1. MRI OF THE KNEE JOINT.
Dr/ ABD ALLAH NAZEER. MD.

2. Clinical Indication
Acute pain secondary to trauma in the presence of an effusion
without fracture on x-ray.
Suspected unstable knee with history of knee locking or positive
McMurray test on examination.
Suspected stable meniscus tear following treatment with
analgesia and physiotherapy and activity modification for at least
4 weeks in the presence of persistent joint effusion or history of
locking
Suspected cruciate ligament injury with a history of knee giving
way and laxity of between 5 and 11mm) on examination
grade II-III instability (medial laxity between 5 and 11mm on
examination.
Suspected multi-ligamentous or lateral collateral ligament injury
when there is grade II-III instability
Suspected medial collateral ligament injury with grade II-III
instability despite treatment with brace and activity modification
for at least 6 weeks
Other knee conditions of unknown etiology when there are both
symptoms and signs that suggest a significant underlying injury
and when knee x-ray is non-diagnostic for the etiology of the
underlying condition

3. Knee - AP View

4. Lateral View

5. Skyline View
Intercondylar
View

6. Protocol of examination
 Axial T1 localizer
 Sagittal T1, PD, T2
 Coronal gradient echo,
STIR
 If contrast is injected
[ Axial, Sagittal ,coronal T1 WIs ]

7. How to know the pulse sequence?!
T1 T2 Gradient STIR
Upper EgyptLower Egypt

8. Items to be evaluated Where?!
 Menisci (medial & lateral)
 Ligaments
- Cruciate (ACL, PCL)
- Collateral
- Retinacular
 Tendons ( Quadriceps, Patellar)
 Bones
 Synovial effusion
Sagittal PD
Coronal.
Sagittal,coronal
and axial.
Coronal
Axial
Sagittal PD
Sagittal T1& T2
Sagittal T2

9. Anatomy of the meniscus.

10. Meniscus
Medial meniscus
 Semilunar - shaped
Posterior horn wider,
longer, taller than
anterior horn
Posterior horn tightly
attached to the capsule

11. Lateral meniscus
 C- shape
 Posterior and anterior horns are symmetric
 Anterior horn may be hypo plastic, extremely
thin
 Discoid meniscus and meniscal cysts more
common

12. AC
B
A B C

13. Lateral meniscus

14. Medial meniscus

15. Medial and lateral meniscus.

17. Medial and lateral meniscusMedial and lateral meniscus..

21. Patellar retinacular ligaments

22. Collateral
Ligaments

23. Proton density coronal image shows the normal medial collateral
ligament as a thin, taut, well-defined, low-signal structure extending
from the medial femoral epicondyle to the medial tibial metaphysis

24. Coronal and sagittal proton density image demonstrating the
normal lateral collateral ligament in its entirety, from the
femoral condyle origin to the fibular head insertion.

25. MeniscalMeniscal
LesionsLesions
Degeneration
 Tear
 Cyst
Discoid

26. Simple Tear Complex Tear
Type II
Type I Normal

27. Types of Meniscal degenerationTypes of Meniscal degeneration
 Grade IGrade I
 Grade IIGrade II
 Meniscal frayingMeniscal fraying

28. Tear

29.  Grade 1 degeneration. Grade 11 degeneration

30. Meniscal degeneration with free edge fraying.

31. Meniscal degeneration with free edge fraying

33. Types of Meniscal TearsTypes of Meniscal Tears
 SimpleSimple
 ComplexComplex
 Special typesSpecial types

34. Simple Meniscal TearSimple Meniscal Tear
 HorizontalHorizontal
 VerticalVertical
 RadialRadial

36. Horizontal tear

37. Horizontal tear

38. Horizontal tear

40. Vertical tear
Occurs typically in the outer 1/3 of
the posterior horn or body of the
meniscus
]rare in the anterior horn[

41. Vertical
tear

42. Vertical tear

46. Body radial tear.

47. Full thickness body radial tear

48. Marching cleft sign in discoid lateral
meniscus indicates radial meniscal tear

49. Meniscal radial tear (arrow).

50. Vertical radial meniscal tear in the mid-body lateral
meniscus. (A) A sagittal fat-suppressed proton-density image
shows a vertical tear (arrow) of the central edge of the lateral
meniscus, oriented perpendicular to the curvature of the meniscus.
Note the superimposed horizontal tear of the anterior horn. (B) A
coronal fat-suppressed T2-weighted image shows the same tear
with truncation of the central meniscal margin (arrow).

