Bone marrow lesions: A systematic diagnostic approach

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Bone marrow lesions on magnetic resonance (MR) imaging are common and may be seen with various pathologies. The authors outline a systematic diagnostic approach with proposed categorization of various etiologies of bone marrow lesions. Utilization of typical imaging features on conventional MR imaging techniques and other problem-solving techniques, such as chemical shift imaging and diffusion-weighted imaging (DWI), to achieve accurate final diagnosis has been highlighted.

Related collections

Most cited references 56

Record: found
Abstract: found
Article: not found

Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture.

Takayuki Yamamoto, P Bullough (2000)

Spontaneous osteonecrosis of the knee is a superficial subchondral lesion classically seen in the medial femoral condyle; in general, it is markedly different in its clinicopathological presentation from the classic wedge-shaped subchondral osteonecrotic lesions seen in the hip, knee, and other joints. Recent reports on subchondral insufficiency fracture of the femoral head, which has marked morphological similarities with spontaneous osteonecrosis of the knee, led us to reevaluate a series of patients who had had operative treatment because of a clinical and pathological diagnosis of spontaneous osteonecrosis of the knee. We reviewed the cases of fourteen patients who had had operative treatment of spontaneous osteonecrosis of the knee in order to reevaluate the gross and histological morphology of this lesion. The patients included eight women and six men who ranged in age from fifty-nine to eighty-eight years. In all patients, the diagnosis of spontaneous osteonecrosis of the knee had been based on clinical presentation, imaging studies, and pathological findings. The appearance of the lesion on plain radiographs was categorized into four stages, which corresponded to the gross and histological findings. In stage 1, the radiographic appearance is normal; in stage 2, a radiolucent oval area is seen subchondrally or there is slight flattening of the convexity of the condyle, or both; in stage 3, the radiolucent area is expanded and is surrounded by a sclerotic halo; and in stage 4, secondary osteoarthritic changes are apparent. No patient had a stage-1 lesion. Three patients, all of whom had a stage-2 lesion, were considered to have a subchondral insufficiency fracture of the medial femoral condyle. Another six patients, all of whom had a stage-3 lesion, were considered to have a subchondral fracture and associated focal osteonecrosis that was confined to the area between the fracture line and the articular surface. The remaining five patients, three of whom had a stage-3 lesion and two of whom had a stage-4 lesion, had indeterminate findings because the lesion had become detached from the condyle. Our histopathological findings suggest that the primary event leading to spontaneous osteonecrosis of the knee is a subchondral insufficiency fracture and that the localized osteonecrosis seen in association with this disease is the result of a fracture.

0 comments Cited 51 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review.

Adrian B M Khoo, Anwar Padhani, Asif Saifuddin … (2011)

Magnetic resonance imaging (MRI) is the mainstay of diagnosis, staging and follow-up of much musculoskeletal pathology. Diffusion-weighted magnetic resonance imaging (DWI) is a recent addition to the MR sequences conventionally employed. DWI provides qualitative and quantitative functional information concerning the microscopic movements of water at the cellular level. A number of musculoskeletal disorders have been evaluated by DWI, including vertebral fractures, bone marrow infection, bone marrow malignancy, primary bone and soft tissue tumours; post-treatment follow-up has also been assessed. Differentiation between benign and malignant vertebral fractures by DWI and monitoring of therapy response have shown excellent results. However, in other pathologies, such as primary soft tissue tumours, DWI data have been inconclusive in some cases, contributing little additional information beyond that gained from conventional MR sequences. The aim of this article is to critically review the current literature on the contribution of DWI to musculoskeletal MRI.

0 comments Cited 45 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Bone marrow imaging.

Amy J. Vogler, Debra Murphy (1988)

0 comments Cited 45 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Indian J Radiol Imaging

Journal ID (iso-abbrev): Indian J Radiol Imaging

Journal ID (publisher-id): IJRI

Title: The Indian Journal of Radiology & Imaging

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0971-3026

ISSN (Electronic): 1998-3808

Publication date (Print): Jul-Sep 2014

Volume: 24

Issue: 3

Pages: 279-287

Affiliations

[1]The Russell H. Morgan Departments of Radiology and Radiology Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA

Author notes

Correspondence: Dr. Avneesh Chhabra, The Russell H. Morgan Departments of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, 601 North Wolfe Street, Baltimore, MD 21287, USA. E-mail: achhabr6@ 123456jhmi.edu

Article

Publisher ID: IJRI-24-279

DOI: 10.4103/0971-3026.137049

PMC ID: 4126144

PubMed ID: 25114392

SO-VID: 7a054d23-7c03-40af-8413-18f58c2c643a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bone marrow lesions: A systematic diagnostic approach

Read this article at

Abstract

Related collections

Stroke MRI

Most cited references 56

Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture.

Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review.

Bone marrow imaging.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 292

Cited by 11

Most referenced authors 420