A recognizable soft tissue edema pattern is seen in SIFK and may have an important role in early diagnosis. [Relevance of different sequences in MRI-detected subchondral bone damage of the knee joint and possible therapeutic options]. 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. Ramnath RR, Kattapuram SV. Careers. Copyright 2016 Elsevier Ireland Ltd. All rights reserved. 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 government site. Objective: North Am. 2013;21 (2): 340-5. ADVERTISEMENT: Supporters see fewer/no ads. To propose an magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to Allam E, Boychev G, Aiyedipe S, Morrison W, Roedl JB, Singer AD, Gonzalez FM. (2019) AJR. This site needs JavaScript to work properly. Yates PJ, Calder JD, Stranks GJ et-al. Osteoarthr Cartil Open. Careers. Careers. The .gov means its official. 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. PMC [Concomitant occult osseous injuries in knee joint injuries]. Clin. 8600 Rockville Pike J Bone Joint Surg Am. Case study, Radiopaedia.org (Accessed on 05 Dec 2022) https://doi.org/10.53347/rID-88093 18. 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). Disclaimer, National Library of Medicine Knee. Lotke PA, Nelson CL, Lonner JH. Typical MRI findings in insufficiency fractures include a pattern of bone marrow edema with a low-signal-intensity line (resp. 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 eCollection 2021 Sep. Husain R, Nesbitt J, Tank D, Verastegui MO, Gould ES, Huang M. J Orthop. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Unable to process the form. Clin. eCollection 2020 Nov-Dec. Roemer FW, Collins J, Kwoh CK, Hannon MJ, Neogi T, Felson DT, Hunter DJ, Lynch JA, Guermazi A. Osteoarthritis Cartilage. North Am. MeSH Our retrospective study included 219 patients with knee pain and SIFK seen on MRI. ADVERTISEMENT: Supporters see fewer/no ads. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Before physiologic limits of normal bone. 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 Bookshelf Before (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. Orthop. Narvez JA, Narvez J, De Lama E et-al. Skeletal Radiol. 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. 6. and transmitted securely. Broida SE, Wong PK, Umpierrez E, Kakarala A, Reimer NB, Gonzalez FM. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. An official website of the United States government. Keywords: {"url":"/signup-modal-props.json?lang=gb\u0026email="}, Kabra U, Subchondral insufficiency fracture of the knee. The https:// ensures that you are connecting to the Cartilage. Also, SIFK may affect equally males and females in the 6th decade and may progress more in females. Accessibility One of the important differential diagnoses of subchondral insufficiency fractures of the femoral head may include osteonecrosis. By definition,secondary osteonecrosis of the knee occurs secondary to an insult. Edema pattern of bones. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Epub 2018 Oct 31. Eur Radiol. 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 insufficiency fractures of the knee: review of imaging findings. 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 Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Patients with subchondral insufficiency fracture characteristically Jerosch J, Castro WH, Lahm A, Assheuer J. Sportverletz Sportschaden. Skeletal Radiol. -. Skeletal Radiol. official website and that any information you provide is encrypted 2009;17 (9): 1115-31. Subchondral insufficiency fracture of the knee is Arthritis Rheum. AJR Am J Roentgenol. 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. 15. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Unable to process the form. Kabra U, Subchondral insufficiency fracture of the knee. Subchondral insufficiency fractures of the knee is also known as spontaneous osteonecrosis of the knee (SONK). Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty. 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. Subchondral insufficiency fractures are typically found in older female patients with increased bone fragility. Joint diseases; bone fractures; knee; magnetic resonance imaging (MRI); osteopenia. 2008 Mar;22(1):38-44. doi: 10.1055/s-2008-1027232. The pain typically subchondral stress/fatigue fracture: overuse injuries in patients without associated risk factors 17. SIFK lesions were categorized from grade 1 to 4 with a low grade (1 and 2) vs high grade (3 and 4) distinction. Pareek A, Parkes CW, Bernard C, Camp CL, Saris DBF, Stuart MJ, Krych AJ. Check for errors and try again. Prognosis varies from complete recovery to total joint collapse 2. 