Skeletal Radiology

, Volume 48, Issue 7, pp 1011–1021 | Cite as

Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb

  • Sangoh LeeEmail author
  • Asif Saifuddin
Review Article


Subchondral insufficiency fracture (SIF) is a non-traumatic condition that has historically been associated with elderly, osteoporotic women and patients with systemic conditions. There has been much work done to determine the pathogenesis of SIF, which has previously been regarded as idiopathic, rapid-progressive osteoarthritis or osteonecrosis of the hip, spontaneous osteonecrosis of the knee (SONK), osteochondral defect (OCD) of the talus and adult-onset Freiberg infraction of the metatarsal head. Early diagnosis and management are crucial to prevent subchondral collapse, secondary osteonecrosis and early-onset osteoarthritis. Magnetic resonance imaging (MRI) plays an important role in the diagnosis of SIF, which is often inconspicuous on initial radiographs. In this article, the authors provide an update on the role of MRI in identifying key imaging features of SIF in various joints of the lower limb to aid in its correct diagnosis.


Subchondral insufficiency fracture Hip Knee Ankle Metatarsal Lower limb Magnetic resonance imaging 


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© ISS 2019

Authors and Affiliations

  1. 1.Department of Clinical ImagingImperial College Healthcare NHS TrustLondonUK
  2. 2.Royal National Orthopaedic Hospital NHS TrustStanmoreUK
  3. 3.Everlight RadiologyLondonUK

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