51. Radial tear of lateral meniscus.

53. Vertical tear of the free edge of the meniscus [Root tear[
Ghost meniscus

54. Ghost meniscus
If there is no history of
Meniscal surgery and
the posterior horn is
absent near the
intercondylar notch

55. Meniscus Extrusion

56. Meniscal extrusion

57. Special Meniscal TearsSpecial Meniscal Tears
 FlapFlap
 Bucket handleBucket handle
 MC separationMC separation

58. Flap tear:displaced horizontal
or longitudinal tears

59. Flap tear [Oblique[
Should have tow components , horizontal and
Vertical common in the medial meniscus

60. Flap tear.

61. Bucket handle tearBucket handle tear

62. Small sized
posterior horn
[ sagittal[
Medially displaced
fragment[ coronal[
Double PCL sign
]sagittal[

64. Bucket Handel tearBucket Handel tear

65. Bucket Handel tearBucket Handel tear

66. Flipped meniscus : Double Delta Sign
Bucket Handel tear , Lateral meniscus

67. Flipped meniscus : Double Delta Sign

68. Flipped meniscus : Double Delta Sign

69. Flipped meniscus : Double Delta Sign

70. Parrot beak tear (displaced radial oblique tear(.

71. MENISCOCAPSULAR SEPARATIONMENISCOCAPSULAR SEPARATION..

72. Post-traumatic contusion
of the lateral femoral and
tibial condyles

74. Discoid meniscus
Dysplastic meniscus with loss of normal semi lunar shape.
50%or more coverage of the tibial plateau.
Meniscal body segment seen in 3 or more sagittal images

75. Discoid meniscusDiscoid meniscus

76. Discoid meniscusDiscoid meniscus

77. Meniscal cyst
A Cyst extending from a meniscal tear
Common sites : Anterior horn LM , Posterior horn MM

78. Meniscal cyst

79. Meniscal cyst

82. Magic angle phenomenon
5555

83. Closed MRI
Open MRI

84. Open MRIClosed MRI

85. In closed MRI scanner,In closed MRI scanner,
magic angle artifact canmagic angle artifact can
be found in one locationbe found in one location::
The up-sloping of theThe up-sloping of the
posterior horn lateralposterior horn lateral
meniscusmeniscus..
In open, vertical field magnets,
magic angle artifact will be
found in two locations:
1)1(junction of anterior horn
and body of meniscus and
2)2(junction of posterior horn
and body of meniscus

86. Normal intrameniscal signal evolution in the site of surgery, with very good final result.

87. Normal healing sequence. Typical worsening in the first scans - intrameniscal
signal after surgery is worse then before surgery. No healing disturbance.

88. Abnormal healing of degenerated meniscus.

89. Ligamentous
Lesions
 ACL
 PCL
 Collateral
 Retinacular

90. Anterior cruciate ligament

91. Anterior cruciate ligament

92. MRI shows the normalMRI shows the normal
linear low signal intensitylinear low signal intensity
ACL adjacent to theACL adjacent to the
lateral bony wall of thelateral bony wall of the
upper intercondylar notchupper intercondylar notch
(arrow). The normal ACL(arrow). The normal ACL
moves away from the wallmoves away from the wall
and diverges into multipleand diverges into multiple
fascicles on more distalfascicles on more distal
imagesimages.

93. Anterior cruciate ligament Posterior cruciate ligament

94. Primary signs [ In the ligament ]
Total discontinuity
Abnormal signal
Abnormal configuration
Abrupt angulation
Wavy appearance
Abnormal axis
Anterior cruciate ligament injury
Intercondylar
roof

95. Anterior cruciate ligament injury

96. Anterior cruciate ligament injury.

97. Normal ACL

98. Normal ACL
Non visualization of the ACL with a cloud of edema and hemorrhage

99. Secondary signs [ Outside the
ligament ]
• Blumensaat angle sign.
• Bone contusions [Pivot- shift bruises ]
• Anterior translocation of the tibia
• Uncovered meniscus sign
• Avulsion fracture of the tibial insertion
• Segond fracture 70-100% with ACL tear
• PCL buckling
• PCL line sign
Anterior cruciate ligament injury
Hyperextension ACL tear withHyperextension ACL tear with
"kissing bone bruises"kissing bone bruises."."

