Subchondral insufficiency fracture
Updates to Article Attributes
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.
Pathology
They tend to occur when normal physiological forces are repeatedly applied to an area of bone. Callus formation occurs along with non-mineralised osteoid and the absence of bone infarction.
Risk factors
- osteoporosis
- obesity
- abnormal loading through the joint
- overuse
Location
Typical sites include:
- knee: can progress to spontaneous osteonecrosis of the knee 5
- femoral head
- femoral condyles
- tibial plateau
- metatarsal head
Complications
- secondary osteonecrosis
- osteonecrosis with cavitation (crescent sign)
- articular collapse
- destructive arthropathy
Radiographic features
Plain radiography and CT
Radiographs are normal preceding the development of callus formation or collapse of the articular surface. Linear or patchy subchondral sclerosis may be present representing cancellous fracture.
MRI
-
T1: may be characteristically low signal intensity band through the affected region
- parallels the subchondral bone plate whereas osteonecrosis is curvilinear
- preservation of the articular cartilage whereas an osteochondral defect is involved
- T2: florid marrow oedema
History and etymology
It is described in many regions but the the term subchondral insufficiency fracture of "femoral head" was coined by Bangil et al in 1996 7.
Differential diagnosis
The differential diagnosis of subchondral marrow oedema includes:
See also
-</ul><h4>History and etymology</h4><p>It is described in many regions but the the term subchondral insufficiency fracture of "femoral head" was coined by <strong>Bangil </strong>et al in 1996<sup> 7</sup></p><h4>Differential diagnosis</h4><p>The differential diagnosis of subchondral marrow oedema includes:</p><ul>- +</ul><h4>History and etymology</h4><p>It is described in many regions but the term subchondral insufficiency fracture of "femoral head" was coined by Bangil et al in 1996<sup> 7</sup>.</p><h4>Differential diagnosis</h4><p>The differential diagnosis of subchondral marrow oedema includes:</p><ul>
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