ReviewInsights into imaging2023
Subchondral insufficiency fractures, subchondral insufficiency fractures with osteonecrosis, and other apparently spontaneous subchondral bone lesions of the knee-pathogenesis and diagnosis at imaging.
Review in Insights into imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Clinical and Radiological Outcomes of Oral Bisphosphonate Therapy Combined with Conservative Treatment in Subchondral Bone Marrow Edema of the Knee: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Association between radial meniscal tears with and without posterior root involvement and subchondral insufficiency fracture of the knee on MRI: The mediating role of meniscal extrusion.Diagnostic and interventional imaging · 2026Article
- Intraosseous tumours of the knee.Skeletal radiology · 2026Review
- Subchondral bone abnormalities in the knee: imaging techniques, regional anatomy, and pathology.Skeletal radiology · 2026Review
- Mid-Term Clinical Outcomes of Pullout Repair Combined with Osteochondral Autograft Transplantation for Medial Meniscus Posterior Root Tears with Focal Cartilage Defects: A Treatment-Stratified Cohort Study.Bioengineering (Basel, Switzerland) · 2026Article
- [Research advances on subchondral insufficiency fracture and osteonecrosis of the knee].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- [Subchondral insufficiency fractures of the knee : Navigating the complex terminology landscape].Radiologie (Heidelberg, Germany) · 2026Review
- Micro-computed tomographical and histopathological analyses of medial tibial plateaus from patients with subchondral insufficiency fracture or osteoarthritis of the knee.Arthritis research & therapy · 2026Article
- How to choose treatment for patients who are eligible for both unicompartmental knee arthroplasty and high tibial osteotomy?Journal of orthopaedic translation · 2026Review
- Article
- Concavities of the margins of focal bone lesions on MRI: a retrospective study of 586 cases.Insights into imaging · 2025Article
- [Etiology of osteonecrosis and bone marrow edema].Orthopadie (Heidelberg, Germany) · 2025Review
- Subchondral insufficiency fracture of the knee.Orthopadie (Heidelberg, Germany) · 2025Review
- Subchondral bone: An emerging target for the treatment of articular surface lesions of the knee.Journal of experimental orthopaedics · 2024Review
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Subchondral insufficiency fractures (SIFs) and SIFs with osteonecrosis (SIF-ONs) of the knee (previously misnamed spontaneous osteonecrosis of the knee (SONK)) are bone lesions that appear without prior traumatic, tumoral, or inflammatory event.Both conditions are characterized in the early stages by epiphyseal bone marrow edema (BME)-like signal at MRI. However, while SIFs usually heal spontaneously, they can also evolve to osteonecrosis (i.e., SIF-ON), which may progress to an irreversible collapse of the articular surface. Careful analysis of other MRI signs may help differentiate the two conditions in the early phase. In SIFs, the BME edema-like signal extends to the area immediately adjacent to the subchondral plate, while in SIF-ONs, this subchondral area shows low signal intensity on fluid-sensitive MR images due to altered bone marrow. The thickness and length of subchondral areas with low fluid-sensitive signal intensity are important factors that determine the prognosis of SIF-ONs. If they are thicker than 4 mm or longer than 14 mm, the prognosis is poor. The differential diagnosis of SIFs and SIF-ONs include bone lesions associated with the "complex regional pain syndrome" (CRPS), epiphyseal osteonecrosis of systemic origin, and those related to cartilage pathology.Clinical relevance statement Imaging plays an essential role in diagnosing subchondral insufficiency fractures (SIFs) from subchondral insufficiency fractures with osteonecrosis (SIF-ONs) and collapse, as well as in distinguishing them from other spontaneous knee subchondral bone lesions presenting with bone marrow edema-like signal.Key points• Subchondral insufficiency fractures may affect the knee, especially in older adults.• Subchondral insufficiency fractures usually heal spontaneously.• Sometimes, subchondral osteonecrosis and collapse may complicate subchondral insufficiency fractures.• Bone marrow-like edema is an aspecific sign seen in all these lesions.• Degraded marrow in osteonecrosis complicating fractures is hypointense on fluid-sensitive sequences.
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