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📌Epiphyseal Collapse (Articular Collapse)
✅ Definition and Terminology
- Collapse Definition: The term "collapse" refers to a fracture of the subchondral bone plate occurring in an atraumatic setting. In the context of acute trauma, the term "osteochondral fracture" is preferred.
- Descriptive Terms: Both "epiphyseal collapse" and "articular collapse" are acceptable descriptive terms, indicating progression of disease that is nonreversible and often requires joint replacement.
- failure of the subchondral bone plate undermines the integrity of the overlying articular cartilage. This can lead to delamination of the entire chondral layer and portions of the subchondral bone plate due to shear forces.
✅ Conditions Associated with Collapse
- Osteonecrosis: A condition where bone tissue dies due to a lack of blood supply, leading to collapse.
- Subchondral Insufficiency Fracture (SIF): A type of stress fracture due to weakened bone, commonly seen in older adults.
- Rapidly Destructive Osteoarthritis: A severe form of osteoarthritis that rapidly deteriorates joint cartilage and underlying bone.
✅ Patterns of Bone Plate Failure
1️⃣ Deformity of the Subchondral Bone Plate:
- Hip Involvement: Loss of normal sphericity of the femoral head, focal depression, discrete cortical step-off, or generalized area of subchondral cortical bone collapse.
2️⃣ Fluid-Filled Cleft (Subchondral Cleft):
- Indication: Fracture and separation of the subchondral bone plate, manifested as a fluid-like linear hyperintensity on fluid-sensitive MRI images, separating the subchondral bone plate from the rest of the epiphysis.
References
- AJR 2019; 213:963–982
- MRI Web Clinic – June 2021 Tissue Delamination
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
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#EpiphysealCollapse, #ArticularCollapse, #Osteonecrosis, #SIF, #RapidOsteoarthritis, #SubchondralBone, #MRIImaging, #JointReplacement, #BoneHealth, #Orthopedics
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