(Fig 5-B.12) Osteoarthritis vs. Subchondral Insufficiency Fracture

https://youtu.be/fVZpPIihs7Y

https://youtu.be/9qehWGE9dp4

 

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📌 Osteoarthritis vs. Subchondral Insufficiency Fracture

✅ Bone Sclerosis in Osteoarthritis vs. SIF

• Osteoarthritis (OA): Bone sclerosis in OA at MRI may resemble the subchondral low-signal-intensity areas seen in Subchondral Insufficiency Fracture (SIF).
• SIF: However, in SIF, the bone marrow edema-like pattern is extensive, while it is typically localized in OA.
• Cartilage Preservation: Articular cartilage may be preserved in early SIF, while significant cartilage loss typically accompanies eburnation in OA.

 

✅ Extent of Bone Marrow Edema

• SIF: At MRI, SIF is associated with marked bone marrow edema emanating from the subchondral region and extending over large areas, often involving the entire femoral condyle.
• OA: This differs from the more localized bone marrow edema lesion subjacent to cartilage loss in OA.
• Prognostic Significance: The extent of bone marrow edema has no prognostic significance.

 

✅ Degenerative Findings in OA

• SIF: Sclerotic changes in the subchondral bone in OA may resemble the subchondral low-signal intensity area in SIFK.
• OA: OA is often associated with other degenerative findings, such as severe cartilage damage and osteophyte formation.

 

✅ Bone Marrow Edema-like Signal Intensity

• OA: Bone marrow edema-like signal intensity in OA corresponds to a mixture of necrosis, fibrosis, and abnormal trabeculae and tends to be confined to a limited area of subchondral bone compared with SIFK.

 

✅ Resolution with Conservative Therapy

• SIF: Subchondral hypointense fracture lines tend to resolve with conservative therapy and can be seen in patients with transient reversible SIF and in 78% of those with clinical SONK.

 

References

• RadioGraphics 2018; 38:1478–1495
• Japanese Journal of Radiology (2022) 40:443–457

 

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#Osteoarthritis, #SubchondralInsufficiencyFracture, #BoneSclerosis, #BoneMarrowEdema, #ArticularCartilage, #MRI, #Radiology, #DegenerativeFindings, #CartilageDamage, #Osteophytes