title: MR imaging of epiphyseal lesions of the knee: current concepts, challenges, and controversies.
abstract: This article focuses on spontaneous painful conditions involving the subchondral bone and marrow of mature knee epiphyses. MR imaging is the technique of choice for the work-up of these lesions and enables distinction of two main categories of lesions on the basis of T1-weighted images: avascular necrosis, and lesions presenting the bone marrow edema pattern. This latter category encompasses spontaneous osteonecrosis of the knee, and a variety of self-resolving conditions that may be differentiated by the study of the subchondral bone marrow area on T2-weighted images. Behind definite appellation of lesions, the challenge for the radiologist is to provide a prognosis: the distinction between self-resolving lesions from those that may evolve to epiphyseal collapse and joint impairment should be possible in most cases.
authors.affiliation: Section of Musculoskeletal Radiology, Department of Radiology, Saint Luc University Hospital, Université de Louvain, Hippocrate Avenue 10/2942, Brussels B-1200, Belgium. lecouvet@rdgn.ucl.ac.be
authors.forename: Frédéric E
authors.initials: FE
authors.lastname: Lecouvet
authors.forename: Jacques
authors.initials: J
authors.lastname: Malghem
authors.forename: Baudouin E
authors.initials: BE
authors.lastname: Maldague
authors.forename: Bruno C
authors.initials: BC
authors.lastname: Vande Berg
mesh_terms: D001847:Bone Diseases / Q000175:diagnosis*; D001855:Bone Marrow Diseases / Q000175:diagnosis; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis; D004838:Epiphyses / Q000473:pathology; D005269:Femur / Q000473:pathology*; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D010020:Osteonecrosis / Q000175:diagnosis; D011379:Prognosis