Correlation between subcutaneous knee fat thickness and chondromalacia patellae on magnetic resonance imaging of the knee.

Science.gov (United States)

Kok, Hong Kuan; Donnellan, John; Ryan, Davinia; Torreggiani, William C

2013-08-01

Chondromalacia patellae is a common cause of anterior knee pain in young patients and can be detected noninvasively with magnetic resonance imaging (MRI). The purpose of our study was to evaluate the correlation between subcutaneous fat thickness around the knee joint on axial MRIs as a surrogate marker of obesity, with the presence or absence of chondromalacia patellae. A retrospective review was conducted of knee MRIs in 170 patients who satisfied the inclusion criteria. Imaging was performed over a 12-month period on a 1.5T MRI system with a dedicated extremity coil. Two radiologists experienced in musculoskeletal imaging assessed each examination in consensus for the presence or absence of chondromalacia patellae and graded positive studies from 0 (absent) to 3 (full cartilage thickness defect). Measurement of subcutaneous knee fat thickness was obtained on the medial aspect of the knee. MRI findings of chondromalacia patellae were present in 33 patients (19.4%), of which, there were 11 grade 1 lesions (33.3%), 9 grade 2 lesions (27.3%), and 13 grade 3 lesions (39.4%). The mean subcutaneous knee fat thickness was significantly higher in the chondromalacia patellae group for all grades compared with the normal group (P chondromalacia patellae (R = 0.48 [95% confidence interval, 0.38-0.68]; P chondromalacia patellae. Subcutaneous knee fat thickness as a surrogate marker of obesity was positively associated with the presence and severity of chondromalacia patellae on MRI. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Imaging of early spontaneous osteonecrosis and osteoarthritis of the knee

International Nuclear Information System (INIS)

Kusayama, Takeshi; Tomatsu, Taisuke

1999-01-01

In this paper, the available of MRI in diagnosis on early spontaneous osteonecrosis and osteoarthritis was investigated. Subjects were 5 cases (5 knees) with spontaneous osteonecrosis (stage 1 in Koshino's classification) and 96 cases (104 knees) in osteoarthritis who were more than 50 years old. Patients with an early spontaneous osteonecrosis were elderly females and had night pain and severe spontaneous pain. On MRI, lesions of all cases were clearly detected in early stage. On the other hand, only 47 of 104 knees (45%) were detected in patients with osteoarthritis, and mirror lesions at shank sides were detected in 45 of 47 knees. These results suggest that it is possible to diagnose early spontaneous osteonecrosis from osteoarthritis by MRI image with the clue to mirror lesion at shank sides, incidence, stage, etc. On the diagnosis of early spontaneous osteonecrosis, MRI image should be performed as soon as possible if a patient was older, had no anamnesis of lesions, and no changes by the X-ray radiography in spite of severe pain of the knee joints. (K.H.)

Magnetic resonance imaging (MRI) of articular cartilage of the knee using ultrashort echo time (uTE) sequences with spiral acquisition

International Nuclear Information System (INIS)

Goto, Hajimu; Fujii, Masahiko; Iwama, Yuki; Aoyama, Nobukazu; Ohno, Yoshiharu; Sugimura, Kazuro

2012-01-01

The objective of this study was to evaluate the sensitivity of ultrashort echo time (uTE) sequence for visualisation of calcified deep layers of articular cartilage. MRI with a uTE sequence was performed on five healthy volunteers. Signals from the calcified deep layers of the articular knee cartilage were evaluated on uTE subtraction images and computed tomography images. The calcified deep layers of the articular cartilage changed from having a low to a high signal when imaged with a uTE sequence. The reported uTE sequence was effective in imaging the deep layers of the knee cartilage.

Magnetic resonance imaging for the internal derangement of the knee

International Nuclear Information System (INIS)

Obara, Noboru; Yamauchi, Kazunori; Ohyama, Naoki; Kura, Hideharu; Tokita, Fumio; Sasaki, Tetsuhito

1990-01-01

To assess the usefulness of magnetic resonance imaging (MRI) in the preoperative diagnosis of internal derangement of the knee, MRI findings of 44 knees were reviewed. Definitive diagnoses were made by arthroscopy or arthrotomy: posterior cruciate ligament failure (8 knees), anterior cruciate ligament failure (21), inner meniscus injury (16), and outer meniscus injury (13). T1- and T2-weighted images were obtained by using a 1.5-T superconducting Signa MRI unit. The diagnostic accuracy was 100% for posterior cruciate ligament failure and anterior cruciate ligament failure, 89% for inner meniscus injury, and 93% for outer meniscus injury, suggesting the great potential of MRI in the preoperative diagnosis. For anterior cruciate ligament failure, the diagnostic accuracy was even more increased by combined use of T1-weighted sagittal imaging and T2-weighted coronal imaging. False positive findings for meniscus disorder included rupture of the posterior segment of meniscus, especially in the cnemis end. Longitudinal fissure of the posterior segment of the outer meniscus was misdiagnosed as lacuna of the popliteal muscle tendon. (N.K.)

Imaging of the knee joint with emphasis on magnetic resonance imaging

Energy Technology Data Exchange (ETDEWEB)

Reiser, M.F. [Radiologische Universitaetsklinik, Rheinische Friedrich-Wilhelms-Univ., Bonn (Germany); Vahlensieck, M. [Radiologische Universitaetsklinik, Rheinische Friedrich-Wilhelms-Univ., Bonn (Germany); Schueller, H. [Radiologische Universitaetsklinik, Rheinische Friedrich-Wilhelms-Univ., Bonn (Germany)

1992-04-01

The knee joint is frequently affected by trauma as well as degenerative and inflammatory disorders, involving the internal structures (i.e. ligaments, menisci, cartilage, synovial membrane) and the adjacent bones. Plain radiographs represent an indispensable basis for diagnosis. For further analysis magnetic resonance imaging (MRI) has become the method of choice, and has widely replaced computed tomography, arthrography and stress examinations. Extensive experience has been accumulated in MRI of the knee joint in recent years. In addition, advances in MRI technology have had a major impact on diagnostic accuracy. In this paper, diagnosis of various lesions of the knee joint, such as meniscal and ligamental injuries, aseptic necrosis, lesions of the hyaline cartilage, occult fractures and inflammatory lesions will be discussed. (orig.)

MRI versus ultrasonography to assess meniscal abnormalities in acute knees.

