Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-67293. The methods involve treating the subchondral bone, while preserving, as much as possible, the joint's articular and cartilage surface. AJR Am J Roentgenol. 2. She was treated with partial weight bearing on crutches until 14 months after the injury, viscosupplementation at 4 months to treat osteoarthritis and teriparatide treatment to improve bone healing at 7 months. We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. The typical findings of subchondral insufficiency fracture of the knee on magnetic resonance imaging (MRI) include cortical thickening associated with high-intensity Original Article SONK is now categorized as an advanced SIFK lesion in the spectrum of this disease, and some authors believe the term "SONK" is a misnomer. 1996;63:859861. 9. 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 affecting older adults. Skeletal Radiol. Differentiating subchondral insufficiency fracture from osteonecrosis may help avoid unnecessary total hip arthroplasty Effects of Gastrocnemius Recession on Ankle Motion, Strength, and Functional . Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. 2012;4:173180. Subchondral insufficiency fracture of the knee typically affects individuals that are 55 or older and presents with sudden non traumatic unilateral knee pain. The patient successfully recovered and returned to full athletic function, having recently returned to competitive marathon running. It was first systematically described by Ahlbck in 1968 2. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. Ramnath RR, Kattapuram SV. An official website of the United States government. Subtle bone marrow edema-like signal intensity can be observed around the cyst (asterisk). Am J Sports Med. Subchondral fractures were defined as T1-T2 hypointense signal intensity changes, usually in the form of a line paralleling the articular surface. Figure 2 A and B. 2007;14 (2): 112-6. Results: Forty-one patients were included in the study (21 males, 20 females). Orthopedics 2005;28:236,333-336. . Case study, Radiopaedia.org (Accessed on 05 Dec 2022) https://doi.org/10.53347/rID-88093 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 affecting older adults. MRI plays a significant role in the early diagnosis of SIFK. Broida SE, Wong PK, Umpierrez E, Kakarala A, Reimer NB, Gonzalez FM. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. 2020 May 6;102(9):821-829. doi: 10.2106/JBJS.19.00381. Diagnosis is radiographic for advanced disease but requires MRI for detection of early or . Epub 2020 Aug 19. Breast MRI during pregnancy and lactation: clinical challenges and technical advances. 2021 Sep 3;2021:6622445. doi: 10.1155/2021/6622445. Treatment can either be operative or non-operative, with initial treatment often conservative and consisting of analgesia and protected weight bearing. Rapid Destructive Arthropathy of the Knee in Parkinson's Disease with Pisa Syndrome: A Case of Knee-Spine Syndrome. Epub 2022 Jan 30. doi: 10.1007/s00256-019-3160-4. 2016 Nov;85(11):2096-2103. doi: 10.1016/j.ejrad.2016.08.016. 2000 Jul;8(4):303-8 A diagnosis of AS involving the symphysis pubis was established, and she was started on tumor necrosis factor alpha blocker Adalimumab 0.8 ml subcutaneous injection every 2 weeks. Perspective on subchondral insufficiency fracture of the knee. 48 (12): 1961-1974. Spontaneous Osteonecrosis/Subchondral Insufficiency Fractures of the Knee: High Rates of Conversion to Surgical Treatment and Arthroplasty. 2019;48:10111021. Check for errors and try again. Please enable it to take advantage of the complete set of features! Recently, the MRI has become more popular and is an important diagnostic tool in differentiating femoral stress fractures, particularly distal shaft fractures, from other hip- and knee-related pain.1,2,13 An MRI is often ordered either in conjunction with a bone scan13 or separately20,21 due to its ability to precisely pinpoint the location of . Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. Unable to process the form. 2021 Sep 6;9(25):7445-7452. doi: 10.12998/wjcc.v9.i25.7445. 2004;35 (3): 365-70, x. . Methods Insufficiency fracture s are a type of stress fracture, which are the result of normal stresses on abnormal bone [1] . official website and that any information you provide is encrypted Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review. this study, subchondral insufficiency fracture has been increasingly studied, including the identification of risk factors and associated lesions (3). 