- Subchondral or subcortical fractures of the knee can occur in the femoral condyles or tibial plateau.
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- The key to the diagnosis is seeing a linear low signal line adjacent to and paralleling the cortex without any cortical defect or break in the acute phase. Â
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- There is usually significant bone marrow oedema spreading around the fracture line.
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- An older term for this appearance is SONK (Spontaneous Osteonecrosis of the Knee) however the pathology is now recognised to commence with a subcortical fracture.
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- More chronically osteonecrosis can occur in the region of the fracture with collapse of the cortex.
- When this occurs there will be contour deformity of the cortex.
- Extensive bone marrow oedema tibial plateau (Yellow arrows) and,
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- Linear low signal subcortical line which is low signal on T2FS and T1 (Green arrows) which is a subcortical fracture.
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- Additional and not directly related extrusion of the meniscus (Pink arrow).
Learn more about KNEE Imaging in our ONLINE or ONSITE
Guided MRI KNEE Mini-Fellowship.
More by clicking on the images below.
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