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Subchondral insufficiency fracture of the knee with meniscal root tear

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Knee pain. Limp.

Patient Data

Age: 50 years
Gender: Female

Tear of the posterior root medial meniscus with extrusion of the meniscal body. Upper surface horizontal tear of the body lateral meniscus extending to the undersurface of the posterior horn with posterolateral parameniscal cyst formation.

Grade 4 chondral loss on both femoral and tibial surface medial compartment. 

Edema throughout the medial femoral condyle centered on a 10 mm subchondral T1 hypointensity with some cortical depression of the weight-bearing surface.

Case Discussion

Subchondral insufficiency fractures, previously known as spontaneous osteonecrosis of the knee (SONK), are often very painful. In this case, there are associated severe meniscal injuries. 

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