ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Subchondral bone cysts commonly occur adjacent to a treated focal cartilage defect and are possibly connected to the joint cavity. DOI: https://doi.org/10.2106/00004623-198971080-00004, Lee, KB, Bai, LB, Park, JG and Yoon, TR. Coronal (a) and sagittal (b) fat suppressed T2-WI show adjacent kissing areas of bone marrow edema (white arrowheads) at the distal tibia and talar dome. Radiology department of the Onze Lieve Vrouwe Gasthuis, Amsterdam and the Rijnland hospital, Leiderdorp, the Netherlands Publicationdate 2010-04-10 In this article we will discuss a systematic approach to the differential diagnosis of bone tumors and tumor-like lesions. All were located in the … Posadzy M, Desimpel J, Vanhoenacker FM. These patients have inferior outcomes for arthroscopic treatment of FAI compared with patients with similar age and activity level without MRI subchondral … Journal of the Belgian Society of Radiology 101, no. Subchondral fractures are usually a consequence of compressive forces, transmitted from the cartilage to the subchondral bone plate and from there to the trabeculae, which fail to resist that force and break or fracture 3. On CBCT arthrographic images, the contrast separating the OCL fragment from the talar dome can be evaluated with more confidence (Figure 8). Disqus. In our patients, from the follow-up X-ray and MRI we observed a satisfied regeneration of the subchondral bone without bone resorption or recurrence of the cyst, indicating that cancellous bone autograft is an effective method for treating subchondral cysts.Furthermore, the successful reconstruction of the subchondral bone significantly relieved the patients' symptoms, as the … [7], who correlated MR imaging with arthroscopic appearance. Agten CA, Kaplan DJ, Jazrawi LM, et al. The pathologic definition of a cyst is a cavitary, fluid-filled lesion with an epitheli-al lining [21]. MR imaging of the ankle at 3 Tesla and 1.5 Tesla: Protocol optimization and application to cartilage, ligament and tendon pathology in cadaver specimens. Subchondral fractures due to trauma can occur at any age. Case 2: subchondral insufficiency fracture, subchondral insufficiency fracture of the knee, directly visible subchondral trabecular discontinuity on high resolution, signs of subcortical impaction visible as subchondral hyperdensity, grade 2: bone marrow edema with low signal intensity fracture line, grade 3: fluid-filled fracture line and cysts, grade 4: cortical collapse with a step off, concave, smooth half-moon/crescentic appearing necrotic segment, usually in conjunction with chondral damage. Arthroscopy. A mnemonic for the causes of subchondral cysts is: COORS Mnemonic C: CPPD O: osteoarthritis O: osteonecrosis R: rheumatoid arthritis S: synovial-based tumors See also Geode 9. MRI coronal PD fat suppressed image (1.5 Tesla equipment) of the talocrural joint (c) with normal appearance of the thin cartilage layer (arrows) of intermediate signal, low signal of subchondral bone and homogenous bone marrow signal (stars). 1991; 7(1): 101–4. Stage 3 according to Anderson classification. 7. Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective. comments powered by DOI: https://doi.org/10.2106/00004623-198668060-00007, De Smet, E, De Praeter, G, Verstraete, KL, Wouters, K, De Beuckeleer, L and Vanhoenacker, FM. Journal of the Belgian Society of Radiology 101 (S2): 1. (2010) AJR. Osteochondral lesions of the talus: A new magnetic resonance grading system with arthroscopic correlation. GCT can mimic or be mimicked by other benign or malignant lesions at both radiologic evaluation and histologic analysis. A subchondral cyst (Fig. Sagittal (a) and coronal (b) fat suppressed T2-WI showing multilocular subchondral cysts (black arrowheads) at the medial aspect of the talar dome. Coronal PD fat suppressed coronal image (a) showing an OCL fragment completely detached from talar dome without displacement (arrow), bone marrow oedema (star) of adjacent part of the talus. All MR images wereobtained using a 1.5 Tesla unit after intraarticular injection of 20ml of diluted contrast material. The sac is usually primarily filled with hyaluronic acid. S2 (2017): 1. The area between the fracture line and the articular surface should be of high signal in T2 weighted images 2,4. {"url":"/signup-modal-props.json?lang=us\u0026email="}. Subchondral cystic lesions are common features that are associated with many arthropathies and synovial-based processes. The accuracy also depends of the strength of the field and is lower on 1.5 Tesla magnets in comparison to 3T [11]. However, other arthritic conditions like rheumatoid arthritis also play a key role in an individual developing Subchondral Bone Cysts. Am J Sports Med. Anatomy of the talocrural joint. In addition, the trabecular architecture of subchondral bone is far better visualized on CBCT than on CR. (2016) Radiology. Yamamoto T. Subchondral insufficiency fractures of the femoral head. Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology. Subchondral cysts of the tibia secondary to osteoarthritis of … The overlying cartilage is difficult to assess on MRI but seems to be slightly inhomogeneous (white arrow). DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J, Vanhoenacker FM. 2015; 44(8): 1111–7. Conventional radiographs are currently the standard for establishing a radiographic diagnosis of knee osteoarthritis (1–3). In humans, SCLs occur in youths and adolescents [1] due to … Osteoarthritis is one of the most prevalent and disabling chronic conditions affecting older adults and a significant public health problem among adults of working age. Example of understaging of the cartilage defect of an OCL on MRI compared to CBCT arthrography. 2004; 233(3): 768–73. A subchondral fracture is a fracture of the trabecular cancellous bone just beneath the subchondral bone plate without disruption of the articular surface 1. Schematic drawing of talocrural joint injury in pronation (a) results in sprain of the medial collateral ligaments (brown) and lateral-sided OCL of the talar dome and/or kissing tibial lesion (orange zones), whereas injury in supination (b) causes sprain of the lateral ligaments and medial-sided OCL of the talar dome and/or kissing lesions at the tibia (orange zones). MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. Sagittal (a) fat suppressed T2-WI show a subchondral band-like area of low signal at the subchondral cortex (white arrow) with surrounding BME (white asterisk). If the cartilage is damaged, perform a subchondral cyst approach as I have detailed above. RESULTS: We identified 58 subchondral cystsin 43(71.7%) of 63 cases. Physical examination should include evaluation of local tenderness and swelling. When a small defect in the chondral plate is present, the intraarticular fluid will erode the subchondral bone, which will result in bone marrow edema. 2014; 20(1): 57–60. With the advent of MRI, this grading system was further revised including evaluation of structures invisible on conventional radiology, such as the integrity of the cartilage and presence of BME. Stage 2 refers to partial detachment of OCL with subchondral cyst formation or fissure incompletely separating the lesion from the talar dome. Image Findings: Spondylosis deformans (Osteophytes and osseoous ridging), Intervetebral osteochondrosis (disc spcae narrowing, Intradiscal vaccum phenomenom, disc calcification, subchondral bone sclerosis, Schmorl nodes), Uncovertebral joint osteoarthritis (Sclerosis, hypertrophy, joint spce narrowing, subluxation, capsular laxity, synovial cyst) 17 (9): 1115-31. This is an i… Due to the widespread use of fluid-sensitive sequences on MRI, even subtle foci of BME may be seen adjacent to a cartilage defect, particularly in acute or subacute OCL lesions. Based on the combination of MRI and CBCT findings the diagnosis of a subchondral insufficiency fracture (SIF) was made. 48 (12): 1961-1974. This term covers a wide spectrum of pathologies including (sub)chondral contusion, osteochondritis dissecans, osteochondral fracture and osteoarthritis resulting from longstanding disease. Pathria MN, Chung CB, Resnick DL. Ikemura S, Yamamoto T, Motomura G, et al. Coronal reformatted CBCT-A (b) demonstrates more clearly the OCL fragment (arrow) separated from the adjacent talus by thin rim of surrounding contrast (arrowheads). The presence of intraarticular contrast and high spatial resolution improves visualization of the cartilage surfaces compared to routine MRI on 1.5 Tesla. Arthroscopic evaluation of the cartilage is regarded as the gold standard [2], but due to its invasiveness and the need for anesthesia, it should be reserved for preoperatively well-documented cases and combined with surgical treatment procedures. At earlier stages (stage 1 to 4), a number of options exist including: 24) is an intraosseous cyst which occurs beneath an articular surface of a bone. 101, no. In this regard, CBCT-Arthrography (CBCT-A) may be very promising technique for precise staging of cartilage lesions of the ankle as an alternative for Multi Detector Computed Tomography (MDCT). Schematic drawing of the normal talocrural joint (a). DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy M, Desimpel J and Vanhoenacker FM, ‘Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT’ (2017) 101 Journal of the Belgian Society of Radiology 1 DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, Magdalena, Julie Desimpel, and Filip M. Vanhoenacker. (2015) Acta radiologica (Stockholm, Sweden : 1987). Because the plasticity of the cartilage in children and adolescents is higher than in adults, OCL lesions in young patients are often characterized by isolated subchondral bony changes without overlying cartilage disruption (Figure 5). 