A systematic approach to magnetic resonance imaging evaluation of epiphyseal lesions

Shrey K. Thawait, Gaurav K. Thawait, Frank J. Frassica, Gustav Andreisek, John A. Carrino, Avneesh Chhabra

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Magnetic Resonance Imaging (MRI) is the preferred modality of choice to image epiphyseal lesions. It provides excellent soft tissue resolution and extent of disease. A wide spectrum of tumor and tumor like lesions can involve the epiphysis. Early and accurate diagnosis as well as appropriate management of epiphyseal lesions is critical as these conditions may lead to disabling complications such as, limb length discrepancy, angular or joint surface deformities and secondary osteoarthritis. In this article, we discuss the role of conventional sequences, such as T1W, fluid sensitive T2W and intravenous (IV) Gadolinium enhanced sequences as well as the additional value of problem solving MRI sequences such as, chemical shift and diffusion weighted imaging. Based on the imaging findings on various MRI sequences and lesion characteristics, a systematic approach directed to the diagnoses of epiphyseal lesions is presented and discussed. MRI features of clinically and biopsy proven examples of the epiphyseal lesions, such as osteomyelitis, intra-osseous abscess, infiltrative malignancy, metastases, transient osteoporosis, subchondral insufficiency fracture, avascular necrosis, osteochondral fracture, osteochondritis dissecans, eosinophilic granuloma and geode are demonstrated. Using this systematic approach, the reader will be able to better characterize epiphyseal lesions with a potential to positively affect patient management.

Original languageEnglish (US)
Pages (from-to)418-431
Number of pages14
JournalMagnetic Resonance Imaging
Issue number3
StatePublished - Apr 2013


  • Avascular necrosis
  • Chemical shift imaging
  • Clear cell chondrosarcoma
  • Diffusion weighted imaging
  • Eosinophilic granuloma
  • Epiphyseal lesions
  • Giant cell tumor
  • Magnetic resonance imaging
  • Osteochondral lesion
  • Osteomyelitis
  • Subchondral insufficiency fracture
  • Transient osteoporosis

ASJC Scopus subject areas

  • Biophysics
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging


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