Steroid-related bilateral osteonecrosis of the patella

Osteonecrosis of the patella in patients with nontraumatic osteonecrosis of the femoral head: MRI findings in 60 patients

“…The necrotic lesions were all located in the proximal half of the patella as reported in previous studies (Yamaguchi et al 1988, Oishi et al 1991, Mizuta et al 1993. The reason may be that this part of the patella is supplied by the mid-patellar artery alone, while the distal half of the patella is supplied by both the apical and the mid-patellar arteries (Björkström and Goldie 1980).…”

“…Only 4 cases of nontraumatic osteonecrosis of the patella have been reported after steroid use (Yamaguchi et al 1988, Oishi et al 1991, Mizuta et al 1993 (Table 1). We investigated the rate and the characteristics of osteonecrosis of the patella on three-dimensional MRI in patients with nontraumatic osteonecrosis of the femoral head.…”

Multiple Joint Osteonecrosis in a Patient on Long-term Intranasal Corticosteroids

“…In addition, MRI findings are useful to identify the type of knee ON particularly those with notably larger lesions in patients with secondary ON and with the presence of irregular well-demarcated line between the necrotic and viable bone. 1 Only few cases of bilateral knee ON have been reported in the literature with affection of the patella 12 , 19 and the lateral femoral condyle. 20 , 21 The lesions in our case were localized to the medial tibial plateau bilaterally, which is unusual.…”

Osteoarthritic Cyst Mimicking Patellar Osteonecrosis

“…Patellar osteonecrosis has been described as an unusual cause of patellofemoral pain syndrome. 2,[9][10][11][12]14,18,[21][22][23]27 It usually is related to corticosteroids, 14,18,21,27 patellar fracture, 23 total knee replacement, 2,9 and, in rare cases, is idiopathic. [10][11][12]22 Conventional radiographs, bone scan, and MRI have been reported as the methods of choice to diagnose this condition.…”

“…The origin of this pain in the majority of patients may be overuse and overload of the patellofemoral joint as a result of malalignment of the lower extremity, patellar instability, or direct trauma. Chondromalacia and osteoarthritis is the natural end result when the primary disorder is not addressed; however, unusual conditions such as osteonecrosis, 2,[9][10][11][12]14,18,[21][22][23]27 neuromas, 1,19 and tumors 6,13,15,17,26 may also cause patellofemoral pain. Thus, efforts have to be made to identify classic predisposing factors for anterior knee pain as well as to rule out rare conditions of the patellofemoral joint that could be responsible for the symptoms.…”