Radiology, Vol 191, 403-407, Copyright © 1994 by Radiological Society of North America

ARTICLES

Transient epiphyseal lesions in renal transplant recipients: presumed insufficiency stress fractures

BC Vande Berg, J Malghem, EJ Goffin, TP Duprez and BE Maldague
Department of Medical Imaging, St Luc University Hospital, Catholic University of Louvain, Brussels, Belgium.

PURPOSE: To determine epiphyseal abnormalities in renal transplant recipients. MATERIALS AND METHODS: Initial and final findings on serial conventional radiographs and magnetic resonance (MR) images obtained in symptomatic joints of transplant recipients were determined and correlated. RESULTS: In 42 of 47 joints, T1-weighted MR images depicted 106 ill-delimited areas of low signal intensity. At 1-year follow-up, all lesions had disappeared. T1-weighted MR images depicted nine well- delimited regions of normal signal intensity delineated by a rim of low signal intensity in seven joints. No lesion had completely disappeared at follow-up. Initial radiographs either were normal or showed patchy osteoporosis (13 joints). Follow-up radiographs showed epiphyseal collapse of two femoral heads, with well-delimited lesions on MR images, and subtle subchondral sclerosis in 21 noncollapsed epiphyses. CONCLUSION: Initial MR imaging patterns of transient lesions (92% of lesions) are different from those of irreversible lesions. Transient lesions suggest insufficiency stress fractures, while irreversible lesions suggest avascular osteonecrosis.

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