Science.gov (United States)

Cook, James L; Cook, Cristi R; Stannard, James P; Vaughn, Gavin; Wilson, Nichole; Roller, Brandon L; Stoker, Aaron M; Jayabalan, Prakash; Hdeib, Moses; Kuroki, Keiichi

2014-08-01

While magnetic resonance imaging (MRI) is often considered the "gold standard" diagnostic imaging modality for detection of meniscal abnormalities, it is associated with misdiagnosis in as high as 47% of cases, is costly, and is not readily available to a large number of patients. Ultrasonographic examination of the knee has been reported to be an effective diagnostic tool for this purpose with the potential to overcome many of the shortcomings of MRI. The purpose of this study is to determine the clinical usefulness of ultrasonography for diagnosis of meniscal pathology in patients with acute knee pain and compare its diagnostic accuracy to MRI in a clinical setting. With Institutional Review Board approval, patients (n = 71) with acute knee pain were prospectively enrolled with informed consent. Preoperative MRI (1.5 T) was performed on each affected knee using the hospital's standard equipment and protocols and read by faculty radiologists trained in musculoskeletal MRI. Ultrasonographic assessments of each affected knee were performed by one of two faculty members trained in musculoskeletal ultrasonography using a 10 to 14 MHz linear transducer. Arthroscopic evaluation of affected knees was performed by one of three faculty orthopedic surgeons to assess and record all joint pathology, which served as the reference standard for determining presence, type, and severity of meniscal pathology. All evaluators for each diagnostic modality were blinded to all other data. Data were collected and compared by a separate investigator to determine sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), correct classification rate (CCR), likelihood ratios (LR[+] and LR[-]), and odds ratios. Preoperative ultrasonographic assessment of meniscal pathology was associated with Sn = 91.2%, Sp = 84.2%, PPV = 94.5%, NPV = 76.2%, CCR = 89.5%, LR(+) = 5.78, and LR(-) = 0.10. Preoperative MRI assessment of

MR imaging of the injured meniscus of the knee

International Nuclear Information System (INIS)

Sakai, Naotaka; Imamura, Kiyohiko; Uematsu, Koichi; Iwamura, Yuichi; Ohniwa, Hideo; Ishii, Masayoshi

1992-01-01

MR imagings (0.5 Tesla 5 mm slice, TR/TE: 510-620 msec/27-30) of the injured menisci in 38 knees of 38 patients (28 men and 10 women, with an average age of 25.9) were compared with their arthroscopic findings and classified into two types, the one with linear high-density area and the non-linear one. Menisci with longitudinal tears in 10 knees of 17 and with horizontal tears in 4 of 8 showed a linear high-density area in MRI, but the others including menisci with transverse tears (in 8 knees) or bucket-handle tears (in 7 knees) showed a non-linear high density area. These results may be due to both the angle between the tear and the slice lines of MR imaging, and the degeneration of menisci. The MRI of normal menisci in 10 knees were also investigated. A false-positive high-density area was often seen at the synovia-meniscal junction in the coronal plane of MR imaging and was seen at the posterior or anterior menisci in the saggital plane. (author)

Synovial hemangioma of the knee: MRI findings in two cases

International Nuclear Information System (INIS)

Llauger, J.; Monill, J.M.; Palmer, J.; Clotet, M.

1995-01-01

The findings in two patients with histologically proven synovial hemangioma of the knee are described. Both cases emphasize the typical appearance of this unusual tumor on magnetic resonance imaging. Additional radiologic findings, such as adjacent osseous insolvement, are discussed. The MRI findings of this tumor are highly suggestive of the diagnosis and MRI should eliminate the need for invasive angiographic procedures. (orig.)

Associations between MRI-defined structural pathology and generalized and localized knee pain - the Oulu Knee Osteoarthritis study.

Science.gov (United States)

Kaukinen, P; Podlipská, J; Guermazi, A; Niinimäki, J; Lehenkari, P; Roemer, F W; Nieminen, M T; Koski, J M; Arokoski, J P A; Saarakkala, S

2016-09-01

To determine the associations between multi-feature structural pathology assessed using magnetic resonance imaging (MRI) and the presence of knee pain, and to determine the associations between the locations of structural changes and different knee pain patterns. Eighty symptomatic subjects with knee pain and suspicion or diagnosis of knee OA and 63 asymptomatic subjects underwent knee MRI. Severity of structural changes was graded by MRI Osteoarthritis Knee Score (MOAKS) in separate knee locations. The associations between cartilage damage, bone marrow lesions (BMLs), osteophytes, Hoffa's synovitis, effusion-synovitis, meniscal damage and structural pathologies in ligaments, tendons and bursas and both the presence of pain and the knee pain patterns were assessed. The presence of Hoffa's synovitis (adjusted RR 1.6, 95% CI 1.2-1.3) and osteophytes in any region (2.07, 1.19-3.60) was significantly associated with the presence of pain. Any Hoffa's synovitis was associated with patellar pain (adjusted RR 4.70, 95% CI 1.19-3.60) and moderate-to-severe Hoffa's synovitis with diffuse pain (2.25, 1.13-4.50). Medial knee pain was associated with cartilage loss in the medial tibia (adjusted RR 2.66, 95% CI 1.22-5.80), osteophytes in the medial tibia (2.66, 1.17-6.07) and medial femur (2.55, 1.07-6.09), medial meniscal maceration (2.20, 1.01-4.79) and anterior meniscal extrusions (2.78, 1.14-6.75). Hoffa's synovitis and osteophytes were strongly associated with the presence of knee pain. Medial pain was associated most often with medially located structural pathologies. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Readout-segmented multi-shot diffusion-weighted MRI of the knee joint in patients with juvenile idiopathic arthritis.

Science.gov (United States)

Sauer, Alexander; Li, Mengxia; Holl-Wieden, Annette; Pabst, Thomas; Neubauer, Henning

2017-10-12

Diffusion-weighted MRI has been proposed as a new technique for imaging synovitis without intravenous contrast application. We investigated diagnostic utility of multi-shot readout-segmented diffusion-weighted MRI (multi-shot DWI) for synovial imaging of the knee joint in patients with juvenile idiopathic arthritis (JIA). Thirty-two consecutive patients with confirmed or suspected JIA (21 girls, median age 13 years) underwent routine 1.5 T MRI with contrast-enhanced T1w imaging (contrast-enhanced MRI) and with multi-shot DWI (RESOLVE, b-values 0-50 and 800 s/mm 2 ). Contrast-enhanced MRI, representing the diagnostic standard, and diffusion-weighted images at b = 800 s/mm 2 were separately rated by three independent blinded readers at different levels of expertise for the presence and the degree of synovitis on a modified 5-item Likert scale along with the level of subjective diagnostic confidence. Fourteen (44%) patients had active synovitis and joint effusion, nine (28%) patients showed mild synovial enhancement not qualifying for arthritis and another nine (28%) patients had no synovial signal alterations on contrast-enhanced imaging. Ratings by the 1st reader on contrast-enhanced MRI and on DWI showed substantial agreement (κ = 0.74). Inter-observer-agreement was high for diagnosing, or ruling out, active arthritis of the knee joint on contrast-enhanced MRI and on DWI, showing full agreement between 1st and 2nd reader and disagreement in one case (3%) between 1st and 3rd reader. In contrast, ratings in cases of absent vs. little synovial inflammation were markedly inconsistent on DWI. Diagnostic confidence was lower on DWI, compared to contrast-enhanced imaging. Multi-shot DWI of the knee joint is feasible in routine imaging and reliably diagnoses, or rules out, active arthritis of the knee joint in paediatric patients without the need of gadolinium-based i.v. contrast injection. Possibly due to "T2w shine-through" artifacts, DWI does not reliably

Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

International Nuclear Information System (INIS)

Agten, Christoph A.; Pfirrmann, Christian W.A.; Sutter, Reto; Grande, Filippo del; Fucentese, Sandro F.; Blatter, Samuel

2015-01-01

To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. SEMAC reduced mean artefact size for STIR (11.8 cm 2 vs. 37.7 cm 2 ) and PD (16.8 cm 2 vs. 18.9 cm 2 ), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons' decisions towards surgery, while PD-SEMAC showed no clinical benefit. (orig.)

Computer-aided diagnosis of early knee osteoarthritis based on MRI T2 mapping.

