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Avascular necrosis of tibia with pathological fracture

Case contributed by Dr Paul Leong

Diagnosis certain

Diagnosis certain

Presentation

Acute pain left knee

Patient Data

Age: 50 years

Gender: Male

From the case: Avascular necrosis of tibia with pathological fracture

X-ray

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Frontal

Depressed fracture of the medial tibial plateau.

There is an underlying lesion, which demonstrates a sclerotic margin, with central lucency. This lesion demonstrates a narrow zone of transition. There is associated thick irregular periosteal reaction.

Small knee joint effusion.

From the case: Avascular necrosis of tibia with pathological fracture

CT

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Axial bone window

Subchondral lesion within the medial tibial plateau, with thick sclerotic margin, central lucency as well as dystrophic calcification.

There is an associated pathological depressed fracture of the medial tibial plateau.

Findings suggestive of osteonecrosis, with associated pathological fracture.

Case Discussion

Percutaneous biopsy demonstrated "bone with focal areas of necrosis", which confirms the diagnosis of osteonecrosis.

1 article features images from this case

Avascular necrosis

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