Purpose
Non-traumatic knee pain in adults is a common presentation complaint in the Accident & Emmergency,
Trauma & Orthopaedics and Rheumatology Clinics in a District General Hospital (DGH),
in the UK.
Transient osteoporosis of the femoral condyles is a relatively uncommon cause of knee pain,
is not readily diagnosed with basic first line investigations (clinical examination,
x-rays,
routine blood tests) and has a protracted course.
An early diagnosis is desirable to avoid long-term complications and disability.
Methods and Materials
Adult patients presenting with non traumatic knee pain to our two DGH’s and with initial non concludent first line investigations ( such as x-rays and routine blood tests) were referred to our Imaging Departments for further evaluation by MRI,
when conservative measures failed to control their knee pain.
Patients with impaired weight bearing were prioritized for the test.
Results
620 (n1=620) adult patients presenting with non traumatic knee pain were referred for MR scanning as they failed to improve with conservative treatment and had non concludent first line investigations.
Of these patients 391(k1=391) were males and 229 (k2= 229) females.
The patients’ age range was between 22 to 71,
with the median age of 39.
We detected 7 cases of transient osteoporosis of the femoral condyles on MRI scanning with 5(x1=5) female patients and 2(x2=2) male patients.
A joint effusion was invariably present in...
Conclusion
Transient osteoporosis of the femoral condyles (of the knee) is an uncommon cause for non-traumatic knee pain in adults.
It presents a diagnostic challenge,
as initial first line investigations are usually non concludent.
Early MRI scanning,
in particular for patients with impaired weight bearing,
is mandatory for diagnosis and for avoiding ensuing long-term complications and disability.
References
1) Transient Osteoporosis of the Knee
Vassilios S.
Nikolaou,
MD,
PhD; Anastasia Pilichou,
MD; Demitrios Korres,
MD,
PhD; Nicolas Efstathopoulos,
MD,
PhD
Orthopaedics 2008 Vol.31 Issue 5
DOI: 10.3928/01477447-20080501-19
2)Regional migratory osteoporosis in the knee: MRI findings in 22 patients and review of the literature A.
Karantanas et all
European Journal of radiology 2008
Vol 67,
Issue 1 p(34–41)
DOI:http://dx.doi.org/10.1016/j.ejrad.2008.01.054
Personal Information
Mr.
M.
Williamson is Registrar in Trauma&Orthopaedics at Darent Valley Hospital NHS Trust Dartford Kent UK
Mr.
A.
Tindall is Consultant in Trauma&Orthopaedics at
at Greenwich&Lewisham Hospitals NHS Trust London UK
Mr.
K.
Chettiar is Consultant in Trauma&Orthopaedics at Darent Valley Hospital NHS Trust Dartford Kent UK
Dr.
M.S.
Gulati is Consultant MSK Radiologist at Greenwich&Lewisham Hospitals NHS Trust London UK
Dr.
G.
Constantinescu is Consultant MSK Radiologist at Darent Valley Hospital NHS Trust Dartford Kent UK
Dr.
B.
Bhattacharjee is Consultant MSK Radiologist at...