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Avascular necrosis of tibia with pathological fracture

Case contributed by Paul Leong
Diagnosis certain

Presentation

Acute pain left knee

Patient Data

Age: 50 years
Gender: Male

Depressed fracture of the medial tibial plateau.

There is an underlying lesion, which demonstrates a sclerotic margin, with central lucency. This lesion demonstrates a narrow zone of transition. There is associated thick irregular periosteal reaction. 

Small knee joint effusion.

Subchondral lesion within the medial tibial plateau, with thick sclerotic margin, central lucency as well as dystrophic calcification.

There is an associated pathological depressed fracture of the medial tibial plateau.

Findings suggestive of osteonecrosis, with associated pathological fracture. 

Case Discussion

Percutaneous biopsy demonstrated "bone with focal areas of necrosis", which confirms the diagnosis of osteonecrosis.

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