100. Negative Blumensaat angleNegative Blumensaat angle..

101. Positive Blumensaat anglePositive Blumensaat angle..

102. ACL Graft with negative Blumensaat angleACL Graft with negative Blumensaat angle..

103. The probability of anThe probability of an
ACL tear is very highACL tear is very high
if both such boneif both such bone
bruises are present,bruises are present,
only slightly lower ifonly slightly lower if
the tibial bone bruisethe tibial bone bruise
is present in isolation,is present in isolation,
and still slightlyand still slightly
lower with anlower with an
isolated femoral boneisolated femoral bone
bruise of thisbruise of this
appearance.appearance.

104. Anterior tibial translocation

105. Anterior tibial translocation with” uncovered meniscus sign”

106. Segond fractureSegond fracture..
An elliptical verticallyAn elliptical vertically
3x10mm bone3x10mm bone
fragment parallel to thefragment parallel to the
lateral tibial cortex,lateral tibial cortex,
about 4mm distal toabout 4mm distal to
the plateau. Best seenthe plateau. Best seen
on AP or tunnelon AP or tunnel
radiographic viewsradiographic views
75-100%association with ACL tear

107. Segond fracture inSegond fracture in
patient with ACLpatient with ACL
tear. T1- weightedtear. T1- weighted
coronal MRI shows acoronal MRI shows a
small, low-signalsmall, low-signal
elongated fractureelongated fracture
fragment that isfragment that is
parallel to the lateralparallel to the lateral
tibia. The associationtibia. The association
of Segond fracturesof Segond fractures
with ACL tearswith ACL tears
approaches 100%.approaches 100%.

108. ACL injury

109. +ve
PCL LINE SIGN

110. PCL redundancy as a secondary sign of ACL tear. This is a relativelyPCL redundancy as a secondary sign of ACL tear. This is a relatively
unreliable secondary sign of ACL tear.unreliable secondary sign of ACL tear.

111. Partial ACL tearPartial ACL tear
 Common about 10-43% of ACL tearsCommon about 10-43% of ACL tears
 Suboptimal accuracy of MRISuboptimal accuracy of MRI
 Subtle 1ry and 2ry signsSubtle 1ry and 2ry signs
 Focal angulationsFocal angulations
 Focal increase T2 signalFocal increase T2 signal
[[non specificnon specific ]]
 Single bundle signSingle bundle sign
Sagittal MRI shows an abruptlySagittal MRI shows an abruptly
angulated mid-ACL (arrow) .A wavy orangulated mid-ACL (arrow) .A wavy or
sharply angulated appearance issharply angulated appearance is
abnormal.abnormal.

112. T1-weighted sagittalT1-weighted sagittal
MRI shows a normal-MRI shows a normal-
appearing ACL.appearing ACL.
Partial ACL tear
T1-weighted sagittal MRI imageT1-weighted sagittal MRI image
immediately adjacent to theimmediately adjacent to the
previous image shows a partiallyprevious image shows a partially
disrupted ACLdisrupted ACL

113. Partial ACL tear

114. Partial ACL tear with thickening, angulations and abnormal brightPartial ACL tear with thickening, angulations and abnormal bright
signal inside. The tibial and femoral attachment is preservedsignal inside. The tibial and femoral attachment is preserved..

115. Partial ACL tear with thickening and abnormal bright signal insidePartial ACL tear with thickening and abnormal bright signal inside..

116. Partial ACL tear with diffuse thickening and abnormal signal insidePartial ACL tear with diffuse thickening and abnormal signal inside..

117. Chronic ACL TearChronic ACL Tear
 Fragmented ACL [ common finding ]Fragmented ACL [ common finding ]
 Absent bone edema and contusionsAbsent bone edema and contusions
 Empty notch signEmpty notch sign
 ACL attached to PCLACL attached to PCL

118. ACL tear on axial image showing non-visualization of the anteriorACL tear on axial image showing non-visualization of the anterior
cruciate ligament (ACL) in the upper inter-condylar notchcruciate ligament (ACL) in the upper inter-condylar notch
A large knee effusion and a Baker cyst are noted incidentally.A large knee effusion and a Baker cyst are noted incidentally.
Empty notch sign

119. Chronic ACL tear, empty notch sign. T1-weighted coronal MRI shows fat in theChronic ACL tear, empty notch sign. T1-weighted coronal MRI shows fat in the
lateral intercondylar notch, ACL is absent. This is a frequent MRI appearance of alateral intercondylar notch, ACL is absent. This is a frequent MRI appearance of a
chronic ACL tear after resolution of acute edema and hemorrhage.chronic ACL tear after resolution of acute edema and hemorrhage.

