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Clinical/methodical issue <p>Subchondral insufficiency fractures (SIF) occur without adequate trauma to the weight-bearing joint surfaces due to repeated physiological loading and occur predominantly in older people.</p> Standard radiological methods <p>Magnetic resonance imaging (MRI). Radiographs.</p> Methodological innovations <p>MRI is the best method for the detection, follow-up, and assessment of the prognosis of subchondral insufficiency fractures.</p> Performance <p>The typical MRI findings of SIF are bone marrow edema, a&#xa0;subchondral hypointense fracture line, and possibly a&#xa0;subchondral hypointense area on T2-weighted sequences. Subchondral cortical deformity and a&#xa0;fluid-filled cleft indicate advanced SIF with a&#xa0;poor prognosis.</p> Achievements and practical recommendations <p>Subchondral insufficiency fractures can heal spontaneously or progress to collapse. The task of radiology is to distinguish between lesions that heal (<i>simple subchondral insufficiency fractures</i>) and lesions that progress unfavorably (s<i>ubchondral insufficiency fractures with osteonecrosis</i>).</p>

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Subchondrale Insuffizienzfrakturen des Kniegelenks

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Marc-André Weber

摘要

Clinical/methodical issue

Subchondral insufficiency fractures (SIF) occur without adequate trauma to the weight-bearing joint surfaces due to repeated physiological loading and occur predominantly in older people.

Standard radiological methods

Magnetic resonance imaging (MRI). Radiographs.

Methodological innovations

MRI is the best method for the detection, follow-up, and assessment of the prognosis of subchondral insufficiency fractures.

Performance

The typical MRI findings of SIF are bone marrow edema, a subchondral hypointense fracture line, and possibly a subchondral hypointense area on T2-weighted sequences. Subchondral cortical deformity and a fluid-filled cleft indicate advanced SIF with a poor prognosis.

Achievements and practical recommendations

Subchondral insufficiency fractures can heal spontaneously or progress to collapse. The task of radiology is to distinguish between lesions that heal (simple subchondral insufficiency fractures) and lesions that progress unfavorably (subchondral insufficiency fractures with osteonecrosis).