title: Subchondral bone infractions in acute ligamentous knee injuries demonstrated on bone scintigraphy and magnetic resonance imaging.
abstract: Bone scintigraphy is used to detect radiographically silent fractures. Magnetic resonance imaging (MRI) is currently used to screen knee injuries for cartilage and ligament damage. MRI also delineates bone marrow and fractures. We investigated the bone scintigraphic findings in patients who had subchondral bone injuries demonstrated on MRI. Thirteen patients underwent MRI, three-phase bone scintigraphy with SPECT, and arthroscopic surgery after sustaining acute traumatic hemarthrosis of a knee. They all had clinically unsuspected subchondral bone injuries demonstrated on MRI with normal radiographs and normal overlying articular cartilage at arthroscopy, consistent with occult fractures. All showed focal bone repair on scintigraphy. Two of the 13 patients showed additional bone injuries only on bone scan. Two other patients scintigraphically showed focal bone repair at the medial femoral condyle due to avulsion of the medial collateral ligament. SPECT was easier to interpret than multi-view planar imaging. Bone scintigraphy confirms subchondral fractures demonstrated on MRI but also demonstrates ligament avulsion injuries and additional more subtle bone injuries.
authors.affiliation: Division of Orthopedic Surgery, University Hospital, London, Ontario, Canada.
authors.forename: P H
authors.initials: PH
authors.lastname: Marks
authors.forename: J A
authors.initials: JA
authors.lastname: Goldenberg
authors.forename: W C
authors.initials: WC
authors.lastname: Vezina
authors.forename: M J
authors.initials: MJ
authors.lastname: Chamberlain
authors.forename: A D
authors.initials: AD
authors.lastname: Vellet
authors.forename: P J
authors.initials: PJ
authors.lastname: Fowler
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate
chemical_list: D013669:Technetium Tc 99m Medronate