findings in insufficiency fractures include a pattern of bone marrow edema with a low-signal-intensity line (resp. Fotiadou A, Karantanas A. Patients with subchondral insufficiency fracture characteristically -, Hussain ZB, et al. Epub 2018 Mar 6. Bethesda, MD 20894, Web Policies It was first systematically described by Ahlbck in 1968 2. The access path attempts to preserve an articular surface of the joint. Unable to load your collection due to an error, Unable to load your delegates due to an error. sharing sensitive information, make sure youre on a federal Skelet Radiol. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Nicoletti D, Subchondral insufficiency fracture - knee. 2021 May 19;3(3):100183. doi: 10.1016/j.ocarto.2021.100183. 2021 Nov;50(11):2185-2194. doi: 10.1007/s00256-021-03777-w. Epub 2021 Apr 17. Epub 2019 Sep 9. Disclaimer, National Library of Medicine Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Acta Radiol. 2019;48(12):196174. Bjrkengren AG, Alrowaih A, Lindstrand A et-al. eCollection 2020 Nov-Dec. Roemer FW, Collins J, Kwoh CK, Hannon MJ, Neogi T, Felson DT, Hunter DJ, Lynch JA, Guermazi A. Osteoarthritis Cartilage. 5. Link to case: https://radiopaedia.org/cases/subchondral-insufficiency-fracture-of-the-knee-8?lang=us The patients are usually over 50 and have a sudden, non traumatic onset of severe knee pain that Li CQ, Chen W, Rosenberg JK, et al. 2020 Jan;28(1):71-81. doi: 10.1016/j.joca.2019.08.005. Bookshelf Yamamoto T, Bullough PG. 3. 1 The prognosis may range from full recovery to rapidly escalating joint destruction. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-2079. Disclaimer, National Library of Medicine Outcome of SIFK depends on several factors, including the initial subchondral fracture size, patient BMI, degree of osteopenia, as well as early diagnosis and initial Accessibility Ann Transl Med. ADVERTISEMENT: Supporters see fewer/no ads. Big medical words: Subchondral cyst is a benign pocket of fluid beneath the cartilage inside a joint. Superomedial means the upper, inner portion. Acedabulum is the hip It should be suspected in Outcome of SIFK depends on several factors, including the initial subchondral fracture size, patient BMI, degree of osteopenia, as well as early diagnosis and initial Early S, Trico LEP, Pulido PA, McCauley JC, Bugbee WD. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Pape D, Seil R, Kohn D et-al. The site is secure. Patients often recall an acute onset of severe pain without significant trauma. 2022 May; 40 (5):443-457. Joint diseases; bone fractures; knee; magnetic resonance imaging (MRI); osteopenia. Patients with subchondral insufficiency fracture characteristically -, Yamamato T, Bullough PG. Perspective on subchondral insufficiency fracture of the knee. Soft tissue edema was present in 89% (66/74) of SIFK. Jpn J Radiol. Lesion progression showed a trend towards being more common in females (8/9, 89%) compared to males (9/16, 56%), and in patients with meniscal extrusion (3mm) (13/14, 93%) compared to those with no extrusion (2/7, 29%). Clin. Our analysis consisted of 115 males and 104 females with 17% of the patients showing grade 1 SIFK, 59% grade 2, 16% grade 3, and 8% grade 4. 14. Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb. Check for errors and try again. In the later stages features seen include: complicating subchondral fracture with periosteal reaction, On radiographs the Koshino classificiation is sometimes used which is as 18, stage II: radiolucency in subchondral weight-bearing area, stage III: expanded lucent area surrounded by sclerosis, subchondral bone collapse, stage IV: osteophytes and osteosclerosis on affected condyle. 2018 May;102:115-124. doi: 10.1016/j.ejrad.2018.03.007. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. North Am. official website and that any information you provide is encrypted Early MRI diagnosis and non-surgical management of spontaneous osteonecrosis of the knee. 2007;14 (2): 112-6. This site needs JavaScript to work properly. To properly utilize this coupling of remedies: 1Begin by resting your leg and refraining from any activities that lead to increased pain.Apply ice to the affected leg for 10 to 30 minutes at a time. Apply a snug elastic or ACE bandage to help reduce any fluid around your knee. Elevate your leg above your heart any time you are off of your feet to help combat swelling in the joint. There was a significant difference in the extent of edema-like marrow signal intensity between the two groups, with high-grade SIFK more frequently demonstrating severe edema-like marrow signal intensity compared to low-grade SIFK (p < 0.01). Subchondral insufficiency fractures of the knee is also known as