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Beyond Gonarthrosis in the Elderly: A Case Report of Subchondral Insufficiency Fracture of the Knee

2023-01Journal article Open access
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dc.contributor.authorMartins, Mariana
dc.contributor.authorAraújo, Raquel
dc.contributor.authorPinheiro, Rosana
dc.contributor.authorCosta, Ana
dc.contributor.authorCarvalho, José Luís
dc.date.accessioned2024-06-18T10:32:24Z
dc.date.available2024-06-18T10:32:24Z
dc.date.issued2023-01
dc.description.abstractSubchondral insufficiency fracture of the knee (SIFK) is a non-traumatic condition that has been, historically, associated with the elderly. Early diagnosis and management are essential to prevent evolution to subchondral collapse and secondary osteonecrosis, developing prolonged pain and functional losses. This article presents the case of an 83-year-old patient with severe right knee pain with 15 months of evolution, with sudden onset, and no history of trauma or sprain. Upon observation, the patient presented with a limping gait, antalgic posture with the knee in semi-flexion, pain on palpation of the joint medial line, severe pain on passive mobilization, limited joint range of motion, and a positive McMurray test. The X-ray only demonstrated a gonarthrosis grade 1 in the Kellgren and Lawrence classification with medial compartment affection. Due to the exuberant clinical picture with marked functional compromise, as well as clinical radiological dissociation, MRI was requested to rule out SIFK, which was later confirmed. The therapeutic orientation was then adjusted with an indication for non-weight bearing and analgesia, as well as orientation to an orthopedics consultation to request a surgical evaluation. SIFK is difficult to diagnose and may have an unpredictable outcome due to delayed treatment approaches. This clinical case encourages clinicians to consider subchondral fracture in the differential diagnosis of knee pain when an older patient, with subnormal radiographic findings, reports severe knee pain in the absence of overt traumatic injurypt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMartins M, Araújo R, Pinheiro R, Costa A, Carvalho JL. Beyond Gonarthrosis in the Elderly: A Case Report of Subchondral Insufficiency Fracture of the Knee. Cureus. 2023;15(1):e34366. doi:10.7759/cureus.34366pt_PT
dc.identifier.doi10.7759/cureus.34366pt_PT
dc.identifier.issn2168-8184
dc.identifier.urihttp://hdl.handle.net/10400.16/2958
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCureus, Inc.pt_PT
dc.relation.publisherversionhttps://www.cureus.com/articles/133800-beyond-gonarthrosis-in-the-elderly-a-case-report-of-subchondral-insufficiency-fracture-of-the-knee#!/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectorthopedic surgerypt_PT
dc.subjectradiofrequencypt_PT
dc.subjectrehabilitationpt_PT
dc.subjectsubchondral insufficiency fracture of the knee;pt_PT
dc.subjectsubchondral insufficiency fracturespt_PT
dc.titleBeyond Gonarthrosis in the Elderly: A Case Report of Subchondral Insufficiency Fracture of the Kneept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceUnited States of Americapt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPagee34366pt_PT
oaire.citation.titleCureuspt_PT
oaire.citation.volume15pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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