120. ACL DegenerationACL Degeneration
 Intra ligamentous cystIntra ligamentous cyst
 May be mistaken for a tearMay be mistaken for a tear
 Arthroscopic decompressionArthroscopic decompression

121. Intercondylar notch cystIntercondylar notch cyst
 1% of knee MRIs1% of knee MRIs
 Usually an incidental findingUsually an incidental finding
 Painful if erodes the bonePainful if erodes the bone
 Post-traumatic chronic partialPost-traumatic chronic partial
cruciate ligament tear with internalcruciate ligament tear with internal
degenerationdegeneration
 More common in the ACLMore common in the ACL
 Oval , rounded may be multilocularOval , rounded may be multilocular
 Rim enhancement if inflamedRim enhancement if inflamed
 Arthroscopic drainageArthroscopic drainage
Cruciate ligament cyst

122. Intraligamentous ganglion cyst

123. A 3-D cutaway at the
intercondylar notch in
the sagittal plane
reveals normal
positioning for a
patellar tendon ACL
autograft. The tibial
tunnel should lie
posterior to the line
drawn parallel to the
intercondylar notch
(red) and the femoral
attachment should lie
posterior to a line
drawn parallel to the
cortex of the distal
femoral diaphysis
(blue(.

124. Femoral tunnel is normally positioned
at the junction of the physeal scar and
posterior intercondylar roof (asterisk(.
Abnormal placement of the femoral
tunnel (asterisk), which lies significantly
anterior to a line drawn along the
posterior cortex of the femoral diaphysis
with graft degeneration.

125. Tibial tunnel cyst after ACL graft reconstruction.

126. Cyclops lesion (arrowheads) attached to the ACL (arrow) with a head-like
appearance, showing a focal area of discoloration resembling an eye (curved arrow(

127. Hypointense to isointense nodule (arrowhead) attached to the anterior
surface of the anterior cruciate ligament (ACL) graft (arrow). Sagittal
T1W MRI image (C) shows a hypointense nodule (arrowhead) in the
anterior intercondylar notch, related to Cyclops.

128. ACL reconstruction are provided. Diffuse abnormal fluid signal
intensity is seen along the course of the graft (arrows) on the sagittal
image, compatible with extensive graft ganglion formation.

129. ACL Surgery Failure with stem cells injection.

130. Posterior cruciate ligament.Posterior cruciate ligament.
 The major stabilizer of the kneeThe major stabilizer of the knee
 Uniform low signal , no striationsUniform low signal , no striations
 Twice strong as the ACLTwice strong as the ACL
 The menisco-femoral ligaments are intimately related to PCL.The menisco-femoral ligaments are intimately related to PCL.
They connect the posterior horn of the lateral meniscus to theThey connect the posterior horn of the lateral meniscus to the
medial femoral condylemedial femoral condyle
Ligament of Humphrey anterior to PCLLigament of Humphrey anterior to PCL
Ligament of Weisberg posterior to PCLLigament of Weisberg posterior to PCL

131. Proton-dense sagittal image demonstrates the normal
tibial insertion of the PCL. The insertion site is a
vertically inclined posterior to the articular surface.

132.  PCL injuries represent about 12% of knee injuriesPCL injuries represent about 12% of knee injuries
 Combined PCL injuries represent 97%Combined PCL injuries represent 97%
With ACL 65%With ACL 65%
With MCL 50%With MCL 50%
With MM 30%With MM 30%
Posterior cruciate ligamentPosterior cruciate ligament
TYPES OF PCL INJURES
Complete tear 40%
Partial tear 55%
Avulsion tear 7%

133. NORMAL PCL
TORN PCL
MR FINDINGS
Increased signal due to hemorrhage and edema
Diffuse enlargement of PCL

134. COMPLETE PCL TEAR

135. An enlarged, intermediate signal (obviously torn) PCL.

136. NORMAL PCL
AVULSION TEAR
• Involves the tibial insertion
• Retracted bone fragment
• Bone marrow edema at avulsion site
• The actual PCL may be normal

137. AVULSION PCL TEAR

138. AVULSION PCL TEAR

139. PARTIAL PCL TEAR

140. PD sagittal image
shows partial tear
of the mid-substance
of the PCL. The
normal ligament of
Humphrey (small
arrow) is visualized
better because it is
adjacent to the high
signal intensity edema
of the torn PCL.
PARTIAL PCL TEAR