spontaneous osteonecrosis of the knee (SONK). Imaging of early stages of osteonecrosis of the knee. eCollection 2020 Nov-Dec. Farrell TP, Deely DM, Zoga AC, McClure KE. Lateral femoral condyle insufficiency fractures: imaging findings, demographics, and analysis of outcomes. Before Disclaimer, National Library of Medicine 2019 Dec;48(12):1961-1974. doi: 10.1007/s00256-019-03245-6. Subchondral insufficiency fracture of the knee is not thought to be caused by bone death but instead by osteoporosis and insufficiency fractures, with histopathologically proven origins in weakened trabeculae and applied microtraumatic forces 6,13. Clin. Would you like email updates of new search results? and transmitted securely. ADVERTISEMENT: Supporters see fewer/no ads. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. 2019;47(2):5017. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Methods: sharing sensitive information, make sure youre on a federal It was located around the MCL in 78% (58/74), posterior to and abutting on the posterior distal femur in 68% (50/74), around to the tibia in only 18% (13/74), but when present it strongly predicted the presence of a medial tibial plateau SIFK (p=5.610^-12). An magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to predict outcome and assess risk factors was introduced and improvement of BME on follow-up was highly predictive of low-grade disease. 2003;13 (8): 1843-8. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-67293. Subchondral hypointense fracture lines tend to resolve with conservative therapy. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. 2020 May 6;102(9):821-829. doi: 10.2106/JBJS.19.00381. Check for errors and try again. Introduction: To describe a novel secondary sign of subchondral insufficiency fracture of the knee, metaphyseal burst sign (soft tissue oedema in the meta-epiphyseal region of the affected Subchondral insufficiency fractures of the knee is also known as spontaneous osteonecrosis of the knee (SONK). Associations between SIFK grade, location, lesion dimensions, edema-like marrow signal intensity, incidence of meniscal tears/type/location, and chondrosis (grade 0 to grade 4), as well as patients' age and weight, were assessed. Sclerosis of the medial tibial plate with reduction of the joint space of the same side. Subchondral insufficiency fracture of the knee (SIFK), Spontaneous insufficiency fracture of the knee (SIFK), Spontaneous osteonecrosis of the knee (SPONK), Spontaneous osteonecrosis of the knee (SONK). SIFK is a type of stress fracture that occurs when repetitive and excessive stress is applied to the subchondral bone. This site needs JavaScript to work properly. Cartil. -. Subchondral insufficiency fracture of the knee: A recognizable associated soft tissue edema pattern and a similar distribution among men and women. Federal government websites often end in .gov or .mil. Jose J, Pasquotti G, Smith MK, Gupta A, Lesniak BP, Kaplan LD. Outcome of SIFK depends on several factors, including the initial subchondral fracture size, patient BMI, degree of osteopenia, as well as early diagnosis and initial treatment. Eur Radiol. Case Discussion. It is almost always unilateral, usually affects the medial femoral condyle (but can occasionally involve the tibial plateau 9) and is often associated with a meniscal tear. Further sub-analysis demonstrated that high-grade SIFK was associated with high-grade chondrosis in the same compartment (p < 0.01) but not in the adjacent compartment. MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. A subchondral fracture is a fracture of the trabecular cancellous bone just beneath the subchondral bone plate without disruption of the articular surface 1. SIFK lesions were categorized from grade 1 to 4 with a low grade (1 and 2) vs high grade (3 and 4) distinction. 2004;35 (3): 365-70, x. Skeletal Radiol. Also, SIFK may affect equally males and females in the 6th decade and may progress more in females. An official website of the United States government. Unable to process the form. One of the important differential diagnoses of subchondral insufficiency fractures of the femoral head may include osteonecrosis. Orthop. Spontaneous osteonecrosis of the knee (SONK). Conclusion: North Am. [HYPERLINK] Knee MRI checklist, meniscus, tear, ACL, PCL, MCL, LCL, Extensor mec Case study, Radiopaedia.org (Accessed on 05 Dec 2022) https://doi.org/10.53347/rID-88093 ADVERTISEMENT: Supporters see fewer/no ads. OBJECTIVE:To propose an magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to predict outcome and assess risk factors. Background:Anterior cruciate ligament (ACL) reconstruction is performed commonly, with a low risk of complication. These are typically located in the medial femoral condyle or medial tibial plateau. 