Posttraumatic osteonecrosis has been well described as a common phenomenon seen in fractures of the femoral neck, talus, and scaphoid. In the following case, we describe posttraumatic osteonecrosis in a rare location: the distal tibia. Our report details a child who sustained a distal tibia physeal injury and subsequently developed radiographic findings consistent with aseptic necrosis. Besides a traumatic incident, the patient did not have any of the risk factors known to cause osteonecrosis. Awareness of this complication after Salter-Harris I fractures will help reduce time to diagnosis and optimize treatment.
[Show abstract][Hide abstract] ABSTRACT: We studied the plain film findings in eight patients with immature bone-marrow infarction and correlated the findings with those of MR imaging in four of the cases. Seven patients had underlying systemic disease, including sickle cell disease (two), systemic lupus erythematosus (two), acute lymphocytic leukemia (one), non-Hodgkin lymphoma (one), and renal transplantation (one). In one patient, the bone infarct was idiopathic. Plain films in three of the eight cases were misinterpreted as showing aggressive lesions (i.e., malignancy or infection), and these patients underwent a biopsy that proved the diagnosis of bone infarction. In the other five cases, the diagnoses were established by clinical follow-up. The plain film findings in all eight cases consisted of subtle, mottled, ill-defined radiolucencies in the diametaphyseal region. Four of the patients had mild sclerosis. MR imaging in all four cases in which it was performed showed a central area with high or intermediate signal with a serpentine, thin, low-signal border. The lesions shown by MR imaging corresponded to the areas of abnormality on the plain films and had an appearance similar to that of previously reported bone infarcts. Our experience suggests that in patients with nonspecific subtle radiographic bone changes and an underlying systemic disease, MR imaging is helpful in establishing the diagnosis of bone marrow infarction.
American Journal of Roentgenology 04/1989; 152(3):547-9. DOI:10.2214/ajr.152.3.547 · 2.73 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.