141. Collateral ligaments.
MCL is about 8-11 cm
LCL is about 5-7 cm
Isolated injuries are rare,
usually with ACL and MM

142. Collateral ligaments
Grade I : microscopic tear
Grade II :partial tear
Grade III : complete tear
GRADING SYSTEM
Grade I,II and isolated grade III are treated conservatively, while grade
III tears associated with ACL tears are treated by repairing ACL only

143. Proton density coronal image shows the normal medial collateral
ligament as a thin, taut, well-defined, low-signal structure extending
from the medial femoral epicondyle to the medial tibial metaphysis

144. Coronal and sagittal proton density image demonstrating
the normal lateral collateral ligament in its entirety, from
the femoral condyle origin to the fibular head insertion.

145. Grade I medial collateral ligament tear with surrounding
edema (straight arrows) on a T2WI. Note the normal
thickness and signal of the medial collateral ligament and
continued close apposition to the femoral and tibial cortices.

146. Grade 1 sprain of the medial collateral ligamentGrade 1 sprain of the medial collateral ligament..

147. Grade 11 sprain of the medial collateral ligamentGrade 11 sprain of the medial collateral ligament..

148. Grade II medial collateral ligament tear seen on a coronal proton
density image shows slight thickening of the medial collateral
ligament and separation from the underlying cortices. Bone marrow
edema of the lateral tibial plateau is seen due to valgus stress
7months after
conservative treatment

149. Grade II medial collateral ligament tear seen on a coronal T1
and STIR images showing slight thickening of the medial
collateral ligament and separation from the underlying cortices.

150. Grade 111 tear of the MCLGrade 111 tear of the MCL..

151. Grade III medial
collateral ligament
tear on a coronal
fast spin-echo T2-
weighted image
demonstrates a
disrupted ligament
that is thickened and
retracted with
surrounding edema
(black arrow).

152. Acute grade III tear with a folded ligament (arrow) and
surrounding edema on a coronal proton density image.

153. Acute tear of
the proximal
portion of the
lateral collateral
ligament is seen
on this coronal
proton density
image (white
arrow). Note the
associated grade
II medial
collateral ligament
tear.

154. Grade III MCL tear with retraction

155. Grade III MCL tear with
abnormal signal and edema

156. Grade 111 tear of the LCLGrade 111 tear of the LCL..

157. Ilio-tibial band syndrome. Distal tendon of IT fascia and insert at gerdy,sIlio-tibial band syndrome. Distal tendon of IT fascia and insert at gerdy,s
tubercle of the tibia. It occur in runner, cyclists, football players and weight liftertubercle of the tibia. It occur in runner, cyclists, football players and weight lifter..

158. Pre-patellar bursitis.(housemaid bursitisPre-patellar bursitis.(housemaid bursitis((

160. Backer and Pes anserine cystBacker and Pes anserine cyst..

161. Patellar and quadriceps tendons

164. Patellar
tendons

165. Complete tear of the patellar tendon with ACL teaComplete tear of the patellar tendon with ACL tearr

166. Complete tear of the patellar tendon with ACL tear

167. Partial tear of the patellar tendon

168. Lateral pressure syndrome
 Thickening of the lateral retinaculum
 Lateral knee pain
 Obese, athletic patients
 May be associated with
chondromalacia

169. Patella alta
 Sequlae of
patellofemoral
dysplasia
 Lengthening of the
infrapatellar tendon
 May be associated with
chondromalacia
 Length of patellar
tendon/ length of
patella > 1.3

170. Patella Baja
 Poliomyelitis
 Achondroplasia
 JRA

171. Hyaline cartilage

172. Hyaline cartilage

173. Hyaline cartilage
T2* MT

174. Articular cartilage

175. MT STIR

176. Chondromalacia patellae
Degeneration of the hyaline cartilage
Anterior knee pain in young adults
Four stages
Signal abnormalities
Ulceration [ fraying , partial or
full thickness defects ]
Reactive bone changes [ edema ,
cyst formation , sclerosis ]
Osteoartheritic changes

177. Chondromalacia patella

178. Chondromalacia patella

179. Chondromalacia patella.

180. Loose bodies
• Read with plain films
• Low signal fragments
Synovial osteochondromatosis.

181. Loose bodies

182. Synovial osteochondromatosisSynovial osteochondromatosis
Metaplasia of subsynovial soft tissues cartilage formation
Affects any joint [ knee , hip , elbow[
Age incidence 40 years M : F = 2 : 1
FINDINGSFINDINGS
Widening of the joint space
Bone erosions
Intra articular loose bodies
Secondary osteoarthritic changes

