Presumptive subarticular stress reactions of the knee: MRI detection and association with meniscal tear patterns

Lawrence Yao, Jeffrey Stanczak, Robert D Boutin

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objective: MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as "presumptive subarticular stress related" (PSSR) lesions. Design and patients: All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Results: Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). Conclusions: PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI.

Original languageEnglish (US)
Pages (from-to)260-264
Number of pages5
JournalSkeletal Radiology
Volume33
Issue number5
DOIs
StatePublished - May 2004
Externally publishedYes

Fingerprint

Tears
Knee
Bone Marrow
Mechanical Stress
Osteonecrosis
Knee Joint
Edema
Databases
Pathology

Keywords

  • Avascular necrosis
  • Knee injury
  • Meniscal tear
  • Meniscus
  • MRI
  • Stress fracture

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Presumptive subarticular stress reactions of the knee : MRI detection and association with meniscal tear patterns. / Yao, Lawrence; Stanczak, Jeffrey; Boutin, Robert D.

In: Skeletal Radiology, Vol. 33, No. 5, 05.2004, p. 260-264.

Research output: Contribution to journalArticle

@article{bcf56a5e6c4745df917e705dc1ff03d7,
title = "Presumptive subarticular stress reactions of the knee: MRI detection and association with meniscal tear patterns",
abstract = "Objective: MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as {"}presumptive subarticular stress related{"} (PSSR) lesions. Design and patients: All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Results: Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76{\%} versus 45{\%}, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53{\%} versus 26{\%}, P<0.01). Conclusions: PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI.",
keywords = "Avascular necrosis, Knee injury, Meniscal tear, Meniscus, MRI, Stress fracture",
author = "Lawrence Yao and Jeffrey Stanczak and Boutin, {Robert D}",
year = "2004",
month = "5",
doi = "10.1007/s00256-004-0751-4",
language = "English (US)",
volume = "33",
pages = "260--264",
journal = "Skeletal Radiology",
issn = "0364-2348",
publisher = "Springer Verlag",
number = "5",

}

TY - JOUR

T1 - Presumptive subarticular stress reactions of the knee

T2 - MRI detection and association with meniscal tear patterns

AU - Yao, Lawrence

AU - Stanczak, Jeffrey

AU - Boutin, Robert D

PY - 2004/5

Y1 - 2004/5

N2 - Objective: MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as "presumptive subarticular stress related" (PSSR) lesions. Design and patients: All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Results: Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). Conclusions: PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI.

AB - Objective: MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as "presumptive subarticular stress related" (PSSR) lesions. Design and patients: All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Results: Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). Conclusions: PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI.

KW - Avascular necrosis

KW - Knee injury

KW - Meniscal tear

KW - Meniscus

KW - MRI

KW - Stress fracture

UR - http://www.scopus.com/inward/record.url?scp=2542449093&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2542449093&partnerID=8YFLogxK

U2 - 10.1007/s00256-004-0751-4

DO - 10.1007/s00256-004-0751-4

M3 - Article

C2 - 14999432

AN - SCOPUS:2542449093

VL - 33

SP - 260

EP - 264

JO - Skeletal Radiology

JF - Skeletal Radiology

SN - 0364-2348

IS - 5

ER -