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 subchondral cancellous bone. Before Pape D, Seil R, Kohn D et-al. -. Would you like email updates of new search results? Epub 2018 Aug 17. sharing sensitive information, make sure youre on a federal pt Meniscus injury - Fibrous cartilage in the knee that sustains injury usually from sports - CMs >> Mild swelling, pain on flexion, pop click - Dgx - Arthrogram/ arthroscopy with mri prior - Tx/Nx- Surgery >>arthroscopic . The patient is a 75-year-old male, recreational . Skelet Radiol. -, Lee S, Saifuddin A. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow oedema and subchondral bone collapse. Accessibility 2015 Jun;56(6):714-9. doi: 10.1177/0284185114535132. For example, using T2-weighted MRI images, bone marrow lesions or edemas can be identified, and using T1-weighted MRI images, associated regions of sclerotic bone adjacent to the bone marrow lesion can be identified. Clin. Careers. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Wen PF, Guo WS, Zhang QD, et al. Subchondral insufficiency fractures of the femoral head (SIFFH) are a cause of femoral head collapse leading to degenerative hip disease. Epub 2014 Feb 6. van der Heijden L, van de Sande MA, Heineken AC, Fiocco M, Nelissen RG, Dijkstra PD. 2021 Nov;50(11):2185-2194. doi: 10.1007/s00256-021-03777-w. Epub 2021 Apr 17. ADVERTISEMENT: Supporters see fewer/no ads. MRI of a 73-year-old female patient with SIFK in the medial femoral condyle of the right knee. -, Invest Radiol. The presence of metaphyseal burst sign was evaluated in the cohort. The majority of SIFK lesions were low-grade (LG; 78%) and most of them (70%) were observed in the medial femoral condyle. Narvez JA, Narvez J, De Lama E et-al. A grading system was introduced that classifies lesions as low- vs high-grade. 41, 10/2002. Surgical outcome of atypical subtrochanteric and femoral fracture related to bisphosphonates use in osteoporotic patients with or without teriparatide treatment. Most common forms are osteoarthritis (OA) and rheumatoid arthritis (RA). Epidemiology Subchondral insufficiency fractures are more common in elderly women 1,4,6. 2022 May;40(5):443-457. doi: 10.1007/s11604-021-01224-3. Allam E, Boychev G, Aiyedipe S, Morrison W, Roedl JB, Singer AD, Gonzalez FM. The patient complained of knee pain, MeSH Conclusion: Clipboard, Search History, and several other advanced features are temporarily unavailable. Bookshelf 10. 2022 Apr 9;13(1):71. doi: 10.1186/s13244-022-01214-7. 5. 2020 Oct;39(10):3105-3113. doi: 10.1007/s10067-020-05181-6. Bullough PG: Spontaneous osteonecrosis of the knee: The result of subchondral insufficiency fracture. These mechanisms can cause this class offemur fracture. Huizinga JL, Shah N, Smith SE, Notino A, Kluczynski MA, Jordan K, Bisson LJ, Chen AF, Selzer F, Losina E, Katz JN. Lesion location 3D dimensions, extent of bone marrow edema (BME), location of meniscal tears and associated extrusion, degree of chondrosis and among other parameters were stratified according to lesion grade and compared with follow-up examinations. SIFK is a type of stress fracture that occurs when repetitive and excessive stress is applied to the subchondral bone. 12. 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. Improvement of BME on follow-up was highly predictive of low-grade disease. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses Jpn J Radiol. Subchondral insufficiency fracture of the femoral head. 2008;90 (3): 324-9. Reply to the letter to the editor: rapid progression of joint deformity after subchondral insufficiency fracture of the knee with medial meniscal root tear. Subchondral insufficiency fracture - knee. Subchondral Stress Fracture of the Femoral Head Fig. Davies M, Cassar-Pullicino VN, Darby AJ. North Am. a A sagittal T2WI shows necrotic areas, Frequent sites of OCD. Epub 2014 Jun 11. These are typically located in the medial femoral condyle or medial tibial plateau. subchondral bone, under arthroscopic control, with good results in pain reduction and a small risk of complica-tions [33, 34]. Characterization and pathological characteristics of spontaneous osteonecrosis of the knee. 2000 Oct;35(10):581-8 doi: 10.1177/0363546517743734. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. What is subchondral insufficiency fracture of the knee? Osteonecrosis of the knee is a potentially devastating condition and has been obse. Associated devices and instruments for treatment of the subchondral bone are also disclosed. Type 1: Presence of bone marrow signal abnormality of the subchondral plate with associated thickening and surrounding intense marrow edema (osteitis) in the absence of a visible subchondral fracture. Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: The MOST study. ( a) Plain radiographs taken 2 weeks after the onset of both left and right hip pain show linear increased density lesion in both femoral heads and collapse of the right femoral head. The leg opposite the examiner is flexed at the knee and hip and adducted toward the examiner until the pelvis begins to follow. There is diffuse marrow oedema throughout the lateral femoral condyle and a minimal lateral femoral condylar depression (arrow) consistent with a subchondral insufficiency fracture. 