subcortical subchondral fracture knee tibial plateau mri insufficiency
  • Subchondral or subcortical fractures of the knee can occur in the femoral condyles or tibial plateau.

 

  • The key to the diagnosis is seeing a linear low signal line adjacent to and paralleling the cortex without any cortical defect or break in the acute phase.  

 

  • There is usually significant bone marrow oedema spreading around the fracture line.

 

  • An older term for this appearance is SONK (Spontaneous Osteonecrosis of the Knee) however the pathology is now recognised to commence with a subcortical fracture.

 

  • More chronically osteonecrosis can occur in the region of the fracture with collapse of the cortex.
    • When this occurs there will be contour deformity of the cortex.

  • Extensive bone marrow oedema tibial plateau (Yellow arrows) and,

 

  • Linear low signal subcortical line which is low signal on T2FS and T1 (Green arrows) which is a subcortical fracture.

 

  • Additional and not directly related extrusion of the meniscus (Pink arrow).

Learn more about KNEE Imaging in our ONLINE or ONSITE
Guided MRI KNEE Mini-Fellowship.


More by clicking on the images below.

proximal tibiofibular joint ligament anatomy mri
Fracture
acl-pcl-mucoid-degeneration-mri-findings-radedasia
Anterior Cruciate Ligament

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