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To the Editor:I read with great interest the recent report of Yang et al[1],Clinical Characteristics and Treatment of Spontaneous Osteonecrosis of Medial Tibial Plateau:A retrospective case study (published on November 5,2018,Chin Med J,page 2544-2550),because there have been very few reports on isolated spontaneous medial tibial plateau osteonecrosis and little is known about osteonecrosis of the tibial plateau.I would like to comment on diagnostic issues in this letter.