Science.gov (United States)

Wu, Yixiao; Yang, Ran; Jia, Sen; Li, Zhanjun; Zhou, Zhiyang; Lou, Ting

2014-01-01

This work was aimed at studying the method of computer-aided diagnosis of early knee OA (OA: osteoarthritis). Based on the technique of MRI (MRI: Magnetic Resonance Imaging) T2 Mapping, through computer image processing, feature extraction, calculation and analysis via constructing a classifier, an effective computer-aided diagnosis method for knee OA was created to assist doctors in their accurate, timely and convenient detection of potential risk of OA. In order to evaluate this method, a total of 1380 data from the MRI images of 46 samples of knee joints were collected. These data were then modeled through linear regression on an offline general platform by the use of the ImageJ software, and a map of the physical parameter T2 was reconstructed. After the image processing, the T2 values of ten regions in the WORMS (WORMS: Whole-organ Magnetic Resonance Imaging Score) areas of the articular cartilage were extracted to be used as the eigenvalues in data mining. Then,a RBF (RBF: Radical Basis Function) network classifier was built to classify and identify the collected data. The classifier exhibited a final identification accuracy of 75%, indicating a good result of assisting diagnosis. Since the knee OA classifier constituted by a weights-directly-determined RBF neural network didn't require any iteration, our results demonstrated that the optimal weights, appropriate center and variance could be yielded through simple procedures. Furthermore, the accuracy for both the training samples and the testing samples from the normal group could reach 100%. Finally, the classifier was superior both in time efficiency and classification performance to the frequently used classifiers based on iterative learning. Thus it was suitable to be used as an aid to computer-aided diagnosis of early knee OA.

An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods

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Alizai, Hamza [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); University of Texas Health Science Center at San Antonio, Department of Radiology, San Antonio, TX (United States); Roemer, Frank W. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Hayashi, Daichi [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Yale University School of Medicine, Department of Radiology, Bridgeport Hospital, Bridgeport, CT (United States); Crema, Michel D. [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Hospital do Coracao and Teleimagem, Department of Radiology, Sao Paulo (Brazil); Felson, David T. [Boston University School of Medicine, Clinical Epidemiology Research and Training Unit, Boston, MA (United States); Guermazi, Ali [Boston University School of Medicine, Quantitative Imaging Center, Department of Radiology, Boston, MA (United States); Aspetar Orthopaedic and Sports Medicine Hospital, Doha (Qatar); Boston Medical Center, Boston, MA (United States)

2014-11-07

Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available faor evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems. (orig.)

An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods

International Nuclear Information System (INIS)

Alizai, Hamza; Roemer, Frank W.; Hayashi, Daichi; Crema, Michel D.; Felson, David T.; Guermazi, Ali

2015-01-01

Arthroscopy-based semiquantitative scoring systems such as Outerbridge and Noyes' scores were the first to be developed for the purpose of grading cartilage defects. As magnetic resonance imaging (MRI) became available faor evaluation of the osteoarthritic knee joint, these systems were adapted for use with MRI. Later on, grading methods such as the Whole Organ Magnetic Resonance Score, the Boston-Leeds Osteoarthritis Knee Score and the MRI Osteoarthritis Knee Score were designed specifically for performing whole-organ assessment of the knee joint structures, including cartilage. Cartilage grades on MRI obtained with these scoring systems represent optimal outcome measures for longitudinal studies, and are designed to enhance understanding of the knee osteoarthritis disease process. The purpose of this narrative review is to describe cartilage assessment in knee osteoarthritis using currently available MRI-based semiquantitative whole-organ scoring systems, and to provide an update on the risk factors for cartilage loss in knee osteoarthritis as assessed with these scoring systems. (orig.)

KneeTex: an ontology-driven system for information extraction from MRI reports.

Science.gov (United States)

Spasić, Irena; Zhao, Bo; Jones, Christopher B; Button, Kate

2015-01-01

In the realm of knee pathology, magnetic resonance imaging (MRI) has the advantage of visualising all structures within the knee joint, which makes it a valuable tool for increasing diagnostic accuracy and planning surgical treatments. Therefore, clinical narratives found in MRI reports convey valuable diagnostic information. A range of studies have proven the feasibility of natural language processing for information extraction from clinical narratives. However, no study focused specifically on MRI reports in relation to knee pathology, possibly due to the complexity of knee anatomy and a wide range of conditions that may be associated with different anatomical entities. In this paper we describe KneeTex, an information extraction system that operates in this domain. As an ontology-driven information extraction system, KneeTex makes active use of an ontology to strongly guide and constrain text analysis. We used automatic term recognition to facilitate the development of a domain-specific ontology with sufficient detail and coverage for text mining applications. In combination with the ontology, high regularity of the sublanguage used in knee MRI reports allowed us to model its processing by a set of sophisticated lexico-semantic rules with minimal syntactic analysis. The main processing steps involve named entity recognition combined with coordination, enumeration, ambiguity and co-reference resolution, followed by text segmentation. Ontology-based semantic typing is then used to drive the template filling process. We adopted an existing ontology, TRAK (Taxonomy for RehAbilitation of Knee conditions), for use within KneeTex. The original TRAK ontology expanded from 1,292 concepts, 1,720 synonyms and 518 relationship instances to 1,621 concepts, 2,550 synonyms and 560 relationship instances. This provided KneeTex with a very fine-grained lexico-semantic knowledge base, which is highly attuned to the given sublanguage. Information extraction results were evaluated

MRI performed on dedicated knee coils is inaccurate for the measurement of tibial tubercle trochlear groove distance

International Nuclear Information System (INIS)

Aarvold, A.; Pope, A.; Sakthivel, V.K.; Ayer, R.V.

2014-01-01

Tibial tubercle trochlear groove distance (TTD) is a significant factor in patello-femoral instability. Initially described on CT scans with the knee in full extension, the measurement has been validated on MR scans. Dedicated knee MRI coils have subsequently superseded both CT and MRI body coils for knee imaging. However, the knee rests in partial flexion within the dedicated knee coil. The objective of this study is to investigate whether images from dedicated knee MRI coils produce different TTD measurements from MR body coils. Thirty-two symptomatic knees (27 patients) had simultaneous knee MR scans performed in both a dedicated knee coil and a body coil. TTD measurements were independently compared to assess whether the coil type used affected TTD. Patients' ages ranged from 10 to 27 years (mean 15 years). Mean TTD in the dedicated knee coil (partially flexed knee) was 11.3 mm compared with 19.9 mm in the body coil (that permits full knee extension). The mean difference was 8.6 mm, which was highly significant (p < 0.0001, unpaired t test). Inter-rater correlation co-efficient was 96 %. Of the knees that recorded a ''normal'' TTD on the dedicated knee coil, 60-100 % recorded a ''pathological'' TTD on body coil images, depending on which diagnostic value for ''normal'' cut-off was used. This study has identified a highly significant difference in TTD measurement when knees are scanned in a dedicated knee coil with the knee partially flexed, compared with an MR body coil. It is critical for surgeons and radiologists managing patello-femoral instability to appreciate this profound difference. TTD measurement taken from knees scanned in dedicated knee coils may lead to patients being falsely re-assured or erroneously denied surgery. (orig.)

Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players.

Science.gov (United States)

Walczak, Brian E; McCulloch, Patrick C; Kang, Richard W; Zelazny, Anthony; Tedeschi, Fred; Cole, Brian J

2008-01-01

The purpose of this study was to evaluate the knees of asymptomatic National Basketball Association (NBA) players via magnetic resonance imaging (MRI) and confirm or dispute findings reported in the previous literature. It is thought that a variety of significant abnormalities affecting the knee exist in asymptomatic patients and that these findings can be accurately identified on MRI. Two months prior to the 2005 season, bilateral knee MRI examinations of 14 asymptomatic NBA players (28 knees) were evaluated for abnormalities of the articular cartilage, menisci, and patellar and quadriceps tendons. The presence of joint effusion, subchondral edema, and cystic lesions and the integrity of the collateral and cruciate ligaments were also assessed.

