Osteonecrosis Like Syndrome of the Knee

  • Described in 1976 by D’Angelan
  • Probably has a traumatic aetiology – may be microfractures in the subchondral bone plate.
  • The intraosseous lesion is situated on the articular margin of the femoral or tibial condyles.
  • The commonest site is the medial tibial condyle.
  • Also characterized by sudden onset of pain in the knee.
  • Tenderness is better localized to the medial tibial condyle articular margin.
  • There is no evidence of OA clinically or radiologically & the X-ray shows no evidence of osteonecrosis.
  • The severe pain settles after 6-9 months.
  • Treatment is general supportive measures with analgesics, walking aids & reassurance.