Osteonecrosis-like syndrome of the medial tibial plateau can be due to a stress fracture. MR findings in 13 patients.
OBJECTIVE
To demonstrate the contribution of magnetic resonance imaging to the elucidation of mechanisms involved in "osteonecrosis-like syndrome of the medial tibial plateau".


METHODS
A magnetic resonance study with sagittal and coronal sections was done in 13 patients (age range, 57-95 years) two weeks to four months into a painful syndrome meeting the definition of "osteonecrosis-like syndrome of the medial tibial plateau". Gadolinium injection was used in nine patients. Clinical symptoms resolved within a few weeks in all 13 cases.


RESULTS
T1-weighted images without gadolinium showed diffuse low signal from the epiphysis (n = 12) containing an area of even lower signal seen either as a crescent-shaped subchondral image (n = 3/12) or as a linear image (n = 9/12). On postgadolinium images, the low signal was abolished except for a line of low signal parallel to the subchondral bone. T2-weighted images demonstrated diffuse high signal from the medial tibial plateau with persistence of the line of low signal (n = 8/12).


CONCLUSIONS
Magnetic resonance imaging allows to analyze the anatomic lesion responsible for "osteonecrosis-like syndrome of the medial tibial plateau". Our magnetic resonance findings were similar to those seen in stress fractures at other sites.
Rheumatology Department, Saint-Antoine Teaching Hospital, Paris, France.
L
L
Le Gars
J M
JM
Savy
P
P
Orcel
F
F
Liote
D
D
Kuntz
J M
JM
Tubiana
G
G
Kaplan
J D
JD
Laredo
D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D015775:Fractures, Stress / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007719:Knee Joint; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013577:Syndrome; D013978:Tibial Fractures / Q000150:complications* / Q000175:diagnosis*