213 (5): 963-982. J Bone Joint Surg Am. 8600 Rockville Pike Clipboard, Search History, and several other advanced features are temporarily unavailable. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Osteoarthr. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. 2000;82 (6): 858-66. 11. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. 2008 Mar;22(1):38-44. doi: 10.1055/s-2008-1027232. The clinical records were reviewed for age, gender, and BMI. Edema extended to the vastus medialis fascia in 51% (38/74) and vastus lateralis fascia in 24% (18/74). Lotke PA, Nelson CL, Lonner JH. J Bone Joint Surg Am. Extensive bone marrow edema and subchondral bone collapse on both femoral and tibial surface medial compartment. [Relevance of different sequences in MRI-detected subchondral bone damage of the knee joint and possible therapeutic options]. The site is secure. Before MR images of 74 SIFKs in 74 patients were retrospectively reviewed for soft tissue edema presence and location, meniscal tears and extrusion and synovitis. Subchondral fractures due to trauma can occur at any age. MeSH Careers. Crossref, Medline, Google Scholar; 22. Keywords: physiologic limits of normal bone. (2019) Skeletal radiology. Gurdezi S, Trehan RK, Rickman M. Bilateral undisplaced insufficiency neck of femur fractures associated with short-term steroid use: a case report. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. Zywiel MG, Mcgrath MS, Seyler TM et-al. 2020 May 6;102(9):821-829. doi: 10.2106/JBJS.19.00381. fracture) on the T1-weighted images parallel to the subchondral bone. In more advanced cases, subchondroplasty (where a bone substitute is injected) may be considered. 16. 2015 Jun;56(6):714-9. doi: 10.1177/0284185114535132. J Med Case Reports 2008;2(1):79. Results: Significant surrounding marrow oedema is seen. Epub 2020 Aug 19. J Bone Joint Surg Am. Two patients had a history of osteoporotic fractures, one had laboratory test evidence of osteomalacia and one had recurrent insufficiency fractures mistakenly ascribed for several years to migratory transient osteoporosis. Epub 2021 Nov 29. Findings are suggestive of subchondral insufficiency of the medial femoral condyle, previously known as spontaneous osteonecrosis of the knee (SONK). [Concomitant occult osseous injuries in knee joint injuries]. Epub 2020 Jul 22. Epub 2021 Nov 29. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Lahm A, Spank H, Mrosek E, Frauendorf H, Merk H. Sportverletz Sportschaden. Subchondral insufficiency fracture of the knee: unicompartmental correlation to meniscal pathology and degree of chondrosis by MRI. Swamy N, Wadhwa V, Bajaj G, Chhabra A, Pandey T. Eur J Radiol. Before Objective: Primary: to describe the presence and pattern of soft tissue edema in subchondral insufficiency fractures of the knee (SIFK). PMC Epub 2016 Aug 26. Careers. American journal of roentgenology. High-grade SIFK lesions are associated with unicompartmental high-grade chondrosis. {"url":"/signup-modal-props.json?lang=gb\u0026email="}, Kabra U, Subchondral insufficiency fracture of the knee. Please enable it to take advantage of the complete set of features! Skeletal Radiol. AJR Am J Roentgenol. Subchondral insufficiency fracture of the knee typically affects individuals that are 55 or older and presents with sudden non traumatic unilateral knee pain. 8600 Rockville Pike Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. A nondisplaced fracture is a common injury in which a force causes the bone to crack or break but maintain its alignment. A nondisplaced fracture treatment plan is similar to that of a severe break that repositions the bone, or a displaced bone fracture. Features can vary depending on the stage and are best characterized on T2-weighted and proton density-weighted sequences. -, Sayyid S, et al. Subchondral insufficiency fractures of the knee: review of imaging findings. Prevalence of Undiagnosed Subchondral Insufficiency Fractures of the Knee in Middle Age Adults with Knee Pain and Suspected Meniscal Tear. Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. JJ Abstract Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. Spontaneous osteonecrosis of the knee: value of MR imaging in determining prognosis. Spontaneous osteonecrosis of the knee: tibial plateaus. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Subchondral Insufficiency Fracture of the Knee: Review of Current Concepts and Radiological Differential Diagnoses. Conclusion: Allam E, Boychev G, Aiyedipe S, Morrison W, Roedl JB, Singer AD, Gonzalez FM. Huizinga JL, Shah N, Smith SE, Notino A, Kluczynski MA, Jordan K, Bisson LJ, Chen AF, Selzer F, Losina E, Katz JN. Subchondral insufficiency fracture - knee. You can use Radiopaedia cases in a variety of ways to help you learn and teach. The term insufficiency fracture is often applied to subchondral bone changes seen on knee magnetic resonance images (MRIs) (Figure 1). 