2010;29: 38-42. 6. Would you like email updates of new search results? Epub 2016 Aug 26. Knee Surg Sports Traumatol Arthrosc. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow edema and subchondral bone collapse. SIFK is a type of stress fracture that occurs when repetitive and excessive stress is applied to the subchondral bone. Clinically, it presents as a sudden onset of severe knee pain without trauma or in association with only minor trauma. Spontaneous osteonecrosis of the knee: histopathological differences between early and progressive cases. A 72-year-old female patient with knee OA. Subchondral fractures due to trauma can occur at any age. 2022 Jul;40(7):749-750. doi: 10.1007/s11604-022-01248-3. Epub 2019 Jan 31. 1990;154 (2): 331-6. collagen formation: Marfan syndrome, fibrous dysplasia. Clipboard, Search History, and several other advanced features are temporarily unavailable. Jpn J Radiol. Subchondral insufficiency fractures of the femoral head. Background:Anterior cruciate ligament (ACL) reconstruction is performed commonly, with a low risk of complication. An access path is mapped to a location in the subchondral region where the . 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 extrusion, grade of chondrosis, and extent of surrounding edema-like marrow signal intensity. Before FOIA sharing sensitive information, make sure youre on a federal Wilmot AS, Ruutiainen AT, Bakhru PT, Schweitzer ME, Shabshin N. Eur J Radiol. A SIFK grading system for MRI is introduced. The site is secure. Radiol Case Rep. 2020 Apr 5;15(6):691-696. doi: 10.1016/j.radcr.2020.02.034. Fibular head or neck fracture A direct blow to the proximal fibula resulting in a bony contusion or fracture can cause lateral knee pain that presents with or without swelling . By definition,secondary osteonecrosis of the knee occurs secondary to an insult. J Bone Joint Surg Br. 15. 42 10/2003. government site. Radiol Med. Bjrkengren AG, Alrowaih A, Lindstrand A et-al. Rev Rhum Engl Ed. PMC 2003;13 (8): 1843-8. 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. Until now, how a sudden insufficiency fracture of subchondral bone affects the transcriptomic profiles of cartilage in SIFK and OA patients are largely unknown. A subchondral insufficiency fracture is a type of stress fracture that occurs when bone underlying the cartilage in a joint is unable to bear stresses normally subjected to the joint. Subchondral insufficiency fractures are typically found in older female patients with increased bone fragility. Osteoarthr Cartil Open. Spezialisten fr das Kniegelenk (knee joint specialists), Stern Magazine No. What is claimed is: 1.An instrument for controlled delivery of a device to a target area near a defect of a bone, comprising: a guide frame having a plurality of device portals, each portal defining a trajectory, the frame further including visual markers for aligning the guide frame to an anatomical landmark on the bone to be treated; a holder for releasable attachment with the guide frame; R01 AG046294/AG/NIA NIH HHS/United States. We review the clinical and imaging findings, including the anatomy and terminology history of SIFK, as well as its differential diagnoses. 2022 May;40 (5):443-457. doi: 10.1007/s11604-021-01224-3. Spontaneous osteonecrosis of the knee (SONK). This site needs JavaScript to work properly. Sayyid S, Younan Y, Sharma G, Singer A, Morrison W, Zoga A, Gonzalez FM. Subchondral insufficiency fracture of the knee. Subchondral hypointense fracture lines tend to resolve with conservative therapy. -, Plett SK, Hackney LA, Heilmeier U, Nardo L, Yu A, Zhang CA, et al. 8600 Rockville Pike The patients are usually over 50 and have a sudden, non traumatic onset of severe knee pain that Bookshelf and insufficiency or stress fractures. The term insufficiency fracture is often applied to subchondral bone changes seen on knee magnetic resonance images (MRIs) (Figure 1). Cartil. It is important to note that in cases in which insufficiency fractures lead to bone structural col-lapse, subchondral support techniques are inadequate, and thus, the treatment of choice should be bone Coronal (A) and sagittal (B) T2-weighted, fat-suppressed MRI of the right knee 58days after injury. (2019) Skeletal radiology. - Of these, OA is by far the more common, affecting approximately 27 million Americans, whereas an . Acta Radiol. Although plain radiographs may reveal an intra-articular fracture, generally MRI or computed tomography (CT) is needed to delineate the full extent of the injury. Although low bone density may be present concurrently, it is not the. Associated features that may predict prognosis include: associated meniscal tear and degree of extrusion. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. physiologic limits of normal bone. 14. . Yeh WL, Su CY, Chang CW, Chen CH, Fu TS, Chen LH, Lin TY. Abstract 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. Bethesda, MD 20894, Web Policies Materials and methods: A 60-year-old female patient with sarcoidosis who had been treated with steroids for years. -, Osteoarthritis Cartilage. 2016 Nov;85(11):2096-2103. doi: 10.1016/j.ejrad.2016.08.016. Orthop. This type of injury can happen anywhere in the body, and it most often affects the spine and pelvic bones. 2013;21 (2): 340-5. -, Bangil M, Soubrier M, Dubost JJ, Rami S, Carcanagues Y, Ristori JM, et al. A diagnosis of SIF was made by typical MRI findings of SIF. HHS Vulnerability Disclosure, Help The leading cause of insufficiency fractures is osteoporosis a condition that commonly develops after age 50 that . Avascular necrosis of the first metatarsal head in a young female adult: A case report and review of literature. Roemer FW, Frobell R, Hunter DJ et-al. 2015;44:17851794. Breer S, Oheim R, Krause M et-al. MeSH and transmitted securely. Coronal FS-PDWI and T1WI of a 40-year-old female patient in the postpartum period with transient BMES in the right hip. The .gov means its official. 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. Clin Rheumatol. Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. It usually involves the weight-bearing surfaces and most commonly occurs in the central weight-bearing surface of the medial femoral condyle. 2009;17 (9): 1115-31. The other leg remains extended. Left knee demonstraste a SMALL subchondral insufficiency left knee demonstraste a SMALL subchondral insufficiency fracture over the left medial margin of the medial femoral condyle in read more Dr. P. Jyoti Consultant MD MD 13,131 satisfied customers Dear Dr. of Oncology I am confused on what some things mean Before Admission to the Primo Medico medical network, 2017 The classical and extended classical types both account for 75% of OCD. Osteonecrosis of the knee: a review of three disorders. FOIA Arthroplast Today. Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. ), or their login data. You can use Radiopaedia cases in a variety of ways to help you learn and teach. J Bone Joint Surg Am. 2021 Nov;50(11):2185-2194. doi: 10.1007/s00256-021-03777-w. Epub 2021 Apr 17. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 1 The prognosis may range from full recovery to rapidly escalating joint destruction. Check for errors and try again. BMC Musculoskelet Disord. FOIA Ochi J, Nozaki T, Nimura A, Yamaguchi T, Kitamura N. Subchondral Insufficiency Fracture of the Knee: Review of Current Concepts and Radiological Differential Diagnoses. 2021 Aug 10;26:15-20. doi: 10.1016/j.asmart.2021.07.005. The https:// ensures that you are connecting to the This site needs JavaScript to work properly. Activity/Rest & Sleep: Rheumatoid Arthritis vs. Osteoarthritis & Gout NUR112 - Nursing Care of Clients with Uncomplicated Health Care Needs SUMMER 2013 Arthritis A medical term that literally means joint inflammation. Osteoarthr. Jpn J Radiol. The .gov means its official. 2021;40(5):443-57. These similarities often lead to missed or delayed diagnosis which can often delay or change management. Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation: A case report. ADVERTISEMENT: Supporters see fewer/no ads. A subchondral T2 hypointense line of the affected condyle with extended bone marrow edema-like signal intensity are characteristic findings on MRI. 18. 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. Osteoarthritis of the knee would likely have changes present on the radiograph and no sclerotic lesion would be present. Significance of Lateral Pillar in Osteonecrosis of Femoral Head: A Finite Element Analysis. Disclaimer, National Library of Medicine Epub 2018 Aug 17. Meniscal root tear; Spontaneous osteonecrosis of the knee; Subchondral insufficiency fracture; Subchondral plate. There is also cyst formation in the parent bone (arrowhead). Unable to load your collection due to an error, Unable to load your delegates due to an error. MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. Skeletal Radiol. 2022 Apr;76(2):121-127. doi: 10.18926/AMO/63405. Our retrospective study included 219 patients with knee pain and SIFK seen on MRI. American journal of roentgenology. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. World J Clin Cases. . Images. Plain radiograph of SIFK in a 75-year-old female patient. and transmitted securely. Subchondral insufficiency fractures of the hip have been identified as a cause of accelerated osteoarthritis . Most cases involve the medial femoral condyle, and the lateral femoral condyle is rarely affected. Saucerized defect (arrow) of, MRI of a 50-year-old man with a complaint of sudden left knee pain., MRI of a 73-year-old female patient with SIFK in the medial femoral condyle, Coronal FS-PDWI of a 71-year-old female patient with SIFK in the medial femoral, Coronal and sagittal FS-PDWI of a 79-year-old female patient who complained of a, Coronal FS-PDWI and T1WI of a 40-year-old female patient in the postpartum period, A 60-year-old female patient with sarcoidosis who had been treated with steroids for, A 60-year-old male patient with AVN. sharing sensitive information, make sure youre on a federal Subchondral insufficiency fracture of the knee: A recognizable associated soft tissue edema pattern and a similar distribution among men and women. Predictor variables found to be significantly different between controls and patients were meniscal tear (p = 0.024), location of the medial meniscal tear (p < 0.0001), degree of extrusion (p < 0.0001), chondrosis (p < 0.0001), joint effusion (p < 0.0001), Baker's cyst (p < 0.0001), knee lock (p = 0.03) and buckle (p = 0.01), and history of trauma (p = 0.01). A Case of Subchondral Insufficiency Fracture of the Knee at Lateral Femoral Condyle Treated With Unicompartmental Knee Arthroplasty. Next, the examiner grasps the knee of the adducted leg and palpates the sacroiliac joint with the other hand while exerting resilient axial pressure on the knee. 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. Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome. 2020 Dec;2(4):100089. doi: 10.1016/j.ocarto.2020.100089. Federal government websites often end in .gov or .mil. A reformatted CT coronal image shows multiple lesions with a serpiginous sclerotic border (arrows), which corresponds to lesions of AVN/bone infarction, Frequent sites of OCD. government site. The subchondral bone is key to cartilage and joint health. Subchondral insufficiency fracture of the knee: A recognizable associated soft tissue edema pattern and a similar distribution among men and women. Dgx X-ray to r/o fracture Hx & Ph. Yates PJ, Calder JD, Stranks GJ et-al. Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Subchondral impaction fractures were noted in 5 athletes (1 woman and 4 men) by an experienced musculoskeletal radiologist. Careers. It usually affects the inside of the knee or the medial compartment which bears more stress and may involve the medial condyle of the femur. 2019;47:501507. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. Spontaneous osteonecrosis of the knee associated with tibial plateau and femoral condyle insufficiency stress fracture. 2021 May 19;3(3):100183. doi: 10.1016/j.ocarto.2021.100183. The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature. What is claimed is: 1.A method for treating joint pain comprising: identifying a subchondral defect in a subchondral region of a bone of the joint; selecting a subchondral access path to a location near the subchondral defect; and treating the subchondral defect, via the subchondral access, in a manner that restores normal force distribution and joint function while preserving the articular . Eur Radiol. MRI was performed on the 12th day post-cesarean section for the complaint of severe right hip pain. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-2079, 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). To propose an magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to predict outcome and assess risk factors. summary. SIFK is a type of stress fracture that occurs when repetitive and excessive stress is applied to the subchondral bone. Clin. Nomenclature of Subchondral Nonneoplastic Bone Lesions. Magnetic resonance imaging (MRI) is especially useful in the early stages of the disease, given its high sensitivity to detect bone edema. This article presents a 51-year-old postmenopausal woman, a physician, who had subchondral insufficiency fractures of the knee associated with prolonged standing during clinical work. Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. Takeda M, Higuchi H, Kimura M et-al. Bethesda, MD 20894, Web Policies eCollection 2021 Oct. Asia Pac J Sports Med Arthrosc Rehabil Technol. The 63 best specialists for joints in Germany, FOCUS No. -, Acta Orthop Scand. 2003 Oct 13;163(18):2165-72 -, Clin Imaging. Development and Analysis of Mouse Medial Meniscus Posterior Root Tear Model. Risk factors osteoporosis 4 osteoarthritis 4 Subchondral insufficiency fractures of the knee: review of imaging findings. Objective: OCD rarely occurs in the anterior part of the femur (2%), MRI of a 16-year-old boy with unstable OCD in the medial femoral condyle in the right knee. Acute nontraumatic adult knee pain: the role of MR imaging. 2018 Sep-Oct;38(5):1478-1495. doi: 10.1148/rg.2018180044. 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