CASE OF THE quarter
A previously-healthy, normal-weight 70-year-old female without osteoporosis, presents with the following:
The surgeon thought and submitted this case to pathology as common DJD/OA.
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1. What is your diagnosis?
A. Primary osteonecrosis.
B. Primary osteoarthritis.
C. Subchondral enchondroma.
D. Subchondral insufficiency fracture.E. Primary osteomalacia.
2. What are the known risk factors for subchondral insufficiency fracture (SIF)?
A. Steroids or alcohol abuse
B. Trauma – high external force
C. Bisphosphonate fracture
D. Obesity, osteoporosis, elder female
3. Which one of the following is correct?
A. Subchondral insufficiency fracture cannot be treated by rest.
B. Subchondral insufficiency fracture is typically bilateral and due to steroids.
C. Subchondral insufficiency fracture occurs due to abnormal activity (strong force) on normal bone.
D. Subchondral insufficiency fracture occurs in obese with weight bearing, may be elderly female with osteoporosis.
E. Subchondral insufficiency fracture occurs with high energy force trauma to osteoporotic bone.