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Bone bruise of the knee: histology and cryosections in 5 cases
C Rangger1, A Kathrein, M C Freund
1Universitätsklinik für Unfallchirurgie, Innsbruck, Austria.
Abstract:
We evaluated the histopathologic and cryosectional appearance of bone bruise injuries of the knee detected on MRI. Histologic evaluation of bone biopsies from 3 patients revealed microfractures of cancellous bone, edema and bleeding in the fatty marrow. Between intact lamellar bone trabecules, fragments of hyaline cartilage mixed with highly fragmented bone trabecules were found. Postmortem specimens were obtained from 2 more patients, killed in motor vehicle accidents. MRI revealed bone bruise injuries of the lateral femoral condyle and of the lateral tibial plateau in 1 knee and anterior cruciate ligament disruption, a medial meniscus tear and bone bruise injury of the tibial plateau and of the lateral femoral condyle in the other specimen. The specimens were embedded in physiologic saline solution and frozen to -30 degrees C. By rotationcryotomy, 1 mm slices were removed from the surface of the specimens and documented on photographs. Subchondral lesions and bleeding were found, corresponding to the MR images.
Insights
Histologic evaluation of knee bone bruises detected by MRI reveals microfractures, edema, and bleeding within the bone marrow. Cryosectional analysis confirmed these findings, correlating with magnetic resonance imaging observations.
Area of Science:
- Orthopedic surgery
- Radiology
- Pathology
Background:
- Bone bruise injuries are often detected using magnetic resonance imaging (MRI).
- Histopathological and cryosectional appearances of these injuries require further elucidation.
Purpose of the Study:
- To evaluate the histopathologic and cryosectional appearance of knee bone bruises detected on MRI.
- To correlate imaging findings with tissue-level pathology.
Main Methods:
- Histologic examination of bone biopsies from 3 patients.
- Cryosectional analysis of 2 postmortem knee specimens with documented bone bruises.
- MRI was used to identify bone bruise injuries prior to specimen collection.
Main Results:
- Histology revealed microfractures of cancellous bone, edema, and bleeding in the fatty marrow.
- Fragments of hyaline cartilage and fragmented bone trabeculae were observed between intact lamellar bone.
- Cryosectional analysis showed subchondral lesions and bleeding consistent with MRI findings.
Conclusions:
- MRI accurately detects bone bruise injuries in the knee.
- Histopathology and cryosectional analysis confirm microfractures, edema, and bleeding as key features of bone bruises.
- These findings highlight the utility of correlating imaging with tissue examination for understanding bone bruise pathology.