Subchondral insufficiency fracture
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Subchondral insufficiency fracture refers to a type of stress fracture that occurs below the chondral surface on a weight-bearing surface of a bone due to mechanic failure of subchondral cancellous bone.
abnormal loading through the joint
They tend to occur when normal physiological forces are repeatedly applied to an area of bone. Callus formation occurs along with non-mineralized osteoid and the absence of bone infarction.
Typical sites include:
Plain radiograph / CT
Radiographs are normal preceding the development of callus formation or collapse of the articular surface. Linear or patchy subchondral sclerosis may be present representing cancellous fracture.
T1: there may be a characteristically low signal intensity band through the affected region
T2: florid marrow edema
Treatment and prognosis
osteonecrosis with cavitation (crescent sign)
History and etymology
It has been described in many regions but the term "subchondral insufficiency fracture of the femoral head" was coined by Bangil et al. in 1996 7.
The differential diagnosis of subchondral marrow edema includes:
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