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Insights into Imaging
Fig. 20 | Insights into Imaging

Fig. 20

From: Subchondral insufficiency fractures, subchondral insufficiency fractures with osteonecrosis, and other apparently spontaneous subchondral bone lesions of the knee—pathogenesis and diagnosis at imaging

Fig. 20

Evolution in two stages of subchondral insufficiency fracture (SIF). a, b Coronal T1-weighted (a) and sagittal T2-weighted (b) MR images show BME-like signal intensities in medial condyle (asterisks), except for a very thin (< 4 mm in thickness) subchondral low signal intensity area on the T2-weighted image (arrowhead in b). c MRI follow-up three years later with T2-weighted image (c) shows a small deformation of the lower pole of the condyle with thickening of the subchondral low signal intensity area, now exceeding 4 mm in thickness (arrows), suggesting the evolution of the SIF towards osteonecrosis (SIF-ON). d Nine years after the initial examination, a radiograph confirms an irreversible lesion, with deformation of the epiphyseal surface (arrowhead), which is moderate in this case and clinically well tolerated

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