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). Epub 2019 Sep 9. sharing sensitive information, make sure youre on a federal Risk factors osteoporosis 4 osteoarthritis 4 Lateral femoral condyle insufficiency fractures: imaging findings, demographics, and analysis of outcomes. 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. Subchondral insufficiency fracture usually occurs in association with degenerative joint lesions, including involvement of the meniscus and/or cartilage (2,4-8). In more advanced cases, subchondroplasty (where a bone substitute is injected) may be considered. Methods: 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. The clinical records were reviewed for age, gender, and BMI. Federal government websites often end in .gov or .mil. Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. -, Karim AR, et al. Subchondral fractures due to trauma can occur at any age. 2020 May 6;102(9):821-829. doi: 10.2106/JBJS.19.00381. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses Jpn J Radiol. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Jpn J Radiol. 2007;14 (2): 112-6. 2018 May;102:115-124. doi: 10.1016/j.ejrad.2018.03.007. FOIA 8600 Rockville Pike -, Hussain ZB, et al. MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES). Conclusion: 2022 May; 40 (5):443-457. 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. It should be suspected in Pareek A, Parkes CW, Bernard C, Camp CL, Saris DBF, Stuart MJ, Krych AJ. 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. FOIA Case study, Radiopaedia.org (Accessed on 05 Dec 2022) https://doi.org/10.53347/rID-88093 The site is secure. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. The purpose of this paper is to review the clinical presentation, pathophysiology, image findings, complications and outcome of SIFK. 2010;29: 38-42. Radiol Med. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Sclerosis of the medial tibial plate with reduction of the joint space of the same side. Osteoarthr Cartil Open. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Jpn J Radiol. ADVERTISEMENT: Supporters see fewer/no ads. FOIA 2000;82(6):85866. 2015 Jun;56(6):714-9. doi: 10.1177/0284185114535132. Epub 2018 Mar 6. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. 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%). The site is secure. Epub 2016 Aug 26. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. and transmitted securely. Would you like email updates of new search results? Primary: to describe the presence and pattern of soft tissue edema in subchondral insufficiency fractures of the knee (SIFK). 2020 Jan;28(1):71-81. doi: 10.1016/j.joca.2019.08.005. 12. 1. 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. Significant surrounding marrow oedema is seen. An official website of the United States government. Lahm A, Spank H, Mrosek E, Frauendorf H, Merk H. Sportverletz Sportschaden. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. 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). Spontaneous osteonecrosis of the knee (SONK): The role of MR imaging in predicting clinical outcome. A reinforcing member that stabilizes the insufficiency fracture is Osteonecrosis of the knee: a review of three disorders. Epidemiology Subchondral insufficiency fractures are more common in elderly women 1,4,6. Kabra U, Subchondral insufficiency fracture of the knee. Epub 2020 Aug 19. Subchondral hypointense fracture lines tend to resolve with conservative therapy. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-2079. 2019 Dec;48(12):1961-1974. doi: 10.1007/s00256-019-03245-6. 3. Subchondral insufficiency fractures of the knee is also known as spontaneous osteonecrosis of the knee (SONK). government site. Sclerosis of the medial tibial plate with reduction of the joint space of the same side. Extensive bone marrow edema and subchondral bone collapse on both femoral and tibial surface medial compartment. Before 2021 Jan;50(1):189-199. doi: 10.1007/s00256-020-03548-z. Bjrkengren AG, Alrowaih A, Lindstrand A et-al. eCollection 2021 Sep. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Disclaimer, National Library of Medicine North Am. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Subchondral Fracture, Knee Accessibility official website and that any information you provide is encrypted Spontaneous osteonecrosis of the knee: tibial plateaus. The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav. 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 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. Swamy N, Wadhwa V, Bajaj G, Chhabra A, Pandey T. Eur J Radiol. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. 2020 May 6;102(9):821-829. doi: 10.2106/JBJS.19.00381. An access path is mapped to a location in the subchondral region where the insufficiency fracture resides. Spontaneous osteonecrosis of the knee: histopathological differences between early and progressive cases. By definition,secondary osteonecrosis of the knee occurs secondary to an insult. Skeletal Radiol. