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📌 Subchondral Insufficiency Fracture (SIF)
✅ MRI Findings
Subchondral Insufficiency Fracture (SIF) is characterized by a hypointense line that is irregular, sometimes discontinuous, or open-ended in the subarticular marrow at a variable distance from the epiphyseal surface.
This line is often curvilinear or parallel to the subchondral bone plate and represents the subchondral fracture callus and granulation tissue.
✅ Prognostic Value on MR Images and Radiographs
★ The prognosis of SIF can be determined by evaluating the location, size, and morphologic features on MR images and radiographs. Key indicators of high-grade lesions include:
- Medial meniscus posterior root tears with associated moderate to severe extrusion.
- High-grade chondrosis.
- Larger lesion sizes (anteroposterior/transverse).
- Articular surface collapse.
★ Improvement of bone marrow edema (BME) on follow-up imaging highly predicts low-grade disease.
✅ Key Takeaways
- SIF is indicated by an irregular hypointense line in the subarticular marrow.
- Prognostic factors include lesion location, size, and morphology.
- Larger lesion dimensions suggest a worse prognosis.
- Improvement in BME is a positive indicator for low-grade SIF.
References
- RadioGraphics 2018; 38:1478–1495
- Skeletal Radiol. 2019 Dec;48(12):1961-1974
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
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#SubchondralInsufficiencyFracture, #SIF, #Radiology, #BoneMarrowEdema, #MRImaging, #HighGradeLesions, #PrognosticFactors, #Orthopedics, #MedicalImaging, #BoneHealth
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