Semin Musculoskelet Radiol 2006; 10(3): 177-186
DOI: 10.1055/s-2006-957171
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

MRI Findings in the Subchondral Bone Marrow: A Discussion of Conditions Including Transient Osteoporosis, Transient Bone Marrow Edema Syndrome, SONK, and Shifting Bone Marrow Edema of the Knee

Holly C. Gil1 , Scott M. Levine1 , Adam C. Zoga2
  • 1Brown Medical School, Department of Diagnostic Imaging Rhode Island Hospital, Providence, Rhode Island
  • 2Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
Further Information

Publication History

Publication Date:
27 December 2006 (online)

ABSTRACT

Bone marrow edema signal can be seen in many settings ranging from trauma and arthritis to less common conditions including transient osteoporosis, transient bone marrow edema syndrome, true osteonecrosis, spontaneous osteonecrosis, and shifting bone marrow edema. Terms such as spontaneous osteonecrosis of the knee (SONK) appear frequently in the radiology and orthopedics literature but are rarely described on true, histologic basis. This article reviews the less frequently encountered and less well understood entities and explores their potential pathophysiologies and significance.

REFERENCES

  • 1 Curtiss Jr P H, Kincaid W. Transitory demineralization of the hip in pregnancy. A report of three cases.  J Bone Joint Surg Am. 1959;  41 1327-1333
  • 2 Bloem J L. Transient osteoporosis of the hop: MR imaging.  Radiology. 1988;  167 753-755
  • 3 Lakhanpal S, Ginsburg W W, Harvinder S L, Hunder G G et al.. Transient regional osteoporosis.  Ann Intern Med. 1987;  106 444-450
  • 4 Gupta R C, Popovtzer M M, Huffer W E, Smyth C J. Regional migratory osteoporosis.  Arthritis Rheum. 1973;  16 363-368
  • 5 Lequesne M. Transient osteoporosis of the hip. A non-traumatic variety of Sudeck's atrophy.  Ann Rheum Dis. 1968;  27 463-471
  • 6 Lakhanpal S, Ginsburg W W, Luthra H S, Hunder G G. Transient regional osteoporosis.  Ann Intern Med. 1987;  106 444-450
  • 7 Rosen R A. Transitory demineralization of the femoral head.  Radiology. 1970;  94 509-512
  • 8 Hofmann S, Engel A, Neuhold A, Leder K, Kramer J, Plenk Jr H. Bone-marrow oedema syndrome and transient osteoporosis of the hip: an MRI controlled study of treatment by core decompression.  J Bone Joint Surg Br. 1993;  75 210-216
  • 9 Chan T W, Dalinka M K, Steinberg M E, Kressel H Y. MRI appearance of femoral head osteonecrosis following core decompression and bone grafting.  Skeletal Radiol. 1991;  20 103-107
  • 10 Potter H, Moran M, Schneider R, Bansal M, Sherman C, Markisz J. Magnetic resonance imaging in diagnosis of transient osteoporosis of the hip.  Clin Orthop Relat Res. 1992;  280 223-229
  • 11 Miyanishi K, Yamamoto T, Nakashima Y et al.. Subchondral changes in transient osteoporosis of the hip.  Skeletal Radiol. 2001;  30 255-261
  • 12 Wilson A J, Murphy W A, Hardy D C, Totty W G. Transient osteoporosis: transient bone marrow edema?.  Radiology. 1988;  167 757-760
  • 13 Hayes C W, Conway W F, Daniel W W. MR imaging of bone marrow edema pattern: transient osteoporosis, transient bone marrow edema syndrome, or osteonecrosis.  Radiographics. 1993;  13 1001-1011
  • 14 Mitchell D G, Rao V M, Dalinka M K et al.. Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings.  Radiology. 1987;  162 709-715
  • 15 Vande Berg B E, Malghem J J, Labaisse M A, Noel H M, Maldague B E. MR imaging of vascular necrosis and transient marrow edema of the femoral head.  Radiographics. 1993;  13 501-520
  • 16 Ficat R P. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment.  J Bone Joint Surg Br. 1985;  67 3-9
  • 17 Yamamoto T, Bullough P G. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture.  J Bone Joint Surg Am. 2000;  82 858-866
  • 18 Omar I, Zoga A C, Morrison W B. Types of meniscal tears present in association with SONK (spontaneous osteonecrosis of the knee). Presented at the annual proceedings of the American Roentgen Ray Society 2006 Vancouver, BC;
  • 19 Soucacos P N, Xenakis T H, Beris A E, Soucacos P K, Georgoulis A. Idiopathic osteonecrosis of the medial femoral condyle: classification and treatment.  Clin Orthop Relat Res. 1997;  341 82-89
  • 20 Moosikasuwan J B, Miller T T, Math K, Schultz E. Shifting bone marrow edema of the knee.  Skeletal Radiol. 2004;  33 380-385
  • 21 Yamamoto T, Schneider R, Bullough P G. Subchondral insufficiency fracture of the femoral head.  Am J Surg Pathol. 2000;  24 464-468
  • 22 Lazzarini K M, Troiano R N, Smith R C. Can running cause the appearance of marrow edema on MR images of the foot and ankle?.  Radiology. 1997;  202 540-542
  • 23 Grampp S, Henk C B, Mostbeck G. Overuse edema in the bone marrow of the hand: demonstration with MRI.  J Comput Assist Tomogr. 1998;  22 25-27
  • 24 Schweitzer M E, White L M. Does altered biomechanics cause marrow edema?.  Radiology. 1996;  198 851-853

Holly C GilM.D. 

Department of Diagnostic Imaging Rhode Island Hospital

593 Eddy Street, Providence, RI 02903