The developing role of knee MRI in musculo-skeletal radiology: the progression to 3-D imaging

International Nuclear Information System (INIS)

Kurmis, A.P.

2001-01-01

The purpose of this paper, following a comprehensive and systematic review of the available literature, is to provide both a historical record of the development of knee MRI and outline its progression to new 'state of the art' three dimensional reconstruction techniques. while preliminary work has been done to qualitatively- explore the application of 3D knee MR in controlled research settings the true clinical value of such applications has not yet been clearly established. lt was found that in the absence of valid research findings, much of the reported work in this area relied heavily on both anecdotal evidence and hypothetical expressions of likelihood. Much work must still be done to validate the reliability and clinical usefulness of this new diagnostic tool. In following with the reports of previous authors, the likely benefits of a 3-D computer reconstructed model of the knee include improved display of complex anatomical relationships, clarification of anatomical structures, clear demonstration of anatomy/pathology for those unfamiliar with tomographic or sectional images,and reduced examination time. Work has also suggested that 3-D MR may allow accurate pre-surgical classification of lesions while facilitating operative planning and real time intra-operative navigation. Other areas of cutting edge research also include applications toward surgical robotics, simulated surgical procedures, tele surgery, bone and prosthesis modeling, and virtual endoscopy/arthroscopy One of the more practical potential benefits of 3-D image displays may lie in assisting the radiologist to communicate the appearance of normal anatomy or pathological processes to other medical staff likely to be less familiar with the interpretation of routine two dimensional images. Such a method may also prove useful in aiding clinicians to convey their diagnoses and means of treatment to patients. It is hoped that this review will provide a base point from which future work can be

Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

International Nuclear Information System (INIS)

Tsavalas, Nikolaos; Karantanas, Apostolos H.; Katonis, Pavlos

2012-01-01

To evaluate patellofemoral congruency measurements on MRI and correlate the findings with severity of ipsilateral osteoarthritis. We retrospectively reviewed 650 consecutive knee MRI examinations from 622 patients divided into two age groups: ≤50 and >50 year-old. The femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), lateral patellofemoral angle (LPFA), tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index as well as the grade of focal cartilage defects (ranging from I to IV) in the patellofemoral region were assessed in each subject on axial and sagittal fat-saturated intermediate-w MR images. A significant difference exists between normal and knees with patellofemoral joint osteoarthritis regarding SA (p = 0.0002 and 50 respectively). Significant correlation was found between grading of cartilage defects and SA (rho = 0.21, p = 0.0001 and 0.443, <0.0001), SD (rho = -0.198, p = 0.0003 and -0.418, <0.0001), LPD (rho = 0.176, p = 0.0013 and 0.251, 0.0002) and LPFA (rho = -0.204, p = 0.0002 and -0.239, 0.0005) in both age groups. Knee joint anterior malalignment is multivariably associated with patellofemoral osteoarthritis. circle MRI is an excellent method to evaluate knee alignment and articular cartilage damage. (orig.)

Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study).

Science.gov (United States)

Guermazi, Ali; Niu, Jingbo; Hayashi, Daichi; Roemer, Frank W; Englund, Martin; Neogi, Tuhina; Aliabadi, Piran; McLennan, Christine E; Felson, David T

2012-08-29

To examine use of magnetic resonance imaging (MRI) of knees with no radiographic evidence of osteoarthritis to determine the prevalence of structural lesions associated with osteoarthritis and their relation to age, sex, and obesity. Population based observational study. Community cohort in Framingham, MA, United States (Framingham osteoarthritis study). 710 people aged >50 who had no radiographic evidence of knee osteoarthritis (Kellgren-Lawrence grade 0) and who underwent MRI of the knee. Prevalence of MRI findings that are suggestive of knee osteoarthritis (osteophytes, cartilage damage, bone marrow lesions, subchondral cysts, meniscal lesions, synovitis, attrition, and ligamentous lesions) in all participants and after stratification by age, sex, body mass index (BMI), and the presence or absence of knee pain. Pain was assessed by three different questions and also by WOMAC questionnaire. Of the 710 participants, 393 (55%) were women, 660 (93%) were white, and 206 (29%) had knee pain in the past month. The mean age was 62.3 years and mean BMI was 27.9. Prevalence of "any abnormality" was 89% (631/710) overall. Osteophytes were the most common abnormality among all participants (74%, 524/710), followed by cartilage damage (69%, 492/710) and bone marrow lesions (52%, 371/710). The higher the age, the higher the prevalence of all types of abnormalities detectable by MRI. There were no significant differences in the prevalence of any of the features between BMI groups. The prevalence of at least one type of pathology ("any abnormality") was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees. MRI shows lesions in the tibiofemoral joint in most middle aged and elderly people in whom knee radiographs do not show any features of osteoarthritis, regardless of pain.

Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

Energy Technology Data Exchange (ETDEWEB)

Agten, Christoph A.; Pfirrmann, Christian W.A.; Sutter, Reto [Balgrist University Hospital, Radiology Department, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Grande, Filippo del [Regional Hospital, Radiology, Lugano (Switzerland); Fucentese, Sandro F.; Blatter, Samuel [University of Zurich, Faculty of Medicine, Zurich (Switzerland); Balgrist University Hospital, Orthopedics, Zurich (Switzerland)

2015-07-15

To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. SEMAC reduced mean artefact size for STIR (11.8 cm{sup 2} vs. 37.7 cm{sup 2}) and PD (16.8 cm{sup 2} vs. 18.9 cm{sup 2}), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons' decisions towards surgery, while PD-SEMAC showed no clinical benefit. (orig.)

The MRI appearance of cystic lesions around the knee

International Nuclear Information System (INIS)

McCarthy, Catherine L.; McNally, Eugene G.

2004-01-01

This review presents a comprehensive illustrated overview of the wide variety of cystic lesions around the knee. The aetiology, clinical presentation, MRI appearances and differential diagnosis are discussed. Bursae include those related to the patella as well as pes anserine, tibial collateral ligament, semimembranosus-tibial collateral ligament, iliotibial and fibular collateral ligament-biceps femoris. The anatomical extension, imaging features and clinical significance of meniscal cysts are illustrated. Review of ganglia includes intra-articular, extra-articular, intraosseous and periosteal ganglia, highlighting imaging findings and differential diagnoses. The relationship between proximal tibiofibular joint cysts and intraneural peroneal nerve ganglia is discussed. Intraosseous cystic lesions, including insertional and degenerative cysts, as well as lesions mimicking cysts of the knee are described and illustrated. Knowledge of the location, characteristic appearance and distinguishing features of cystic masses around the knee as well as potential imaging pitfalls such as normal anatomical recesses and atypical cyst contents on MR imaging aids in allowing a specific diagnosis to be made. This will prevent unnecessary additional investigations and determine whether intra-articular surgery or conservative management is appropriate. (orig.)