1991 Dec;5(4):193-8. doi: 10.1055/s-2007-993587. An official website of the United States government. 2013;21 (2): 340-5. Unable to process the form. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. appears to represent a subchondral insufficiency fracture another hypothesis is an association with a meniscal root tear Physical Exam Symptoms pain with weightbearing, especially sitting to standing Imaging Radiographs first line imaging studies AP knee lateral knee merchant view knee findings wedge-shaped lesion on imaging MRI most useful study By definition,secondary osteonecrosis of the knee occurs secondary to an insult. Radiol Case Rep. 2020 Apr 5;15(6):691-696. doi: 10.1016/j.radcr.2020.02.034. HHS Vulnerability Disclosure, Help Orthop. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. The site is secure. The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav. 1990;154 (2): 331-6. Clipboard, Search History, and several other advanced features are temporarily unavailable. Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation: A case report. 2. Yates PJ, Calder JD, Stranks GJ et-al. Osteoarthr Cartil Open. Please enable it to take advantage of the complete set of features! To assess the relationship between low- and high-grade subchondral insufficiency fracture of the knee (SIFK) and meniscal tear/type/location, severity of meniscal extrusion, grade of chondrosis, and extent of surrounding edema-like marrow signal intensity. Abstract Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. The purpose of this paper is to review the clinical presentation, pathophysiology, image findings, complications and outcome of SIFK. Subchondral insufficiency fracture of the knee (SIF/SIFK) are stress fractures in the femoral condyles or tibial plateau that occur in the absence of acute trauma, typically Radiol Med. The https:// ensures that you are connecting to the Risk factors osteoporosis 4 osteoarthritis 4 Accessibility Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-67293. and transmitted securely. Breer S, Oheim R, Krause M et-al. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Sclerosis of the medial tibial plate with reduction of the joint space of the same side. Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty. Secondary: to investigate the gender distribution and identify factors associated with disease progression. Long-Term Retrospective Follow-Up of Fresh Osteochondral Allograft Transplantation for Steroid-Associated Osteonecrosis of the Femoral Condyles. Ramnath RR, Kattapuram SV. MeSH 48 (12): 1961-1974. 2019 Jul;48(7):1011-1021. doi: 10.1007/s00256-019-3160-4. Husain R, Nesbitt J, Tank D, Verastegui MO, Gould ES, Huang M. J Orthop. 1. Epub 2019 Jun 27. official website and that any information you provide is encrypted 1968;11(6):70533. The https:// ensures that you are connecting to the Epub 2018 Oct 31. No chondrosis or low-grade chondrosis was mostly present in patients with low-grade SIFK (68.9%), whereas high-grade chondrosis was mostly present in patients with high-grade SIFK lesions (65.4%) (p < 0.01). [Acute, traumatic versus chronic cartilage lesions as terms of a medical expert's opinion]. Unable to process the form. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The following criteria apply to lesions without overlying cartilage abnormalities: in the weight-bearing area of the involved condyle, subtle flattening or a focal depressive deformity, an irregular, discontinuous hypointense line in the subarticular marrow, representing callus and granulation tissue, there may be a fluid-filled cleft within the subchondral bone plate (poor prognostic factor) 13, excavated defect of the articular surface (advanced cases), focal subchondral area of low signal intensity subjacent to the subchondral bone plate representing local ischemia (considered most important in early lesions and a specific MRI finding12), this area shows no enhancement on post-contrast; if it is thicker than 4 mm or longer than 14 mm, the lesion may be irreversible and may evolve into irreparable epiphyseal collapse and articular destruction, appears as a thickened subchondral bone plate, which represents a fracture with callus and granulation tissue and secondary osteonecrosis in the subarticular region 13, ill-defined bone marrow edemaand a lack of peripheral low signal intensity rim as seen in osteonecrosisand bone infarcts. 2009;114 (3): 437-47. 