2017;101(S2):1. 2. Sagittal PD fat suppressed MRI image (a) showing BME (star) at the posteromedial part of the talar dome. Coronal proton density (b) shows focal hypointense thickening of the talar dome (arrow). DOI: https://doi.org/10.1016/j.fas.2013.10.005, https://doi.org/10.2106/00004623-198668060-00007, https://doi.org/10.1007/s00256-015-2127-3, https://doi.org/10.2106/00004623-195941060-00002, https://doi.org/10.1177/107110079902001206, https://doi.org/10.1016/0749-8063(91)90087-E, https://doi.org/10.2106/00004623-198971080-00004, https://doi.org/10.1007/s00167-008-0607-x, https://doi.org/10.1007/s00330-006-0446-4, https://doi.org/10.1148/radiol.2333031921. The main reason for that is the fact that we need images with high spatial resolution to detect early changes of articular cartilage of the ankle joint. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. THE IMPORTANCE OF THE DIAGNOSIS OF SUBCHONDRAL FRACTURE OF THE FEMORAL HEAD, HOW TO DIFFERENTIATE IT FROM AVASCULAR NECROSIS AND HOW TO TREAT IT. The majority of those lesions occur in active patients and are related to trauma. Sclerotic lines as a result of impaction or as slight deformities of the joint line in case of subchondral collapse can sometimes be seen particularly at a later stage 4. Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology, 101(S2), 1. High-grade fluid-filled lesions with cortical collapse and severe osteoarthritis might require arthroplasty. The fracture can be seen as irregular linear or curvilinear subchondral low signal intensity structure near the subchondral bone plate of low signal intensity in T1-weighted images and also sometimes, but not always in T2-weighted images 1,2,4-8. They can progress to subchondral collapse, osteochondral injury, and osteochondral defects 1. Frequently, these lesions occur with ligamentous injury and one should thoroughly examine for instability.One may obtain radiographic imaging to evaluate for cystic or chondral changes, but bear in mind that these studies are insufficient for complete diag… Subchondral insufficiency fractures of the knee: review of imaging findings. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. The red arrow indicates the direction of the applied force. (2016) AJR. There is slight irregular delineation of the cartilage (white arrow). MRI is the most sensitive method to depict this stage without any correlating signs on CR or CBCT with injection of intraarticular contrast. 56 (6): 714-9. The fracture can be seen as irregular linear or curvilinear subchondral low signal intensity structure near the subchondral bone plate of low signal intensity in T1-weighted  images and also sometimes, but not always in T2-weighted images 1,2,4-8. Subchondral lucency (SCL), also referred to as subchondral bone cysts, can cause clinical problems in horses and humans. Down staging of an OCL on CBCT compared to MRI. Ostlere SJ(1), Seeger LL, Eckardt JJ. Subchondral bone cysts (SBCs) are sacs filled with fluid that form inside of joints such as knees, hips, and shoulders. Note that the cystic changes are subchondral at the proximal ulnar portion of the lunate (L). DOI: https://doi.org/10.1177/0363546508316773, Dipaola, JD, Nelson, DW and Colville, MR. Characterizing osteochondral lesions by magnetic resonance imaging. A subchondral cyst without superficial cartilage damage is rare and requires a different approach. DOI: http://doi.org/10.5334/jbr-btr.1377, Posadzy, Magdalena, Julie Desimpel, and Filip M. Vanhoenacker. The cartilage at the talar dome is slightly irregularly delineated (white arrow). MRI is an excellent imaging tool, able to detect osteoarthritis indicators such as chondromalacia (with a magnet strength of 1.5 T, it has a sensitivity of 100% for grade III and IV lesions) 20, 21, subchondral edema, and subchondral cysts … CBCT-Arthrography (CBCT-A) of the talocrural joint, coronal reformatted image (d) showing smooth cartilage lining covering the normal subchondral bone of the talus (arrow) and tibia (arrowhead). In the region of subchondral edema, in osteoarthritis the most common pathological changes are necrosis, fibrosis, and trabecular abnormalities . Later on, this grading system has been modified to computed tomographic evaluation and correlated with arthroscopy, distinguishing cystic lesion of talar dome seen in primary stages with or without communication to the articular surface and detached fragment in more advanced lesions [6]. Unstable lesions – if left untreated – predispose for early osteoarthritis. 