Spontaneous osteonecrosis of the knee: tibial plateaus.
Spontaneous osteonecrosis of the medial tibial plateau is less recognized than osteonecrosis of the medial femoral condyle, but it presents in a similar manner. These patients have a sudden onset of pain on the medial side of the knee associated with a spectrum of MRI changes in the tibial subchondral bone. The small lesions can resolve with only minimal residual scar remaining in the subchondral zone. If the lesion is large, it can collapse or show MRI changes of osteonecrosis. Recognition of this problem may help avoid unnecessary intra-articular surgical intervention.
Lotke
Paul A
PA
Department of Orthopaedics, University of Pennsylvania Hospital, 3400 Spruce Street, Philadelphia, PA 19104, USA. Paul.lotke@uphs.upenn.edu
Nelson
Charles L
CL
Lonner
Jess H
JH
D000368:Aged; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis* / Q000628:therapy*; D012307:Risk Factors; D012720:Severity of Illness Index