{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T20:01:51Z","timestamp":1762459311867,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,5,14]]},"abstract":"<jats:p>Subchondral insufficiency fractures are non-traumatic fractures that occur immediately below the cartilage of a joint. Although low bone density may be present concurrently, it is not the underlying cause of subchondral insufficiency fractures in the majority of patients. Patients with subchondral insufficiency fracture characteristically have unremarkable plain radiographs, while MRI examination may reveal extensive bone marrow oedema and subchondral bone collapse. This article presents a 51-year-old postmenopausal woman, a physician, who had subchondral insufficiency fractures of the knee associated with prolonged standing during clinical work. She was treated with partial weight bearing on crutches until 14\u2005months after the injury, viscosupplementation at 4\u2005months to treat osteoarthritis and teriparatide treatment to improve bone healing at 7\u2005months. By 26\u2005months after the injury, she tolerated independent walking with a fabric knee support but still experienced mild posterolateral knee pain and numbness on prolonged standing.<\/jats:p>","DOI":"10.1136\/bcr-2015-209399","type":"journal-article","created":{"date-parts":[[2015,6,8]],"date-time":"2015-06-08T06:59:36Z","timestamp":1433746776000},"page":"bcr2015209399","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Subchondral insufficiency fracture of the knee: a non-traumatic injury with prolonged recovery time"],"prefix":"10.1136","volume":"2015","author":[{"given":"Margaret L","family":"Gourlay","sequence":"first","affiliation":[{"name":"Department of Family Medicine, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan B","family":"Renner","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey T","family":"Spang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet E","family":"Rubin","sequence":"additional","affiliation":[{"name":"Department of Medicine\/Endocrinology, University of North Carolina, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,8]]},"reference":[{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2012.4.3.173"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.2","doi-asserted-by":"crossref","first-page":"858","DOI":"10.2106\/00004623-200006000-00013","article-title":"Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture","volume":"82","author":"Yamamoto","year":"2000","journal-title":"J Bone Joint Surg Am"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-014-0194-z"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-012-1492-4"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.5","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00445"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.6","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1177\/0284185114535132","article-title":"Subchondral insufficiency fractures of the knee: review of imaging findings","volume":"56","author":"Jose","year":"2014","journal-title":"Acta Radiol"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.7","doi-asserted-by":"publisher","DOI":"10.1007\/s002560100348"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.8","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.9.982"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2009.03.012"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMct1215534"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.11","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3002214"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.12","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.090731"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.13","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.2015.977249"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105103441904"},{"key":"2025082722481087000_2015.jun08_1.bcr2015209399.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.38290"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-209399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:48:16Z","timestamp":1756360096000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-209399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,8]]},"references-count":15,"alternative-id":["10.1136\/bcr-2015-209399"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-209399","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2015,6,8]]}}}