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Husain R, Nesbitt J, Tank D, Verastegui MO, Gould ES, Huang M. J Orthop. 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. Epub 2019 Jun 27. 2021 May 19;3(3):100183. doi: 10.1016/j.ocarto.2021.100183. 2021;40(5):443-57. Early S, Trico LEP, Pulido PA, McCauley JC, Bugbee WD. 16. 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 MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. The .gov means its official. Nomenclature of Subchondral Nonneoplastic Bone Lesions. Jose J, Pasquotti G, Smith MK, Gupta A, Lesniak BP, Kaplan LD. Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. Objective: Primary: to describe the presence and pattern of soft tissue edema in subchondral insufficiency fractures of the knee (SIFK). Unable to process the form. 4. Long-Term Retrospective Follow-Up of Fresh Osteochondral Allograft Transplantation for Steroid-Associated Osteonecrosis of the Femoral Condyles. The patients are usually over 50 and have a sudden, non traumatic onset of severe knee pain that Ann Transl Med. Pathology. J Bone Joint Surg Am. Case Discussion. 2019 Dec;48(12):1961-1974. doi: 10.1007/s00256-019-03245-6. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. 2016 Nov;85(11):2096-2103. doi: 10.1016/j.ejrad.2016.08.016. Bethesda, MD 20894, Web Policies 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. 2015;3(1):6. Please enable it to take advantage of the complete set of features! ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Objective: Ahlback S, Bauer GC, Bohne WH. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-67293. sharing sensitive information, make sure youre on a federal Osteoarthr. Conclusion: Would you like email updates of new search results? Please enable it to take advantage of the complete set of features! 2021 May 19;3(3):100183. doi: 10.1016/j.ocarto.2021.100183. Z Orthop Unfall. 2020 Nov 19;22:606-611. doi: 10.1016/j.jor.2020.11.014. J Bone Joint Surg Br. Federal government websites often end in .gov or .mil. Cartil. ADVERTISEMENT: Supporters see fewer/no ads. 2022 May;40 (5):443-457. doi: 10.1007/s11604-021-01224 An official website of the United States government. 1968;11(6):70533. 8. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. Secondary: to investigate the gender distribution and identify factors associated with disease progression. Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb. PMC Perspective on subchondral insufficiency fracture of the knee. Extensive bone marrow edema and subchondral bone collapse on both femoral and tibial surface medial compartment. Subchondral insufficiency fracture of the knee: A recognizable associated soft tissue edema pattern and a similar distribution among men and women. 2004;35 (3): 293-303, viii. This site needs JavaScript to work properly. 2008;90 (3): 324-9. Background:Anterior cruciate ligament (ACL) reconstruction is performed commonly, with a low risk of complication. official website and that any information you provide is encrypted Materials and methods Our retrospective study included 219 patients with knee pain and SIFK 9. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Nicoletti D, Subchondral insufficiency fracture - knee. Orthop. Abstract Subchondral insufficiency fracture of the knee (SIFK) is a potentially devastating disorder that may progress rapidly to osteoarthritis with articular surface collapse. Check for errors and try again. PMC Medial meniscal extrusion: Detection, evaluation and clinical implications. Edema extended to the vastus medialis fascia in 51% (38/74) and vastus lateralis fascia in 24% (18/74). Crossref, Medline, Google Scholar; 22. 2009;114 (3): 437-47. 2021 Nov;50(11):2185-2194. doi: 10.1007/s00256-021-03777-w. Epub 2021 Apr 17. Unable to load your collection due to an error, Unable to load your delegates due to an error. 17. Early MRI diagnosis and non-surgical management of spontaneous osteonecrosis of the knee. Li CQ, Chen W, Rosenberg JK, et al. Bethesda, MD 20894, Web Policies 2008 May-Jun;146(3):381-91. doi: 10.1055/s-2008-1038369. Characterization and pathological characteristics of spontaneous osteonecrosis of the knee. 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. Imaging of early stages of osteonecrosis of the knee. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Results: [HYPERLINK] Knee MRI checklist, meniscus, tear, ACL, PCL, MCL, LCL, Extensor mec {"url":"/signup-modal-props.json?lang=us\u0026email="}, Nicoletti D, Subchondral insufficiency fracture - knee. eCollection 2020 Nov-Dec. Farrell TP, Deely DM, Zoga AC, McClure KE. The .gov means its official. Keywords: Subchondral insufficiency fractures are slowly healing fractures of the bone situated immediately below the cartilage of a joint. Iowa Orthop J. Unable to load your collection due to an error, Unable to load your delegates due to an error. Soft tissue edema was present in 89% (66/74) of SIFK. eCollection 2020 Jun. 