Abstract:Depending on the age and location within the skeleton, bone marrow can be mostly fatty or hematopoietic, and both types can be affected by marrow necrosis. This review article highlights the magnetic resonance imaging findings of disorders in which marrow necrosis is the dominant feature.Fatty marrow necrosis is detected on T1-weighted images that show an early and specific finding: the reactive interface. Collapse is a frequent complication of epiphyseal necrosis and detected on fat-suppressed fluid-sensitive… Show more
“…The two loose objects present in the marrow cavities of the pathological femora were diagnosed as dried and condensed remnants and/or breakdown products of fatty marrow, thus indicating a case of “mummified marrow necrosis” [ 21 ]. Because of its sparse blood supply (terminal vascularization, poor capillary network), fatty marrow is more at risk of necrosis than red marrow with its nonterminal vascularization and rich blood supply [ 20 , 21 ].…”
Section: Discussionmentioning
confidence: 99%
“…The two loose objects present in the marrow cavities of the pathological femora were diagnosed as dried and condensed remnants and/or breakdown products of fatty marrow, thus indicating a case of “mummified marrow necrosis” [ 21 ]. Because of its sparse blood supply (terminal vascularization, poor capillary network), fatty marrow is more at risk of necrosis than red marrow with its nonterminal vascularization and rich blood supply [ 20 , 21 ]. In humans, necrosis of fatty marrow is considered a frequent lesion that can affect any bone segment of the appendicular skeleton, with mechanical interruption of arteries due to physical injury as one of the possible causes [ 21 ].…”
Section: Discussionmentioning
confidence: 99%
“…Because of its sparse blood supply (terminal vascularization, poor capillary network), fatty marrow is more at risk of necrosis than red marrow with its nonterminal vascularization and rich blood supply [ 20 , 21 ]. In humans, necrosis of fatty marrow is considered a frequent lesion that can affect any bone segment of the appendicular skeleton, with mechanical interruption of arteries due to physical injury as one of the possible causes [ 21 ].…”
We describe a bilateral craniodorsal dislocation of the hip joint in a free-ranging young roe buck and the associated pathological changes in the ossa coxae and femora of the animal. The highly symmetrical dislocation, which is considered to have developed secondary to hip dysplasia, caused the formation of two false acetabula that each consist of several, partially fused bone portions. The femora exhibit symmetrical outgrowths that extend from the greater trochanter along the intertrochanteric crest to the lesser trochanter. Formation of these outgrowths is attributed to abnormal traction at muscle attachment sites due to the displacement of the femora. On radiographic examination, both femora show signs of avascular necrosis in their head regions and of fatty marrow necrosis in their shafts, which is attributed to the damage of the arterial blood supply of the femora that was associated with the dislocation. The fact that, according to the hunter who shot the buck, the animal’s locomotion was inconspicuous suggests that the false hip joints functioned quite well, thereby demonstrating a remarkable capacity of the musculoskeletal system for functional recovery.
“…The two loose objects present in the marrow cavities of the pathological femora were diagnosed as dried and condensed remnants and/or breakdown products of fatty marrow, thus indicating a case of “mummified marrow necrosis” [ 21 ]. Because of its sparse blood supply (terminal vascularization, poor capillary network), fatty marrow is more at risk of necrosis than red marrow with its nonterminal vascularization and rich blood supply [ 20 , 21 ].…”
Section: Discussionmentioning
confidence: 99%
“…The two loose objects present in the marrow cavities of the pathological femora were diagnosed as dried and condensed remnants and/or breakdown products of fatty marrow, thus indicating a case of “mummified marrow necrosis” [ 21 ]. Because of its sparse blood supply (terminal vascularization, poor capillary network), fatty marrow is more at risk of necrosis than red marrow with its nonterminal vascularization and rich blood supply [ 20 , 21 ]. In humans, necrosis of fatty marrow is considered a frequent lesion that can affect any bone segment of the appendicular skeleton, with mechanical interruption of arteries due to physical injury as one of the possible causes [ 21 ].…”
Section: Discussionmentioning
confidence: 99%
“…Because of its sparse blood supply (terminal vascularization, poor capillary network), fatty marrow is more at risk of necrosis than red marrow with its nonterminal vascularization and rich blood supply [ 20 , 21 ]. In humans, necrosis of fatty marrow is considered a frequent lesion that can affect any bone segment of the appendicular skeleton, with mechanical interruption of arteries due to physical injury as one of the possible causes [ 21 ].…”
We describe a bilateral craniodorsal dislocation of the hip joint in a free-ranging young roe buck and the associated pathological changes in the ossa coxae and femora of the animal. The highly symmetrical dislocation, which is considered to have developed secondary to hip dysplasia, caused the formation of two false acetabula that each consist of several, partially fused bone portions. The femora exhibit symmetrical outgrowths that extend from the greater trochanter along the intertrochanteric crest to the lesser trochanter. Formation of these outgrowths is attributed to abnormal traction at muscle attachment sites due to the displacement of the femora. On radiographic examination, both femora show signs of avascular necrosis in their head regions and of fatty marrow necrosis in their shafts, which is attributed to the damage of the arterial blood supply of the femora that was associated with the dislocation. The fact that, according to the hunter who shot the buck, the animal’s locomotion was inconspicuous suggests that the false hip joints functioned quite well, thereby demonstrating a remarkable capacity of the musculoskeletal system for functional recovery.
Subchondral insufficiency fractures (SIFs) and SIFs with osteonecrosis (SIF-ONs) of the knee (previously misnamed spontaneous osteonecrosis of the knee (SONK)) are bone lesions that appear without prior traumatic, tumoral, or inflammatory event.Both conditions are characterized in the early stages by epiphyseal bone marrow edema (BME)-like signal at MRI. However, while SIFs usually heal spontaneously, they can also evolve to osteonecrosis (i.e., SIF-ON), which may progress to an irreversible collapse of the articular surface. Careful analysis of other MRI signs may help differentiate the two conditions in the early phase. In SIFs, the BME edema-like signal extends to the area immediately adjacent to the subchondral plate, while in SIF-ONs, this subchondral area shows low signal intensity on fluid-sensitive MR images due to altered bone marrow. The thickness and length of subchondral areas with low fluid-sensitive signal intensity are important factors that determine the prognosis of SIF-ONs. If they are thicker than 4 mm or longer than 14 mm, the prognosis is poor. The differential diagnosis of SIFs and SIF-ONs include bone lesions associated with the “complex regional pain syndrome” (CRPS), epiphyseal osteonecrosis of systemic origin, and those related to cartilage pathology.Clinical relevance statement Imaging plays an essential role in diagnosing subchondral insufficiency fractures (SIFs) from subchondral insufficiency fractures with osteonecrosis (SIF-ONs) and collapse, as well as in distinguishing them from other spontaneous knee subchondral bone lesions presenting with bone marrow edema-like signal.Key points• Subchondral insufficiency fractures may affect the knee, especially in older adults.• Subchondral insufficiency fractures usually heal spontaneously.• Sometimes, subchondral osteonecrosis and collapse may complicate subchondral insufficiency fractures.• Bone marrow-like edema is an aspecific sign seen in all these lesions.• Degraded marrow in osteonecrosis complicating fractures is hypointense on fluid-sensitive sequences.
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