MRI of the posterolateral corner of the knee, please have a look

African Journals Online (AJOL)

Mahmoud Agha

2016-09-23

Sep 23, 2016 ... Diagnostic Imaging, Medical Research Institute, Alexandria University, Egypt. Diagnostic .... the radiology department of Al-Mana General Hospital, East- ern Province ... Figure 2. MRI anatomy of knee PLC: (A) Coronal T2-weighted image shows the origin of the lateral gastrocnemius head (arrowhead),.

Imaging appearances of synovial plicae syndrome of the knee

Directory of Open Access Journals (Sweden)

Osama Abdalla Mabrouk Kheiralla

2016-08-01

Full Text Available Synovial plicae are synovial folds that may be found as intraarticular structures within the knee joint. They are remnants of incomplete resorption of mesenchymal tissue during fetal development. Synovial plicae, if present, are supposed to be non-pathological and asymptomatic, however if they are exposed to special events like direct trauma or repeated activities, they may be inflamed and become fibrosed and rigid and irritates the synovium of the underlying femoral condyle resulting in secondary mechanical synovitis and chondromalacia leading to what is known as plica syndrome of the knee. Inspite plica syndrome is always suspected on clinical bases and can be clearly visualized by arthroscopic application, still diagnostic imaging by MRI, CT scan and Sonography play important role in the evaluation and diagnosis of this pathological condition. The aim of this article is to provide an overview of the imaging appearances of synovial plicae syndrome of the knee on ultrasound, magnetic resonance imaging (MRI and computerized tomography scan (CT scan.

The association of magnetic resonance imaging (MRI)-detected structural pathology of the knee with crepitus in a population-based cohort with knee pain: the MoDEKO study.

Science.gov (United States)

Crema, M D; Guermazi, A; Sayre, E C; Roemer, F W; Wong, H; Thorne, A; Singer, J; Esdaile, J M; Marra, M D; Kopec, J A; Nicolaou, S; Cibere, J

2011-12-01

Osteoarthritis (OA) is the most common arthropathy of the knee joint(1). Symptoms reported by patients and signs noted during physical examination guide clinicians in identifying subjects with knee OA(2-4). Pain is one of the most important symptoms reported by subjects with knee OA(2,3). Although very common, pain is a non-specific symptom, related to pathology in several structures within the knee joint, and includes synovitis(5), subchondral bone marrow lesions(6), and joint effusion(7). Further, pain is a subjective symptom that cannot be directly measured or assessed during physical examination. Crepitus or crepitation in association with arthritis is defined as a crackling or grinding sound on joint movement with a sensation in the joint. Crepitus may occur with or without pain and is a common finding during physical examination in subjects with knee OA(2-4,8,9). It is not known whether crepitus is related to pathology in various structures within the knee. The aim of our study was to determine the cross-sectional associations of structural pathologies within the knee with crepitus in a population-based cohort with knee pain, using magnetic resonance imaging (MRI). Subjects with knee pain were recruited as a random population sample, with crepitus assessed in each compartment of the knee using a validated and standardized approach during physical examination(10). MRI of the knee was performed to assess cartilage morphology, meniscal morphology, osteophytes, cruciate ligaments, and collateral ligaments. For both compartment-specific and whole-knee analyses, a multiple logistic regression analysis was performed to assess the associations of MRI-detected structural pathology with crepitus, adjusting for potential confounders. Variables were selected by backwards elimination within each compartment and in the overall knee models, and only statistically significant variables remained in the "selected" models; remaining variables in these models are adjusted for

Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients

International Nuclear Information System (INIS)

Bachmann, G.F.; Rauber, K.; Damian, M.S.; Rau, W.S.; Basad, E.

1999-01-01

We examined 320 patients with MRI and arthroscopy after an acute trauma to evaluate MRI in diagnosis of degenerative joint disease of the knee in relation to sports activity and clinical data. Lesions of cartilage and menisci on MRI were registered by two radiologists in consensus without knowledge of arthroscopy. Arthroscopy demonstrated grade-1 to grade-4 lesions of cartilage on 729 of 1920 joint surfaces of 320 knees, and MRI diagnosed 14 % of grade-1, 32 % of grade-2, 94 % of grade-3, and 100 % of grade-4 lesions. Arthroscopy explored 1280 meniscal areas and showed degenerations in 10 %, tears in 11.4 %, and complex lesions in 9.2 %. Magnetic resonance imaging was in agreement with arthroscopy in 81 % showing more degenerations but less tears of menisci than arthroscopy. Using a global system for grading the total damage of the knee joint into none, mild, moderate, or severe changes, agreement between arthroscopy and MRI was found in 82 %. Magnetic resonance imaging and arthroscopy showed coherently that degree of degenerative joint changes was significantly correlated to patient age or previous knee trauma. Patients over 40 years had moderate to severe changes on MRI in 45 % and patients under 30 years in only 22 %. Knee joints with a history of trauma without complete structural or functional reconstitution showed marked changes on MRI in 57 %, whereas stable joints without such alterations had degenerative changes in only 26 %. There was no correlation of degenerative disease to gender, weight, type, frequency, and intensity of sports activity. Therefore, MRI is an effective non-invasive imaging method for exact localization and quantification of chronic joint changes of cartilage and menisci that recommends MRI for monitoring in sports medicine. (orig.) (orig.)

Generating finite element models of the knee: How accurately can we determine ligament attachment sites from MRI scans?

NARCIS (Netherlands)

Rachmat, H.H.; Janssen, D.; Zevenbergen, W.J.; Verkerke, Gijsbertus Jacob; Diercks, R.L.; Verdonschot, Nicolaas Jacobus Joseph

2014-01-01

In this study, we evaluated the intra- and inter-observer variability when determining the insertion and origin sites of knee ligaments on MRI scan images. We collected data of five observers with different backgrounds, who determined the ligament attachment sites in an MRI scan of a right knee of a

Diagnostic performance of 3D standing CT imaging for detection of knee osteoarthritis features.

Science.gov (United States)

Segal, Neil A; Nevitt, Michael C; Lynch, John A; Niu, Jingbo; Torner, James C; Guermazi, Ali

2015-07-01

To determine the diagnostic performance of standing computerized tomography (SCT) of the knee for osteophytes and subchondral cysts compared with fixed-flexion radiography, using MRI as the reference standard. Twenty participants were recruited from the Multicenter Osteoarthritis Study. Participants' knees were imaged with SCT while standing in a knee-positioning frame, and with postero-anterior fixed-flexion radiography and 1T MRI. Medial and lateral marginal osteophytes and subchondral cysts were scored on bilateral radiographs and coronal SCT images using the OARSI grading system and on coronal MRI using Whole Organ MRI Scoring. Imaging modalities were read separately with images in random order. Sensitivity, specificity and accuracy for the detection of lesions were calculated and differences between modalities were tested using McNemar's test. Participants' mean age was 66.8 years, body mass index was 29.6 kg/m(2) and 50% were women. Of the 160 surfaces (medial and lateral femur and tibia for 40 knees), MRI revealed 84 osteophytes and 10 subchondral cysts. In comparison with osteophytes and subchondral cysts detected by MRI, SCT was significantly more sensitive (93 and 100%; p osteophytes) than plain radiographs (sensitivity 60 and 10% and accuracy 79 and 94%, respectively). For osteophytes, differences in sensitivity and accuracy were greatest at the medial femur (p = 0.002). In comparison with MRI, SCT imaging was more sensitive and accurate for detection of osteophytes and subchondral cysts than conventional fixed-flexion radiography. Additional study is warranted to assess diagnostic performance of SCT measures of joint space width, progression of OA features and the patellofemoral joint.