183. Synovial chondromatosisSynovial chondromatosis

184. Synovial chondromatosis.

185. Lipoma arborescenceLipoma arborescence
RareRare
IdiopathicIdiopathic
Fatty synovial infiltrations formingFatty synovial infiltrations forming
variable sized villous projectionsvariable sized villous projections
withinwithin
the joint capsule commonly in thethe joint capsule commonly in the
supra- patellar pouchsupra- patellar pouch
Associated with joint effusionAssociated with joint effusion
Painless swellingPainless swelling
Treatment by synovectomyTreatment by synovectomy

186. Lipoma arborescence
Lipoma
arborescens

187. Pigmented villo-nodular synovitisPigmented villo-nodular synovitis
 IdiopathicIdiopathic
 Monoarticular disease 1% incidenceMonoarticular disease 1% incidence
 Hypertrophic synovial masses with hemosiderinHypertrophic synovial masses with hemosiderin
laden macrophages bone erosionsladen macrophages bone erosions
 Intermediate signal in T1 andIntermediate signal in T1 and low signal in T2low signal in T2 withwith
enhancement after contrast injectionenhancement after contrast injection
 Typical location posterior to HoffaTypical location posterior to Hoffa’’s fat pads fat pad
 Painless swelling , pain with progressive diseasePainless swelling , pain with progressive disease
 Treatment by synovectomyTreatment by synovectomy

188. PIGMENTED VELLONODULAR
SYNOVITIS

189. PIGMENTED VILLONODULAR SYNOVITIS

190. PIGMENTED VILLONODULAR SYNOVITIS VERSUS
LIPOMA ARBORESCENS

191. Pigmented
villo-
nodular
synovitis

192. POPLITEAL CYST
Fluid in the bursa which is usually
communicating with the joint space
Other names
Baker’s cyst
Gastrocnemius/semimembranosus
bursa

193. Medial plica syndromeMedial plica syndrome
 Inflamed synovial plica causing pain , crepitusInflamed synovial plica causing pain , crepitus
and pseudolockingand pseudolocking
 Often in adolescents and athleticsOften in adolescents and athletics
 No measurement for plica thicknessNo measurement for plica thickness
Four types of plicaFour types of plica
Suprapatellar 90%Suprapatellar 90%
Medial 15 -30%Medial 15 -30%
InfrapatellarInfrapatellar
Lateral [ rare]Lateral [ rare]

194. PLICA SYNDROME

195. Medial plica

196. Osteochondritis dissecansOsteochondritis dissecans
 Osteochondral fragmentOsteochondral fragment in a typical locationin a typical location
 Young maleYoung male
 Lateral aspect of the medial femoral condoyleLateral aspect of the medial femoral condoyle
 Variable sized fragment attached or detachedVariable sized fragment attached or detached
 Criteria of unstable fragmentCriteria of unstable fragment
Large size more than 1cmLarge size more than 1cm
Fluid between the fragment and donor boneFluid between the fragment and donor bone
Cystic changes at the donor siteCystic changes at the donor site
Enhancement of the separation lineEnhancement of the separation line

197. Osteochondritis
Dissecans

198. Osteochondritis Dissecans along the medial femoral condyleOsteochondritis Dissecans along the medial femoral condyle

199. OSTEOCHONDRITIS DISSECANS

200. Red marrow recon version / marrowRed marrow recon version / marrow
lesionlesion

201. Bone marrow contusion

202. Migratory osteoporosis

203. Bone infarctsBone infarcts
 Serpigenous lesions in the bone marrowSerpigenous lesions in the bone marrow
 Variable in size [ Chinese figures ]Variable in size [ Chinese figures ]
 Double line sign is diagnostic [peripheralDouble line sign is diagnostic [peripheral
hyperintense with hypointense inner border on T2hyperintense with hypointense inner border on T2
 CAUSESCAUSES
POSTTRAUMATICPOSTTRAUMATIC
STEROIDSSTEROIDS
COLLAGEN DISEASESCOLLAGEN DISEASES
ALCOHOLISMALCOHOLISM
PANCREATITISPANCREATITIS
SPONTANEOUSSPONTANEOUS

204. BONE INFARCTS.

205. BONE INFARCTS

206. BONE INFARCTS

207. EnchondromaEnchondroma..

208. Thank You.