Review Question - QID 5977

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Spontaneous Osteonecrosis of the Knee (SONK) QID: 5977 (SAE07HK.17)

QID 5977 (Type "5977" in App Search)

A 74-year-old woman has had acute medial right knee pain for the past 3 months. She denies any history of trauma or previous problems. Coronal and sagittal MRI scans are shown in Figures 11a and 11b. What is the most likely diagnosis?

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Osteoarthritis

83/900

Rheumatoid arthritis

7/900

Medial meniscal tear

69/900

Osteonecrosis

75%

676/900

Transient osteoporosis

56/900

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Spontaneous osteonecrosis of the medial femoral condyle is seen in the MRI scans, and is most common in women older than age 60 years. Although usually present in the weight-bearing portion of the medial femoral condyle, spontaneous osteonecrosis has also been described involving the lateral femoral condyle and patella. Most patients are seen postcollapse, and the treatment of choice is arthroplasty. Optimal treatment in precollapse stages is controversial.