Comparison of a fast 5-min knee MRI protocol with a standard knee MRI protocol. A multi-institutional multi-reader study

Energy Technology Data Exchange (ETDEWEB)

FitzGerald Alaia, Erin; Beltran, Luis S.; Garwood, Elisabeth; Burke, Christopher J.; Gyftopoulos, Soterios [NYU Langone Medical Center, Department of Radiology, Musculoskeletal Division, New York, NY (United States); Benedick, Alex [Case Western Reserve University, School of Medicine, Cleveland, OH (United States); Obuchowski, Nancy A. [Cleveland Clinic, Department of Quantitative Health Sciences, Cleveland, OH (United States); Polster, Joshua M.; Schils, Jean; Subhas, Naveen [Cleveland Clinic, Department of Radiology, Musculoskeletal Division, Cleveland, OH (United States); Chang, I. Yuan Joseph [Texas Scottish Rite Hospital for Children, Dallas, TX (United States)

2018-01-15

To compare diagnostic performance of a 5-min knee MRI protocol to that of a standard knee MRI. One hundred 3 T (100 patients, mean 38.8 years) and 50 1.5 T (46 patients, mean 46.4 years) MRIs, consisting of 5 fast, 2D multi-planar fast-spin-echo (FSE) sequences and five standard multiplanar FSE sequences, from two academic centers (1/2015-1/2016), were retrospectively reviewed by four musculoskeletal radiologists. Agreement between fast and standard (interprotocol agreement) and between standard (intraprotocol agreement) readings for meniscal, ligamentous, chondral, and bone pathology was compared for interchangeability. Frequency of major findings, sensitivity, and specificity was also tested for each protocol. Interprotocol agreement using fast MRI was similar to intraprotocol agreement with standard MRI (83.0-99.5%), with no excess disagreement (≤ 1.2; 95% CI, -4.2 to 3.8%), across all structures. Frequency of major findings (1.1-22.4% across structures) on fast and standard MRI was not significantly different (p ≥ 0.215), except more ACL tears on fast MRI (p = 0.021) and more cartilage defects on standard MRI (p < 0.001). Sensitivities (59-100%) and specificities (73-99%) of fast and standard MRI were not significantly different for meniscal and ligament tears (95% CI for difference, -0.08-0.08). For cartilage defects, fast MRI was slightly less sensitive (95% CI for difference, -0.125 to -0.01) but slightly more specific (95% CI for difference, 0.01-0.5) than standard MRI. A fast 5-min MRI protocol is interchangeable with and has similar accuracy to a standard knee MRI for evaluating internal derangement of the knee. (orig.)

Comparison of a fast 5-min knee MRI protocol with a standard knee MRI protocol. A multi-institutional multi-reader study

International Nuclear Information System (INIS)

FitzGerald Alaia, Erin; Beltran, Luis S.; Garwood, Elisabeth; Burke, Christopher J.; Gyftopoulos, Soterios; Benedick, Alex; Obuchowski, Nancy A.; Polster, Joshua M.; Schils, Jean; Subhas, Naveen; Chang, I. Yuan Joseph

2018-01-01

To compare diagnostic performance of a 5-min knee MRI protocol to that of a standard knee MRI. One hundred 3 T (100 patients, mean 38.8 years) and 50 1.5 T (46 patients, mean 46.4 years) MRIs, consisting of 5 fast, 2D multi-planar fast-spin-echo (FSE) sequences and five standard multiplanar FSE sequences, from two academic centers (1/2015-1/2016), were retrospectively reviewed by four musculoskeletal radiologists. Agreement between fast and standard (interprotocol agreement) and between standard (intraprotocol agreement) readings for meniscal, ligamentous, chondral, and bone pathology was compared for interchangeability. Frequency of major findings, sensitivity, and specificity was also tested for each protocol. Interprotocol agreement using fast MRI was similar to intraprotocol agreement with standard MRI (83.0-99.5%), with no excess disagreement (≤ 1.2; 95% CI, -4.2 to 3.8%), across all structures. Frequency of major findings (1.1-22.4% across structures) on fast and standard MRI was not significantly different (p ≥ 0.215), except more ACL tears on fast MRI (p = 0.021) and more cartilage defects on standard MRI (p < 0.001). Sensitivities (59-100%) and specificities (73-99%) of fast and standard MRI were not significantly different for meniscal and ligament tears (95% CI for difference, -0.08-0.08). For cartilage defects, fast MRI was slightly less sensitive (95% CI for difference, -0.125 to -0.01) but slightly more specific (95% CI for difference, 0.01-0.5) than standard MRI. A fast 5-min MRI protocol is interchangeable with and has similar accuracy to a standard knee MRI for evaluating internal derangement of the knee. (orig.)

3D knee segmentation based on three MRI sequences from different planes.

Science.gov (United States)

Zhou, L; Chav, R; Cresson, T; Chartrand, G; de Guise, J

2016-08-01

In clinical practice, knee MRI sequences with 3.5~5 mm slice distance in sagittal, coronal, and axial planes are often requested for the knee examination since its acquisition is faster than high-resolution MRI sequence in a single plane, thereby reducing the probability of motion artifact. In order to take advantage of the three sequences from different planes, a 3D segmentation method based on the combination of three knee models obtained from the three sequences is proposed in this paper. In the method, the sub-segmentation is respectively performed with sagittal, coronal, and axial MRI sequence in the image coordinate system. With each sequence, an initial knee model is hierarchically deformed, and then the three deformed models are mapped to reference coordinate system defined by the DICOM standard and combined to obtain a patient-specific model. The experimental results verified that the three sub-segmentation results can complement each other, and their integration can compensate for the insufficiency of boundary information caused by 3.5~5 mm gap between consecutive slices. Therefore, the obtained patient-specific model is substantially more accurate than each sub-segmentation results.

Evaluation of MRI acquisition workflow with lean six sigma method: case study of liver and knee examinations.

Science.gov (United States)

Roth, Christopher J; Boll, Daniel T; Wall, Lisa K; Merkle, Elmar M

2010-08-01

The purpose of this investigation was to assess workflow for medical imaging studies, specifically comparing liver and knee MRI examinations by use of the Lean Six Sigma methodologic framework. The hypothesis tested was that the Lean Six Sigma framework can be used to quantify MRI workflow and to identify sources of inefficiency to target for sequence and protocol improvement. Audio-video interleave streams representing individual acquisitions were obtained with graphic user interface screen capture software in the examinations of 10 outpatients undergoing MRI of the liver and 10 outpatients undergoing MRI of the knee. With Lean Six Sigma methods, the audio-video streams were dissected into value-added time (true image data acquisition periods), business value-added time (time spent that provides no direct patient benefit but is requisite in the current system), and non-value-added time (scanner inactivity while awaiting manual input). For overall MRI table time, value-added time was 43.5% (range, 39.7-48.3%) of the time for liver examinations and 89.9% (range, 87.4-93.6%) for knee examinations. Business value-added time was 16.3% of the table time for the liver and 4.3% of the table time for the knee examinations. Non-value-added time was 40.2% of the overall table time for the liver and 5.8% for the knee examinations. Liver MRI examinations consume statistically significantly more non-value-added and business value-added times than do knee examinations, primarily because of respiratory command management and contrast administration. Workflow analyses and accepted inefficiency reduction frameworks can be applied with use of a graphic user interface screen capture program.

Correlation between subcutaneous knee fat thickness and chondromalacia patellae on magnetic resonance imaging of the knee.