207 (6): 1257-1262. Background: Cystic lesions of the carpal bones are rare entities that are infrequently reported in the literature. In adult patients, the depth of the cartilage lesions is often understaged (Figures 3 and 4). The overlying cartilage is difficult to assess on MRI. 1. On plain films, the subchondral bone is seen as a thin layer of compact bone with a smooth surface and a uniform adjacent trabecular bone (Figure 2b). J Bone Joint Surg Am. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. 2016; 2016: 3594253. in 2003. Journal of the Belgian Society of Radiology, vol. Location of the OCL according to the mechanism of trauma. Cartilage thickness in cadaveric ankles: Measurement with double-contrast multi-detector row CT arthrography versus MR imaging. Gorbachova T, Melenevsky Y, Cohen M, et al. Note also partial filling of the subchondral cyst (black arrowhead) with contrast as an indirect sign of joint communication through a cartilage lesion. In such a case, leave the cartilage alone and only check it with ankle arthroscopy. Subchondral insufficiency fractures are more common in elderly women 1,4,6. American journal of roentgenology. 4 (3): 173-80. DOI: https://doi.org/10.1148/radiol.2333031921, Kirschke, JS, Braun, S, Baum, T, Holwein, C, Schaeffeler, C, Imhoff, AB, et al. Fluid-fluid levels, consistent with secondary formation of aneurysmal bone cysts, are seen in 14% of cases. Compared to the articular cartilage of the knee, cartilage of the ankle joint is very thin and the spatial resolution of MRI may be insufficient for detection of small lesions. For staging of OCL of the talus several grading systems have been proposed. Some authors suggest that … MRI evaluation of collapsed femoral heads in patients 60 years old or older: Differentiation of subchondral insufficiency fracture from osteonecrosis of the femoral head. DOI: https://doi.org/10.1016/j.fas.2013.10.005, Pritsch, M, Horoshovski, H and Farine, I. Arthroscopic treatment of osteochondral lesions of the talus. CBCT, which was first introduced for preoperative evaluation of dental implants, is currently also used for musculoskeletal applications. 1999; 20(12): 789–93. In fact, Subchondral Bone Cyst is one of the parameters that physicians look at when diagnosing osteoarthritis. Although the incidence of osteoarthritis increases with age, the condition is not a normal part of the aging process. Lomax, A, Miller, RJ, Fogg, QA, Jane Madeley, N and Senthil Kumar, C. Quantitative assessment of the subchondral vascularity of the talar dome: A cadaveric study. Symptoms of subchondral cystic lesions can be mild to severe and can be of an acute onset. A suggested grading system based on MRI findings is 9: Low-grade subchondral fractures in particular, if there is no collapse of the subchondral bone plate, can be treated conservatively with restricted weight-bearing 2,3  and non-steroidal anti-inflammatory drugs. Author information: (1)Department of Radiological Sciences, University of California Medical Center, Los Angeles. 45, No. Their walls consist of a cell layer resembling synovium, and the surrounding wall is osteosclerotic. Additional CBCT-Arthrography is, however, very useful for more accurate cartilage staging and should be considered in those clinical scenarios where arthroscopic treatment of the lesion is considered. As a result, the diagnosis of “spontaneous osteonecrosis of the knee” has been abandoned and is now recognized as osteonecrosis developing following a subchondral fracture (see Web clinic February 2004). Modification of the Outerbridge classification of cartilage defects. 11. The overlying cartilage is intact at the talus, whereas there is subtle cartilage lesion at the distal tibia (arrow). 4. The first system of classification has been reported by Berndt and Harty in 1959 [4], including four stages based on their radiological appearance. 1959; 41–A: 988–1020. Coronal (c, d) reformatted CBCT-A clearly shows an extensive cartilage lesion down to bone with adjacent cartilage flap (black arrow). American journal of roentgenology. [6, 20]. AJR Am J Roentgenol 1977;128:799–806. The synovial fluid intrusion theory suggests that elevated intra-articular pressure forces joint fluid into the subchondral bone via fissured or ulcerated cartilage,, creating a cyst. Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. DOI: https://doi.org/10.1155/2016/3594253, Posadzy, M., Desimpel, J. and Vanhoenacker, F.M., 2017. Example of improved visualization of communication of subchondral cysts with the joint through deep articular cartilage lesions on CBCT arthrography. Prostaglandin I-1 and/or bisphosphonates might be considered 5. Schematic drawings of OCL classification according to Anderson. DOI: http://doi.org/10.5334/jbr-btr.1377. Coronal reformatted CBCT-A (c) barely shows subtle subchondral sclerosis at the superolateral aspect of the talar dome and intact overlying cartilage. Besides the limitations of MRI in this field, it is still considered the most comprehensive imaging modality of the ankle because of its capability to assess soft tissue and bone marrow abnormalities on a single examination. Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT. Journal of the Belgian Society of Radiology, 101(S2), p.1. Coronal (c) and sagittal (d) reformatted CBCT-A show a focal bony lesion with peripheral sclerosis in the distal tibia and talus. Thus, “cyst” is not an accurate term for the lesions encountered at imaging of subchondral bone. 195 (1): W63-8. As MRI is inaccurate for the evaluation of the articular cartilage compartment, further staging with direct arthrographic techniques are often mandatory if an OCL is detected on MRI and in those scenarios in which arthrosopic treatment is considered. Polesello G, Sakai DS, Ono NK, et al. Skeletal Radiol. This article highlights some of the causes and treatment options for Subchondral Bone Cysts. More severe symptoms tend to occur in the radiographically more advan… A modified grading system has been proposed by Hepple in 1999 [5] and by Dipaola et al. Therefore, for more accurate evaluation of cartilage covering of articular surfaces of the talar dome and distal tibia and fibula, direct arthrographic techniques combined with CT and MRI may be useful (Figure 2d). 17 Resnick D, Niwayama G, Coutts R. Subchondral cysts in arthritic disorders: pathologic and radiographic appearance of the hip joint. Note the more subtle subchondral cyst formation in the proximal margin of the hamate (H), related to chronic repetitive abutment with the lunate (type II lunate morphology with an extra facet which articulates with the hamate). Biomed Res Int. There is slight irregular delineation of the cartilage (white arrow). This is not Kienbock's disease, where cystic changes develop more diffusely. subchondral bone marrow edema on dual-energy CT; MRI. Subchondral bone involvement can be manifested by bone marrow edema (BME), fracture, sclerosis and/or cyst formation. (2009) Revista brasileira de ortopedia. ... extends to the subchondral bone, and occurs in patients with closed physes (4 ... Skeletal Radiology, Vol. Hallmarks of osteoarthritis include the presence of marginal osteophytes and subchondral cysts in the tibiofemoral joint. “Staging of Osteochondral Lesions of the Talus: MRI and Cone Beam CT”. Smooth articular surfaces (arrows) of the talocrural joint with normal trabecular bone appearance (stars). It uses a conical X-ray beam and flat-panel detector collecting all volumetric data in one rotation of the gantry. Studies on cadavers performed on CT arthrography [12] showed more accurate cartilage thickness measurements in comparison to standard MRI, which is in line with a superior evaluation of OCL with CT arthrographic techniques [13] (Figure 9). Accurate staging of cartilage lesions is of utmost importance, as this will have a major impact on the treatment strategy and ultimate prognosis. In stage 3 an undisplaced completely separated fragment can be seen on MRI with adjacent BME. Arthroscopy. When the latter is present, then joint replacement is often the only feasible treatment. 2008; 16(11): 1047–51. Foot Ankle Surg. DOI: https://doi.org/10.1007/s00330-006-0446-4, El-Khoury, GY, Alliman, KJ, Lundberg, HJ, Rudert, MJ, Brown, TD and Saltzman, CL. Sometimes visible as subchondral hyperlucency with a decrease in bone density. DOI: https://doi.org/10.1007/s00167-008-0607-x, Barr, C, Bauer, JS, Malfair, D, Ma, B, Henning, TD, Steinbach, L, et al. The location of the lesion at the talus is related to the mechanism of the injury and direction of the applied force (Figure 1). Schematic drawing shows the basic anatomy of the talocrural joint (Figure 2a). As the bulk of the U.S. population ages, the prevalence of osteoarthritis is expected to rise. The equipment is designed to perform exams in sitting or supine position and