Steroid Injections of Hip and Knee May Damage Joints (IMAGE)

Radiological Society of North America

Steroid Injections of Hip and Knee May Damage Joints

Caption

Rapid progressive osteoarthritis joint space loss (type 1) and subchondral insufficiency fracture in a 53-year-old man who presented with hip pain. (a) Anteroposterior left hip radiograph shows mild osteophytic changes (arrows) and no joint space loss. This patient was referred for intra-articular corticosteroid injection. (b) Seven weeks after injection, he returned with worsening hip pain. Repeat anteroposterior left hip radiograph shows accelerated loss of joint space (arrows). (c) Sagittal intermediate-weighted fat-suppressed MRI obtained at the same time as b shows a linear subchondral hypointensity representing subchondral insufficiency fracture of the anterior superior femoral head with subtle flattening of the overlying articular surface (arrows). Extensive bone marrow edema extends to the femoral neck (*). (d) Corresponding coronal intermediate-weighted fat-suppressed MRI enables us to confirm the presence of a subchondral insufficiency fracture (arrow) and depicts the true extent of bone marrow edema (*).

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Radiological Society of North America

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