LENUS (Irish Health Repository)

Kok, Hong Kuan

2013-08-01

Chondromalacia patellae is a common cause of anterior knee pain in young patients and can be detected noninvasively with magnetic resonance imaging (MRI). The purpose of our study was to evaluate the correlation between subcutaneous fat thickness around the knee joint on axial MRIs as a surrogate marker of obesity, with the presence or absence of chondromalacia patellae.

Variability of Measurement of Patellofemoral Indices with Knee Flexion and Quadriceps Contraction: An MRI-Based Anatomical Study

Science.gov (United States)

Laugharne, Edward; Bali, Navi; Purushothamdas, Sanjay; Almallah, Faris; Kundra, Rik

2016-01-01

Purpose The purpose of this study was to investigate the impact of varying knee flexion and quadriceps activity on patellofemoral indices measured on magnetic resonance imaging (MRI). Materials and Methods MRI of the knee was performed in 20 patients for indications other than patellar or patellofemoral pathology. Axial and sagittal sequences were performed in full extension of the knee with the quadriceps relaxed, full extension of the knee with the quadriceps contracted, 30° flexion of the knee with the quadriceps relaxed, and 30° flexion with the quadriceps contracted. Bisect offset, patella tilt angle, Insall-Salvati ratio and Caton-Deschamps index were measured. Results With the knee flexed to 30° and quadriceps relaxed, the mean values of patellar tilt angle, bisect offset, Insall-Salvati ratio and Caton-Deschamps index were all within normal limits. With the knee extended and quadriceps contracted, the mean patellar tilt angle (normal value, patellofemoral indices. MRI taken with the knee in 30° of flexion allows more reliable assessment of the patellofemoral joint and minimises the confounding effect of quadriceps contraction. PMID:27894177

MRI of normal anterior cruciate ligament (ACL) and reconstructed ACL: comparison of when the knee is extended with when the knee is flexed

International Nuclear Information System (INIS)

Nakanishi, K.; Horibe, S.; Shiozaki, Y.; Ishida, T.; Narumi, Y.; Ikezoe, J.; Nakamura, H.

1997-01-01

The purpose of this study was to evaluate, using MRI, the morphology of normal anterior cruciate ligament (ACL) and ACL grafts when the knee was extended compared with when the knee was flexed. Eighteen normal controls and 22 ACL graft patients were studied. Spin-echo (SE) T1-weighted images (TR 330 ms/TE 15 ms, NEX 1) were obtained with a slice thickness of 3 mm. Oblique sagittal images parallel to the ACL were obtained at various flexed angles of the knee joint. In 12 of the 18 normal controls the ACL appeared convex toward the posterior side when the knee was extended and gradually became straight when the knee was flexed. In 15 of the 22 ACL graft patients the grafts appeared straight when the knee was extended and became convex toward the anterior side when the knee was flexed. It is concluded that the morphological changes seen on MR images of ACL grafts from when the knee is extended to when the knee is flexed are different from those in the normal ACL. (orig.). With 7 figs., 1 tab

Knee joint anterior malalignment and patellofemoral osteoarthritis: an MRI study

Energy Technology Data Exchange (ETDEWEB)

Tsavalas, Nikolaos; Karantanas, Apostolos H. [University Hospital, University of Crete, Department of Medical Imaging, Heraklion, Crete (Greece); Katonis, Pavlos [University Hospital, University of Crete, Department of Orthopaedic Surgery, Heraklion, Crete (Greece)

2012-02-15

To evaluate patellofemoral congruency measurements on MRI and correlate the findings with severity of ipsilateral osteoarthritis. We retrospectively reviewed 650 consecutive knee MRI examinations from 622 patients divided into two age groups: {<=}50 and >50 year-old. The femoral sulcus angle (SA) and depth (SD), lateral patellar displacement (LPD), lateral patellofemoral angle (LPFA), tibial tubercle-trochlear groove (TT-TG) distance and Insall-Salvati index as well as the grade of focal cartilage defects (ranging from I to IV) in the patellofemoral region were assessed in each subject on axial and sagittal fat-saturated intermediate-w MR images. A significant difference exists between normal and knees with patellofemoral joint osteoarthritis regarding SA (p = 0.0002 and <0.0001), SD (p = 0.0004 and <0.0001), LPD (p = 0.0014 and 0.0009) and LPFA (p = 0.0002 and 0.0003) in both age groups ({<=}50 and >50 respectively). Significant correlation was found between grading of cartilage defects and SA (rho = 0.21, p = 0.0001 and 0.443, <0.0001), SD (rho = -0.198, p = 0.0003 and -0.418, <0.0001), LPD (rho = 0.176, p = 0.0013 and 0.251, 0.0002) and LPFA (rho = -0.204, p = 0.0002 and -0.239, 0.0005) in both age groups. Knee joint anterior malalignment is multivariably associated with patellofemoral osteoarthritis. circle MRI is an excellent method to evaluate knee alignment and articular cartilage damage. (orig.)

MRI and X-ray findings of osteonecrosis in the knee

International Nuclear Information System (INIS)

Shimizu, Koh

2009-01-01

This paper describes the retrospective comparison of MRI and X-ray findings of steroid-induced and idiopathic osteonecrosis in the knee to see their similarity and difference for the ultimate purpose of making the early diagnosis and treatment as well as knowing their pathogenesis. Subjects are images of 250 steroid-induced osteonecrotic knees of 136 patients (M 23/F 113, av. age of 39 y) among whom 114 patients (84%) having the bilateral disease, and of 50 knees of 48 patients (10/38, 71 y) with the idiopathic disease. The former group has the treatment history with a large dose (>30 mg/day) of predonisolone. X-ray images are classified as previously reported. T1-weighted spin echo (SE) and short inversion time inversion recovery (STIR) MRI is done with 1.5 T superconducting machine Gyroscan and images giving the necrotic finding are classified in the band (bright), mixed (dark in the bright) and diffuse (dark) types according to the contrast distribution in the lesion. The site of steroidal lesion is found to occur more frequently in the order of posterior lateral condyle, distal metaphysis and posterior medial condyle of femur, and necrosis, at the end of blood stream in the marrow, giving the band and mixed types. Idiopathic one occurs limitedly at the center of medial condyle of femur, giving the diffuse type. Idiopathic osteonecrosis thus differs from steroidal disease and its imaging findings do not lead to the conclusion that fracture is the cause of the idiopathy. (R.T)

Evaluation of focal cartilage lesions of the knee using MRI T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC).

Science.gov (United States)

Årøen, Asbjørn; Brøgger, Helga; Røtterud, Jan Harald; Sivertsen, Einar Andreas; Engebretsen, Lars; Risberg, May Arna

2016-02-11

Assessment of degenerative changes of the cartilage is important in knee cartilage repair surgery. Magnetic Resonance Imaging (MRI) T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) are able to detect early degenerative changes. The hypothesis of the study was that cartilage surrounding a focal cartilage lesion in the knee does not possess degenerative changes. Twenty-eight consecutive patients included in a randomized controlled trial on cartilage repair were evaluated using MRI T2 mapping and dGEMRIC before cartilage treatment was initiated. Inclusion was based on disabling knee problems (Lysholm score of ≤ 75) due to an arthroscopically verified focal femoral condyle cartilage lesion. Furthermore, no major malalignments or knee ligament injuries were accepted. Mean patient age was 33 ± 9.6 years, and the mean duration of knee symptoms was 49 ± 60 months. The MRI T2 mapping and the dGEMRIC measurements were performed at three standardized regions of interest (ROIs) at the medial and lateral femoral condyle, avoiding the cartilage lesion The MRI T2 mapping of the cartilage did not demonstrate significant differences between condyles with or without cartilage lesions. The dGEMRIC results did not show significantly lower values of the affected condyle compared with the opposite condyle and the contra-lateral knee in any of the ROIs. The intraclass correlation coefficient (ICC) of the dGEMRIC readings was 0.882. The MRI T2 mapping and the dGEMRIC confirmed the arthroscopic findings that normal articular cartilage surrounded the cartilage lesion, reflecting normal variation in articular cartilage quality. NCT00885729 , registered April 17 2009.