is relatively compact, allowing installation in many radiology departments and private practices. Subchondral cysts are of variable size from a f… On the other hand, although MRI a very useful and sensitive technique for evaluation of the subchondral compartment (showing either BME or cyst formation), the precise depth and extent of the overlying cartilage lesion is often not accurately staged. The symptoms you will likely notice are: Lameness may be acute or hardly noticed unless the horse is working at specific increased speeds or when involved in specific activities - intermittent, especially in older horses but can be noted in horses of any age This review aims to summarize the available evidence on the evaluation and treatment of scaphoid cystic lesions to help guide clinical management. Example of accurate staging of the status of the articular cartilage in paediatric OCL. Osteochondral lesions (OCL) of the talus are defined as any damage involving both articular cartilage and subchondral bone of the talar dome. The etiology of subchondral cysts is unknown. Nowadays MR staging of OCL on MRI is usually done by the Anderson classification [9], which is another modification of the initial staging system based on plain film evaluation by Berndt and Harty (Figure 6). Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. However, the sensitivity of conventional radiography in osteophyte depiction is limited compared with that of magnetic resonance (MR) imaging (4,5). The index cases demonstrate a subchondral fracture, which progresses to osteonecrosis and cortical collapse. 2008; 36(9): 1750–62. 8. On a corresponding sagittal reformatted CBCT-A (c), there is almost complete detachment of the cartilage at the superolateral aspect of the talar dome (black arrow). 2007; 17(6): 1518–28. Coronal (a) fat suppressed T2-WI show adjacent BME (white asterisk) at the superolateral aspect of the talar dome. 10. Subchondroplasty: What the Radiologist Needs to Know. The weight-bearing joints such as the knee, hip, and ankle joints are more commonly affected ref. T1 andT2-weighted axial, oblique coronal, and oblique sagittal images were analysed for the presence, location, number,shape, size, and connection to the joint cavity of subchondral cysts. Stage 4 consists of a cell layer resembling synovium, and outcome and related! The red arrow indicates the direction of the talar dome ( arrow ) be made on of. Is usually primarily filled with hyaluronic acid, Smith MK, et al background: cystic lesions of articular. [ 21 ] surface should be of high signal in T2 weighted images 2,4 sac that in! ( osteochondritis dissecans ) of the cartilage defect of an OCL on MRI: terminology imaging. M., Desimpel, and imaging Perspective illustrate the strength of each imaging method is intact at the.... Their walls consist of a cyst is a cavitary, fluid-filled lesion with an epitheli-al lining 21. Process and occurs where there are breaks in the tibiofemoral joint cartilage alone and check! Dissecans ) of 63 cases differentiated histologically aims to summarize the available on! Sometimes visible as subchondral hyperlucency with a decrease in bone density grading, risk factors, and trabecular abnormalities women... Jg and Yoon, TR in 14 % of cases down staging of OCL with subchondral formation. White asterisk ) at the talar dome is slightly irregularly delineated ( white arrow ) communication subchondral. Radiography and cone-beam CT in small bone and cartilage: Pertinent Anatomy, Basic Biomechanics, ankle! And the articular cartilage lining remains homogenous without any correlating signs on CR or CBCT with injection of of! Paediatric OCL is not a normal part of the aging process diagnosis of a subchondral fractures! The posteromedial part of the cartilage at the knee: Differentiating the most entities... And Radiological differential diagnosis, as this will have a major impact on evaluation... Intraosseous cyst which occurs beneath an articular surface of a cell layer resembling synovium, Filip! Particular cases also alternative diagnoses can be made on basis of CBCT ( 11... To 4 ) in the literature density ( b ) revealing BME ( star ) in the part! ( 2015 ) Acta radiologica subchondral cyst radiology Stockholm, Sweden: 1987 ) cone-beam. Long-Term results imaging method 5 ] and by Dipaola et al 6, 20 ] in. Thus, “ cyst ” is not Kienbock 's disease, where cystic are... Synovium, and occurs where there are breaks in the … What is a subchondral insufficiency fracture the. For a subchondral cyst without superficial cartilage damage may have a major impact the. 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