Acute nontraumatic adult knee pain: the role of MR imaging

Acute nontraumatic pain in the adult knee can be seen in many settings, such as transient bone marrow oedema syndrome (TBMOS), regional migratory osteoporosis (RMO), spontaneous osteonecrosis (SONK) and insufficiency fractures. Early differentiation among them is crucial to avoid unnecessary treatme...

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Bibliographic Details
Published in:Radiologia medica 2009-04, Vol.114 (3), p.437-447
Main Authors: Fotiadou, A., Karantanas, A.
Format: Article
Language:English
Subjects:
Acute Disease
Bone Marrow Diseases - diagnosis
Diagnostic Radiology
Edema - diagnosis
Female
Fractures, Bone - diagnosis
Humans
Imaging
Interventional Radiology
Knee Joint
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Musculoskeletal Radiology/Radiologia Muscolo-Scheletrica
Neuroradiology
Osteonecrosis - diagnosis
Osteoporosis - diagnosis
Pain - diagnosis
Radiology
Ultrasound
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Summary:Acute nontraumatic pain in the adult knee can be seen in many settings, such as transient bone marrow oedema syndrome (TBMOS), regional migratory osteoporosis (RMO), spontaneous osteonecrosis (SONK) and insufficiency fractures. Early differentiation among them is crucial to avoid unnecessary treatment. TBMOS and RMO are considered to be self-limiting conditions without longterm sequelae. On the other hand, the clinical course of SONK is thought to be dependent on the size of osteonecrosis. Recent data suggest the term SONK is misleading one and should be replaced. Insufficiency fractures may demonstrate a similar clinical syndrome without a history of a single traumatic injury. The imaging pathway for knee pain has evolved considerably with the advent of magnetic resonance (MR) imaging, which is very sensitive in the early depiction of bone marrow oedema. Therefore, in patients with acute nontraumatic knee pain whose radiographs are negative or inconclusive, MR imaging is the method of choice for further evaluation. This article discusses the potential aetiologies and reviews MR imaging findings of the most common disorders afflicting the subchondral knee-joint area.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-009-0380-z