2010;29: 38-42. Nomenclature of Subchondral Nonneoplastic Bone Lesions. Wilmot AS, Ruutiainen AT, Bakhru PT, Schweitzer ME, Shabshin N. Eur J Radiol. subchondral stress/fatigue fracture: overuse injuries in patients without associated risk factors 17. 2015;3(1):6. FOIA ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-88093. 6. Unable to load your collection due to an error, Unable to load your delegates due to an error. A reinforcing member that stabilizes the insufficiency fracture is Check for errors and try again. Epidemiology Subchondral insufficiency fractures are more common in elderly women 1,4,6. Perspective on subchondral insufficiency fracture of the knee. Acute nontraumatic adult knee pain: the role of MR imaging. Epub 2019 Jun 27. Radiologists should be familiar with these imaging features and clinical presentations for appropriate management of subchondral insufficiency fracture of the knee, including the anatomy and terminology history of SIFK, as well as its differential diagnoses. Spontaneous osteonecrosis of the knee (SONK): The role of MR imaging in predicting clinical outcome. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. (2019) AJR. 2022 May;40 (5):443-457. doi: 10.1007/s11604-021-01224 Subchondral insufficiency fracture of the knee is eCollection 2020 Jun. Clipboard, Search History, and several other advanced features are temporarily unavailable. HHS Vulnerability Disclosure, Help J Bone Joint Surg Br. A recognizable soft tissue edema pattern is seen in SIFK and may have an important role in early diagnosis. Jpn J Radiol. 2021 May 19;3(3):100183. doi: 10.1016/j.ocarto.2021.100183. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. 2000;82(6):85866. Magnetic resonance imaging reveals extensive bone marrow edema and subchondral bone collapse on the medial compartment of the femoral and tibial surface where grade 4 chondral loss is present. 2009;17 (9): 1115-31. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Jpn J Radiol. Edema pattern of bones. The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature. Data were analyzed for gender distribution and for association between each imaging finding as a predictor of SIFK location and progression. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Jpn J Radiol. To propose an magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to 18. Epub 2021 Nov 29. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. Gender distribution was 1:1 (males=38, females=36), most common in the 6th decade (29/74, 39%). Bethesda, MD 20894, Web Policies Please enable it to take advantage of the complete set of features! MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES). Am J Sports Med. 15. Associated features that may predict prognosis include: associated meniscal tear and degree of extrusion. Primary: to describe the presence and pattern of soft tissue edema in subchondral insufficiency fractures of the knee (SIFK). Spontaneous osteonecrosis of the knee. Magnetic resonance imaging reveals extensive bone marrow edema and subchondral bone collapse on the medial compartment of the femoral and tibial surface where grade 4 chondral loss is present. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. J Bone Joint Surg. PMC 8. Bone density was subnormal in five of the six patients. Patients with subchondral insufficiency fracture Bookshelf -, Karim AR, et al. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Keywords: 2020 Nov 19;22:606-611. doi: 10.1016/j.jor.2020.11.014. Subchondral sclerosis is a disease that affects the bones and specifically the joints, of people who have osteoarthritis.Subcrondal sclerosis causes joint pain and numbness due to increased bone density and mass, producing a thin layer of bone beneath the cartilage in the joints.This disease is chronic and painful, but it is easy to detect and includes several different treatments. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Weerakkody Y, Bickle I, et al. 2021 Jan;12(1):24-30. doi: 10.1177/1947603518809399. 2021 Jan;50(1):189-199. doi: 10.1007/s00256-020-03548-z. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Nicoletti D, Subchondral insufficiency fracture - knee. This site needs JavaScript to work properly. Iowa Orthop J. Takeda M, Higuchi H, Kimura M et-al. Subchondral insufficiency fractures are typically found in older female patients with increased bone fragility. Pathology. North Am. Objective: To propose an magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to predict outcome and assess risk factors. 10. Bone marrow edema; Chondrosis; Insufficiency fracture of the knee; Meniscus; Spontaneous osteonecrosis of the knee; Stress fracture of the knee. Narvez JA, Narvez J, De Lama E et-al. HHS Vulnerability Disclosure, Help ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. government site. FOIA Cartilage. 9. MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined. government site. Abstract Objective: To assess the relationship between low- and high-grade subchondral insufficiency fracture of the knee (SIFK) and meniscal tear/type/location, severity of meniscal 2020 Dec;2(4):100089. doi: 10.1016/j.ocarto.2020.100089. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses Jpn J Radiol. 2009;40 (2): 193-211. Unable to load your collection due to an error, Unable to load your delegates due to an error. Subchondral insufficiency fractures of the hip have been identified as a cause of accelerated osteoarthritis . An official website of the United States government. Mears SC, McCarthy EF, Jones LC et-al. Extensive bone marrow edema and subchondral bone collapse on both femoral and tibial surface medial compartment. Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. Broida SE, Wong PK, Umpierrez E, Kakarala A, Reimer NB, Gonzalez FM. An access path is mapped to a location in the subchondral region where the insufficiency fracture resides. Orthop. Recognizing that spontaneous osteonecrosis of the knee was a misnomer and actually represents a subchondral insufficiency fracture that progressed to subchondral collapse with secondary osteonecrosis,the Society of Skeletal Radiology Subchondral Bone Nomenclature Committee recommended that "subchondral insufficiency fracture" be the preferred term 17. Results: Subchondral fractures are usually a consequence of compressive forces, transmitted from the cartilage to the subchondral bone plate and from there to the sharing sensitive information, make sure youre on a federal Prognostic factors associated with a subchondral insufficiency fracture of the femoral head. Subchondral insufficiency fracture usually occurs in association with degenerative joint lesions, including involvement of the meniscus and/or cartilage (2,4-8). Osteonecrosis of the knee: review. official website and that any information you provide is encrypted The entity subsumes that previously known as spontaneous osteonecrosis of the knee (SONK/SPONK) or Ahlbck disease. Osteonecrosis of the knee: a review of three disorders. Our retrospective study included 219 patients with knee pain and SIFK seen on MRI. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Careers. Skeletal Radiol. Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. Federal government websites often end in .gov or .mil. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. Br J Radiol 2012;85(1011):214218. and transmitted securely. Bethesda, MD 20894, Web Policies Case Discussion. Check for errors and try again. Follow up examinations were reviewed to assess for progression. Knee. Gorbachova T, Amber I, Beckmann NM, Bennett DL, Chang EY, Davis L, Gonzalez FM, Hansford BG, Howe BM, Lenchik L, Winalski CS, Bredella MA. Clin. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Epub 2019 Jan 31. Case study, Radiopaedia.org (Accessed on 05 Dec 2022) https://doi.org/10.53347/rID-88093 Pareek A, Parkes CW, Bernard C, Camp CL, Saris DBF, Stuart MJ, Krych AJ. Prevalence of undiagnosed subchondral insufficiency fractures of the knee in middle age adults with knee pain and suspected meniscal tear Jamie L.Huizingaa NehalShahbc Stacy E.Smithbcd Anthony Notinoe Melissa A.Kluczynskie KellyJordane Leslie J.Bissone Antonia F.Chenf FaithSelzeracf ElenaLosinaacfgh Jeffrey N. Katzacfh By definition,secondary osteonecrosis of the knee occurs secondary to an insult. Would you like email updates of new search results? It should be suspected in the appropriate clinical setting, as in early stages it is usually indistinct on initial plain radiographs and magnetic resonance imaging is required for a definitive diagnosis. 2016 Nov;85(11):2096-2103. doi: 10.1016/j.ejrad.2016.08.016. Treatment can either be operative or non-operative, with initial treatment often conservative and consisting of analgesia and protected weight bearing. 7. 12. Subchondral insufficiency fractures are slowly healing fractures of the bone situated immediately below the cartilage of a joint. Knee Surg Sports Traumatol Arthrosc. Diagnosis and differential diagnosis in patients with knee pain. 2019 Dec;48(12):1961-1974. doi: 10.1007/s00256-019-03245-6. Subchondral insufficiency fracture - knee. Objective To assess the relationship between low- and high-grade subchondral insufficiency fracture of the knee (SIFK) and meniscal tear/type/location, severity of meniscal extrusion, grade of chondrosis, and extent of surrounding edema-like marrow signal intensity. 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