Multifocal bone infarcts
Patient under long-term corticosteroid therapy due to an autoimmune disease complained from knee pain bilaterally.
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There are irregular, serpiginous abnormal signal lines observed within the medullary space of the distal of the femur and proximal of tibia bilaterally. On PD images, there is a hyperintense line paralleling the inner surface of the hypointense line within the marrow.
Degenerative changes are seen at the knee joints bilaterally as followed:
Cartilage loss at the medial femorotibial compartments
Marginal and patellofemoral osteophyte formation
Radial tearing at the medial meniscus body
Medullary bone infarcts and avascular necrosis are common complications of aggressive or long-term steroid therapy.