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 American journal of roentgenology. 2004;35 (3): 365-70, x. Osteonecrosis of the knee: review. Acta Radiol. Jpn J Radiol. MeSH Unable to load your collection due to an error, Unable to load your delegates due to an error. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. Treatment can either be operative or non-operative, with initial treatment often conservative and consisting of analgesia and protected weight bearing. Prevalence of Undiagnosed Subchondral Insufficiency Fractures of the Knee in Middle Age Adults with Knee Pain and Suspected Meniscal Tear. 5. The term insufficiency fracture is often applied to subchondral bone changes seen on knee magnetic resonance images (MRIs) (Figure 1). 2020 Nov 19;22:606-611. doi: 10.1016/j.jor.2020.11.014. Bethesda, MD 20894, Web Policies Epub 2021 Nov 29. Would you like email updates of new search results? 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. 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 Fotiadou A, Karantanas A. Meniscal extrusion may predispose to disease progression. Subchondral insufficiency fracture of the knee typically affects individuals that are 55 or older and presents with sudden non traumatic unilateral knee pain. Findings are suggestive of subchondral insufficiency of the medial femoral condyle, previously known as spontaneous osteonecrosis of the knee (SONK). This site needs JavaScript to work properly. Bone marrow edema; Chondrosis; Insufficiency fracture of the knee; Meniscus; Spontaneous osteonecrosis of the knee; Stress fracture of the knee. Epub 2021 Nov 29. Please enable it to take advantage of the complete set of features! Diagnosis and differential diagnosis in patients with knee pain. Takeda M, Higuchi H, Kimura M et-al. 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. Associated features that may predict prognosis include: associated meniscal tear and degree of extrusion. You can use Radiopaedia cases in a variety of ways to help you learn and teach. Subchondral insufficiency fracture - knee. J Bone Joint Surg Am. Acute nontraumatic adult knee pain: the role of MR imaging. Skelet Radiol. Gorbachova T, Amber I, Beckmann NM, Bennett DL, Chang EY, Davis L, Gonzalez FM, Hansford BG, Howe BM, Lenchik L, Winalski CS, Bredella MA. The https:// ensures that you are connecting to the {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Weerakkody Y, Bickle I, et al. HHS Vulnerability Disclosure, Help and transmitted securely. 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. 2. Pape D, Seil R, Kohn D et-al. The entity subsumes that previously known as spontaneous osteonecrosis of the knee (SONK/SPONK) or Ahlbck disease. 1 The prognosis may range from full recovery to rapidly escalating joint destruction. 14. Accessibility Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Jpn J Radiol. government site. -, Sayyid S, et al. 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. Subchondral insufficiency fracture of the knee. 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 MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined. Materials and methods: Clipboard, Search History, and several other advanced features are temporarily unavailable. SIFK is a type of stress fracture that occurs when repetitive and excessive stress is applied to the subchondral bone. Skeletal Radiol. Skeletal Radiol. Keywords: 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. Epub 2019 Jun 27. Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Subchondral Insufficiency Fracture of the Knee: Review of Current Concepts and Radiological Differential Diagnoses. 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. Disclaimer, National Library of Medicine J Med Case Reports 2008;2(1):79. Wilmot AS, Ruutiainen AT, Bakhru PT, Schweitzer ME, Shabshin N. Eur J Radiol. Unable to process the form. Clin. Jpn J Radiol. Knee Surg Sports Traumatol Arthrosc. Insufficiency fracture; Knee; Meniscus; Osteoarthritis; Spontaneous osteonecrosis of the knee. Secondary: to investigate the gender distribution 213 (5): 963-982. 48 (12): 1961-1974. 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. 2021 Jan;12(1):24-30. doi: 10.1177/1947603518809399. Epub 2014 Jun 11. Epub 2021 Nov 29. Federal government websites often end in .gov or .mil. 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. Am J Sports Med. HHS Vulnerability Disclosure, Help 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. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-67293. 2020 Dec;2(4):100089. doi: 10.1016/j.ocarto.2020.100089. 2019;48(12):196174. 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). -, Yamamato T, Bullough PG. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. Spontaneous osteonecrosis of the knee. Features can vary depending on the stage and are best characterized on T2-weighted and proton density-weighted sequences. Yamamoto T, Bullough PG. Mears SC, McCarthy EF, Jones LC et-al. Subchondral insufficiency fracture of the knee. 2019;47(2):5017. The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature. Orthop. These are typically located in the medial femoral condyle or medial tibial plateau. 1991 Dec;5(4):193-8. doi: 10.1055/s-2007-993587. Patients with subchondral insufficiency fracture characteristically A subchondral fracture is a fracture of the trabecular cancellous bone just beneath the subchondral bone plate without disruption of the articular surface 1. Gurdezi S, Trehan RK, Rickman M. Bilateral undisplaced insufficiency neck of femur fractures associated with short-term steroid use: a case report. Huizinga JL, Shah N, Smith SE, Notino A, Kluczynski MA, Jordan K, Bisson LJ, Chen AF, Selzer F, Losina E, Katz JN. 7. fracture) on the T1-weighted images parallel to the subchondral bone. Gender distribution was 1:1 (males=38, females=36), most common in the 6th decade (29/74, 39%). Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation: A case report. 1990;154 (2): 331-6. (2019) Skeletal radiology. Osteoarthr Cartil Open. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. JJ Abstract Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. 2009;40 (2): 193-211. HHS Vulnerability Disclosure, Help 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. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-88093. Patients often recall an acute onset of severe pain without significant trauma. Subchondral insufficiency fractures of the hip have been identified as a cause of accelerated osteoarthritis . sharing sensitive information, make sure youre on a federal [Acute, traumatic versus chronic cartilage lesions as terms of a medical expert's opinion]. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. Perspective on subchondral insufficiency fracture of the knee. Epub 2020 Jul 22. The site is secure. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. The access path attempts to preserve an articular surface of the joint. Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. Epub 2019 Jan 31. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. Zywiel MG, Mcgrath MS, Seyler TM et-al. Case Discussion. J Bone Joint Surg. Bone density was subnormal in five of the six patients. Subchondral fractures are usually a consequence of compressive forces, transmitted from the cartilage to the subchondral bone plate and from there to the Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Subchondral insufficiency fracture of the knee: unicompartmental correlation to meniscal pathology and degree of chondrosis by MRI. Check for errors and try again. Clipboard, Search History, and several other advanced features are temporarily unavailable. Prognostic factors associated with a subchondral insufficiency fracture of the femoral head. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty. Breer S, Oheim R, Krause M et-al. Data were analyzed for gender distribution and for association between each imaging finding as a predictor of SIFK location and progression. Check for errors and try again. 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. Subchondral insufficiency fracture - knee. Br J Radiol 2012;85(1011):214218. It was first systematically described by Ahlbck in 1968 2. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2019 Jul;48(7):1011-1021. doi: 10.1007/s00256-019-3160-4. Spontaneous osteonecrosis of the knee: value of MR imaging in determining prognosis. Results: 8600 Rockville Pike 2000;82 (6): 858-66. Link to case: https://radiopaedia.org/cases/subchondral-insufficiency-fracture-of-the-knee-8?lang=us Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. Roemer FW, Frobell R, Hunter DJ et-al. 2004;33 (10): 575-81. 11. The https:// ensures that you are connecting to the High-grade SIFK lesions are associated with unicompartmental high-grade chondrosis. There is subchondral linear T1/PD/PD fatsat hypointensity parallel to the overlying cortex. Follow up examinations were reviewed to assess for progression. Bookshelf 2003;13 (8): 1843-8. Spontaneous osteonecrosis of the knee (SONK). Patients with subchondral insufficiency fracture ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Bookshelf Radiol Case Rep. 2020 Apr 5;15(6):691-696. doi: 10.1016/j.radcr.2020.02.034. MeSH 10. 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