Document Type : Case reports
Authors
1 1- Department of Orthopedics, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran. 2- Bone, Joint, and Related Tissues Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Sport Medicine and Knee Research Center, Milad Hospital, Tehran, Iran
3 1- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2- Joint, Bone, and Connective Tissue Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
4 Tehran University of Medical Sciences, Tehran, Iran
Abstract
Metaphyseal burst sign, which is soft tissue edema in the metaepiphyseal region, is defined as a novel initial sign of subchondral insufficiency fracture of the knee (SIFK). We reported the first Iranian case of the SIFK in femoral medial condyle characterized by a metaphyseal burst sign which could be an early sign of the SIFK. Early diagnosis and treatment could dramatically relieve the sign and symptoms of patients with significant improvement of the MRI scan.
Keywords
- Atoun E, Segal G, Debi R, Lubovsky O, Djabbarov R, Peskin B, Falah M, Mor A, Elbaz A. Gait assessment of patients with spontaneous osteonecrosis of the knee. OsteoarthrCartil. 2016;24(S394).
- Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Osteochondral lesions of the knee: differentiating the most common entities at MRI. Radiographics. 2018; 38(5):1478–1495. doi: 10.1148/rg.2018180044. [PubMed: 30118392].
- Yamamoto T, Bullough PG. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. JBJS. 2000;82(6):858–66. doi: 10.2106/00004623-200006000-00013. [PubMed: 10859106].
- Yamamoto T, Bullough PG. Subchondral insufficiency fracture of the femoral head and medial femoral condyle. SkeletRadiol. 2000; 29(1):40–4. doi: 10.1007/s002560050007. [PubMed: 10663588].
- 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(8): 1843–8. doi: 10.1007/s00330-002-1775-6. [PubMed: 12942284].
- Lotke PA, Nelson CL, Lonner JH. Spontaneous osteonecrosis of the knee: Tibial plateaus. Orthop Clin North Am. 2004; 35(3):365–70. doi: 10.1016/j.ocl.2004.02.009. [PubMed: 15271545].
- Soucacos PN, Xenakis TH, Beris AE, Soucacos PK, Georgoulis A. Idiopathic osteonecrosis of the medial femoral condyle. Classification and treatment. Clin Orthop Relat Res. 1997;(341):82–9. [PubMed: 9269159].
- Pape D, Seil R, Kohn D, Schneider G. Imaging of early stages of osteonecrosis of the knee. Orthop Clin North Am. 2004;35(3):293–303. doi: 10.1016/j.ocl.2004.04.001. [PubMed: 15271537].
- 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(1):53–6. doi: 10.1007/s002560000290. [PubMed: 11289636].
- Hussain ZB, Chahla J, Mandelbaum BR, Gomoll AH, Laprade RF. The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature. Am J Sports Med. 2019;47(2):501-507. doi: 10.1177/0363546517743734. [PubMed: 29253348].
- Sibilska A, Góralczyk A, Hermanowicz K, Malinowski K. Spontaneous osteonecrosis of the knee: what do we know so far? A literature review. Int Orthop. 2020;44(6)1063-69. doi: 10.1007/s00264-020-04536-7. [PubMed: 32249354].
- Yates PJ, Calder JD, Stranks GJ, Conn KS, Peppercorn D, Thomas NP. Early MRI diagnosis and non-surgical management of spontaneous osteonecrosis of the knee. Knee. 2007;14(2):112–6. doi: 10.1016/j.knee.2006.10.012. [PubMed: 17161606].
- Karachalios T, Zibis A, Papanagiotou P, Karantanas AH, Malizos KN, Roidis N. MR imagingfindings in early osteoarthritis of the knee. Eur J Radiol. 2017;50(3):225–30. doi:10.1016/j.ejrad.2004.01.018.
- Griffiths H. Spontaneous osteonecrosis. Orthopedics. 1986;9(4):596, 598–602. [PubMed: 3960793].
- Zywiel MG, McGrath MS, Seyler TM, Marker DR, Bonutii PM, MontMA. Osteonecrosis of the knee: a review of three disorders. Orthop Clin North Am. 2009;40(2):193–211. doi: 10.1016/j.ocl.2008.10.010. [PubMed: 19358905].
- Moosikasuwan JB, Miller TT, Math K, Schultz E. Shifting bone marrow edema of the knee.Skeletal Radiol. 2004;33(7):380–5. doi:10.1007/s00256-004-0783-9. [PubMed: 15138729].
- Karim AR, Cherian JJ, Jauregui JJ, Pierce T, Mont MA. Osteonecrosis of the knee: review. Ann Transl Med. 2015;3(1):6. doi: 10.3978/j.issn.2305-5839.2014.11.13. [PubMed: 25705638].
- Lecouvet FE, van de Berg BC, Maldague BE, LebonCJ, Jamart J, Saleh N et al. Early irreversible osteonecrosis versus transient lesions of the femoral condyles: prognostic value of subchondral bone and marrow changes on MR imaging. AJR Am J Roentgenol. 1998; 170(1):71–7. doi: 10.2214/ajr.170.1.9423603. [PubMed: 9423603].
- Barr MS, Anderson MW. The knee: bone marrow abnormalities. Radiol Clin North Am. 2017;40(5):1109–20. doi: 10.1016/s0033-8389(02)00051-9. [PubMed: 12462471].
- Yang WM, Zhao CQ, Lu ZY, Yang WY, Lin DK, CaoXW. Clinical characteristics and treatment of spontaneous osteonecrosis of medial tibial plateau: a retrospective case study. Chin Med J (Engl). 2018;131(21):2544-50. doi: 10.4103/0366-6999.244113. [PubMed: 30381587].
- Vidoni A, Shah R, Mak D, Beale D, Beale S, James S et al. Metaphyseal burst sign: A secondary sign on MRI of subchondral insufficiency fracture of the knee. J Med Imaging Radiat Oncol. 2018; 62(6):764-8. doi: 10.1111/1754-9485.12781. [PubMed: 30113137].
- 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(9):1115–31. doi: 10.1016/j.joca.2009.03.012. [PubMed: 19358902].
- Kirschner MH, Menck J, Hennerbichler A, Gaber O, Hofmann GO. Importance of arterial blood supply to the femur and tibia for transplantation of vascularized femoral diaphyses and knee joints. World J Surg. 1998;22(8):845–52. doi: 10.1007/s002689900480. [PubMed: 9673557].
- van der Woude JAD, van Heerwaarden RJ, Bleys RLAW. Periosteal vascularization of the distal femur in relation to distal femoral osteotomies: a cadaveric study. J Exp Orthop. 2016;3(1):6. doi: 10.1186/s40634-016-0042-8. [PubMed: 26915006].
- Reddy AS, Frederick RW. Evaluation of the intraosseous and extraosseous blood supply to the distal femoral condyles. Am J Sports Med. 1998;26(3):415–9. doi: 10.1177/03635465980260031201. [PubMed: 9617405].
- Bhatia S, LaPrade CM, Ellman MB, LaPrade RF. Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 2014;42(12):3016–30. doi: 10.1177/0363546514524162. [PubMed: 24623276].
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