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Musculoskeletal #35

52-year-old patient:
·With chronic right hip pain

MRI findings:

T1W
T1W
T2W Fat Sat
T2W Fat Sat
T2W Fat Sat
What is the underlying reason for the alterations observed in the bone marrow?

What is the underlying reason for the alterations observed in the bone marrow?

– A subchondral insufficiency fracture accompanied by bone marrow edema is noted
– The presence of additional bone marrow edema in the right femoral neck, particularly in the anterolateral region, is likely indicative of an insufficiency response
– Complete cartilage damage is observed

Pelvic insufficiency fractures

-Pelvic insufficiency fractures typically manifest in the lateral aspect of the femoral neck, while stress fractures tend to occur on the medial aspect

-Additionally, damage to the articular surface can result from cartilage loss, a condition distinct from osteonecrosis

Reference: Peh WC et al: Imaging of pelvic insufficiency fractures. Radiographics. 16(2):335-48, 1996

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