Tumor biology and incidence

  • Localized area of bone with avascular necrosis
  • Conditions associated with bone infarction:
    • Trauma
    • Alcohol
    • Steroids
    • Working in conditions requiring air compression and decompression (deep see diving, caisson workers )
    • Gaucher’s disease
    • Sickle cell disease
    • Gout
  • Bone infarction involving articulating ends of long bones (femur, humerus) or weight-bearing bones (talus) usually found early due to pain or joint involvement
  • Bone infarction involving metaphysis or diaphysis generally asymptomatic
    • Remain undetected until incidentally found or if patient experiences pathologic fracture or sarcomatous degeneration

Plain films



Tumor effect on bone
  • Irregularly serpiginous-shaped calcified periphery possible
  • Patchy sclerosis ans lucency possible
  • Linear densities generally appear within the lesion

If cortex involved, spares outer one third while affecting inner two thirds


  • May be diagnostic
  • May see central marrow fat within the lesion
  • May see classic "double ring" sign
    • Manifests as an inner serpiginous margin of lower T2-weighted signal and adjacent outer ring of high T2-weighted signal intensity