Osteonecrosis-like syndrome of the medial tibial plateau can be due to a stress fracture - MR findings in 13 patients

Objective. To demonstrate the contribution of magnetic resonance imaging to the elucidation of mechanisms involved in "osteonecrosis-like syndrome of the medial tibial plateau", Patients and methods. A magnetic resonance stud y with sagittal and coronal sections was done in 13 patients (age range, 57 -95 years) two weeks to four months into a painful syndrome meeting the def inition of "osteonecrosis-like syndrome of the medial tibial plateau". Gado linium injection was used in nine patients, Clinical symptoms resolved with in a few weeks in all 13 cases. Results. T1-weighted images without gadolin ium showed diffuse low signal from the epiphysis (n=12) containing an area of even lower signal seen either as a crescent-shaped subchondral image (n= 3/12) or as a linear image (n=9/12). On postgadolinium images, the low sign al was abolished except for a line of low signal parallel to the subchondra l bone. Ta-weighted images demonstrated diffuse high signal from the medial tibial plateau with persistence of the line of low signal (n=8/12). Conclu sion. Magnetic resonance imaging allows to analyze the anatomic lesion resp onsible for "osteonecrosis-like syndrome of the medial tibial plateau'. Our magnetic resonance findings were similar to those seen in stress fractures at other sites.