Subchondral bone abnormalities in the knee: imaging techniques, regional anatomy, and pathology

Area of Science:

• Orthopedic imaging
• Radiology
• Knee anatomy and pathology

Background:

• The subchondral bone is vital for knee shock absorption and load distribution.
• Subchondral bone injuries, from trauma or degeneration, are common clinical issues.
• Initial radiographs may miss subtle osseous abnormalities.

Purpose of the Study:

• To review the magnetic resonance imaging (MRI) features of subchondral bone abnormalities in the knee.
• To highlight key diagnostic findings and reporting practices for radiologists.
• To emphasize MRI's role in characterizing diverse subchondral bone pathologies.

Main Methods:

• Review of imaging features of subchondral bone abnormalities.
• Focus on magnetic resonance imaging (MRI) as the preferred modality.
• Discussion of normal anatomy and various pathological conditions.

Main Results:

• MRI accurately evaluates osseous contusions, insufficiency fractures, stress responses, osteonecrosis, arthropathy, and neoplasms.
• MRI effectively identifies osteochondral derangements like fractures and osteochondritis dissecans.
• Detailed knowledge of MRI appearance is necessary for accurate diagnosis.

Conclusions:

• Magnetic resonance imaging (MRI) is the gold standard for evaluating knee subchondral bone abnormalities.
• Accurate diagnosis relies on understanding normal and abnormal MRI appearances.
• Standardized reporting terminology enhances diagnostic clarity.