Volume 62, Issue 6 pp. 764-768
Medical Imaging—Original Article

Metaphyseal burst sign: A secondary sign on MRI of subchondral insufficiency fracture of the knee

Alessandro Vidoni

Corresponding Author

Alessandro Vidoni

Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Northfield, Birmingham, UK

Correspondence

Dr Alessandro Vidoni, Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Bristol Road South, Northfield, Birmingham B31 2AP, UK.

Email: [email protected]

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Rachit Shah

Rachit Shah

Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Northfield, Birmingham, UK

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Davina Mak

Davina Mak

Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Northfield, Birmingham, UK

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David Beale

David Beale

Heath Lodge Clinic, Solihull, UK

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Sioned Beale

Sioned Beale

Heath Lodge Clinic, Solihull, UK

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Steven James

Steven James

Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Northfield, Birmingham, UK

Heath Lodge Clinic, Solihull, UK

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Rajesh Botchu

Rajesh Botchu

Radiology Department, Royal Orthopaedic Hospital, NHS Foundation Trust, Northfield, Birmingham, UK

Heath Lodge Clinic, Solihull, UK

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First published: 16 August 2018
Citations: 10
A Vidoni MD; R Shah FRCR; D Mak FRCR; D Beale FRCR; S Beale MD; S James FRCR; R Botchu FRCR.
Conflict of interest: The authors declare that they have no conflict of interest.

Abstract

Introduction

To describe a novel secondary sign of subchondral insufficiency fracture of the knee, metaphyseal burst sign (soft tissue oedema in the meta-epiphyseal region of the affected condyle).

Methods

An electronic database research of 7926 knee MRI examinations was performed. Forty-eight scans were included in the study. The diagnosis of subchondral insufficiency fracture (SIF) was confirmed in a consensus review by one fellowship trained musculoskeletal (MSK) radiologist and one radiology fellow. The presence of metaphyseal burst sign was evaluated in the cohort.

Results

Forty-one patients were included in the study (21 males, 20 females). The mean age was 61.5 years (range 41–80 years). The anatomical location was medial femoral condyle (n = 28), the lateral femoral condyle (n = 5) and medial tibial condyle (n = 8).

The metaphyseal burst sign was present in 45 of the 48 scans reviewed. The average craniocaudal length of the soft tissue oedema defined as metaphyseal burst sign was 7 cm (range 10.5 to 4.5).

Conclusion

The metaphyseal burst sign is an early, indirect sign of SIF.

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