Serap DOGAN, Mustafa OZTURK, Ahmet Candan DURAK, Serkan SENOL, Afra YİLDİRİM, Ertugrul MAVİLİ

Early stage spontaneous osteonecrosis of the knee: mr ımaging findings

Bu çalışma diz MR incelemesi için radyoloji kliniğine konsülte edilen 21 spontan osteonekroz olgusunu (12 erkek, 9 kadın; orta- lama yaş 56.9 yıl) içermektedir. Tüm olgularda antero-posteriyor ve lateral diz radyografileri elde edildi. MR görüntülemede 21 olguda 25 lezyon saptandı. MR görüntülerinde lezyonların boyutu, lokalizasyonu, subkondral hipointensite varlığı, fokal kontur depresyonu varlığı ve ilave meniskal patoloji varlığı değerlendirildi. Medikal tedavi olarak intravenöz iloprost verildi. Olgularda radyografik olarak spesifik patolojik bulgu saptanmadı. 16 olguda lezyon medial femoral kondilde lokalize idi. 9 lezyon (%36) küçük boyutlu, 16 lezyon (%64) büyük boyutlu olarak değerlendirildi. Subkondral hipointens odak 11 olguda görüldü. Kontur depresyonu, medialde ağırlık taşıyan eklem yüzeylerinde 2 olguda saptandı. 15 olguda medial menisküs posteriyor boynuzda grade 2 meniskal dejenerasyon saptandı. MR görüntüleme, erken evre spontan osteonekroz tanısında efektif bir modalite olarak kullanılabilir.

Diz ekleminin erken evre spontan osteonekrozunun MR görüntüleme bulgularını değerlendirmek

To evaluate the MR imaging findings of early stage spontaneous osteonecrosis of the knee. This study includes 21 spontaneous osteonecrosis cases (12 men, 9 women; mean age, 56.9 years) consulting to a radiology clinic for MR imaging of knee joint. Antero- posterior and lateral knee radiographies of all patients were obtained. 25 lesions observed on MRI in 21 patients were analysed. MR images were analysed for the localization and dimension of the lesion, the presence of hypointensity in the subchondral bone, the presence of focal contour depression and the presence of additional meniscal pathology. As a means of medical treatment intravenous iloprost was applied. There was no specific pathological finding on plain radiography. In 16 cases, the lesions were localized on the medial femoral condyle. Nine lesions were defined as small sized (36 %), and 16 as large (64 %). Subchondral hypointense focus was seen in 11 lesions. Contour depression was found on medial weight bearing joint surfaces in 2 cases. In 15 cases, grade 2 meniscal degeneration was found on the posterior horn of the medial meniscus. MR imaging can be applied as an effective modality for the diagnosis of early stage spontaneous osteonecrosis.

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