Traumatic knee extension deficit (the locked knee)

DEFF Research Database (Denmark)

Helmark, I C; Neergaard, K; Krogsgaard, M R

2007-01-01

In the present study we investigated the validity of magnetic resonance imaging (MRI) and arthroscopy in knees with acute, traumatic extension deficit (the "locked knee"), and evaluated whether arthroscopy of knees with no mechanical pathology could be avoided by MRI evaluation. The study consisted...... of 50 patients who had an acute, traumatic extension deficit of the knee. All patients were submitted to MRI prior to arthroscopy. Following MRI and surgery, standardized forms were filled out, attempting to objectify the findings. The orthopaedic surgeon was not aware of the MRI result prior to surgery....... Evaluating MRI, all grade-3 meniscal lesions were considered able to cause a mechanical block as well as acute partial or total anterior cruciate ligament (ACL)-ruptures. ACL-ruptures with an old appearance were not considered able to cause locking. Assuming that arthroscopy was the gold standard...

The study of subchondral lesions in osteoarthritis of the knee using magnetic resonance imaging

International Nuclear Information System (INIS)

Takagishi, Hiroshi

2001-01-01

In order to examine the significance of the signal abnormalities of subchondral bone in osteoarthritic knee with 0.5 T magnetic resonance imaging (MRI), especially in T2-low signal lesions which show a low signal intensity on both the T1- and T2-weighted images and T2-high signal lesions which show a low signal intensity on the T1-weighted image and a high signal intensity on the T2-weighted image, we examined 54 patients (representing 58 knees) with osteoarthritis (OA) of the knee on MRI as compared with the arthroscopic findings or operative findings and histologically evaluated them. In addition, in order to elucidate what becomes of those signal abnormalities in the subchondral bone after biomechanical treatment utilizing a high tibial osteotomy (HTO) which reduces the maldistributed load, we examined 30 patients (representing 34 knees) under HTO on MRI and compared these findings with the arthroscopic findings. The incidence of the presence of those signal abnormalities of subchondral bone on MRI tended to correlate with the severity of the articular cartilage damage, and also reflected the degree of damage to the articular cartilage well. In a histologically investigation, T2-high signal lesions showed granulation tissue with high vascularity, which seemed to be an active phase in OA. T2-low signal lesions of OA in a late stage showed subchondral sclerosis histologically. In addition, the signal changes of the subchondral bone on MRI seemed correlate with the changes in the load distribution in the knee joint because T2-high signal lesions before HTO were observed to either diminish or disappear after undergoing a successful osteotomy. The signal abnormalities of the subchondral bone on MRI on OA thus helped in determining the appropriate phase, therapeutic effects and prognosis of OA. (author)

MR imaging findings in early osteoarthritis of the knee

International Nuclear Information System (INIS)

Karachalios, Theofilos; Zibis, Aristidis; Papanagiotou, Panagiotis; Karantanas, Apostolos H.; Malizos, Konstantinos N.; Roidis, Nikolaos

2004-01-01

Purpose: To carry out a modern diagnostic survey among patients with a clinical and radiological diagnosis of early osteoarthritis of the knee. Materials and methods:A magnetic resonance imaging survey was performed on 70 patients (82 knees) with a mean age of 59 years. (range, 40-71 years) who had chronic knee pain, clinical diagnosis of early osteoarthritis of the knee and conventional knee radiographs classified as 1 and 2 on the Kellgren-Lawrence scale. Results: A variety of different disorders was found; degenerative meniscal lesions with or without ruptures of the anterior cruciate ligament in 70.7% of the knees, osteonecrosis of the femoral and tibial condyles in 9.75%, osteophytes and degenerative articular cartilage lesions in 8.54%, transient osteoporosis in 2.44% and benign neoplasms and cysts in 6.1%. Conclusions: The existence of such a heterogenous group of disorders in these 'early osteoarthritic knees' may explain failures in treatment and it may justify a modern MRI imaging approach to proper diagnosis

Association of medial meniscal extrusion with medial tibial osteophyte distance detected by T2 mapping MRI in patients with early-stage knee osteoarthritis.

Science.gov (United States)

Hada, Shinnosuke; Ishijima, Muneaki; Kaneko, Haruka; Kinoshita, Mayuko; Liu, Lizu; Sadatsuki, Ryo; Futami, Ippei; Yusup, Anwajan; Takamura, Tomohiro; Arita, Hitoshi; Shiozawa, Jun; Aoki, Takako; Takazawa, Yuji; Ikeda, Hiroshi; Aoki, Shigeki; Kurosawa, Hisashi; Okada, Yasunori; Kaneko, Kazuo

2017-09-12

Medial meniscal extrusion (MME) is associated with progression of medial knee osteoarthritis (OA), but no or little information is available for relationships between MME and osteophytes, which are found in cartilage and bone parts. Because of the limitation in detectability of the cartilage part of osteophytes by radiography or conventional magnetic resonance imaging (MRI), the rate of development and size of osteophytes appear to have been underestimated. Because T2 mapping MRI may enable us to evaluate the cartilage part of osteophytes, we aimed to examine the association between MME and OA-related changes, including osteophytes, by using conventional and T2 mapping MRI. Patients with early-stage knee OA (n = 50) were examined. MRI-detected OA-related changes, in addition to MME, were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. T2 values of the medial meniscus and osteophytes were measured on T2 mapping images. Osteophytes surgically removed from patients with end-stage knee OA were histologically analyzed and compared with findings derived by radiography and MRI. Medial side osteophytes were detected by T2 mapping MRI in 98% of patients with early-stage knee OA, although the detection rate was 48% by conventional MRI and 40% by radiography. Among the OA-related changes, medial tibial osteophyte distance was most closely associated with MME, as determined by multiple logistic regression analysis, in the patients with early-stage knee OA (β = 0.711, p T2 values of the medial meniscus were directly correlated with MME in patients with early-stage knee OA, who showed ≥ 3 mm of MME (r = 0.58, p = 0.003). The accuracy of osteophyte evaluation by T2 mapping MRI was confirmed by histological analysis of the osteophytes removed from patients with end-stage knee OA. Our study demonstrates that medial tibial osteophyte evaluated by T2 mapping MRI is frequently observed in the patients with early-stage knee OA, showing

Magnetic resonance imaging of anatomical variations in the knee. Part 1: ligamentous and musculotendinous

International Nuclear Information System (INIS)

Tyler, Philippa; Datir, Abhijit; Saifuddin, Asif

2010-01-01

Magnetic resonance imaging (MRI) is now the modality of choice for the investigation of internal derangement of the knee. Technological advances, including the wider availability of stronger magnets and new sequences, allows improved visualisation of smaller structures. Normal variants must be recognised as such, so that both over-investigation and mis-diagnosis are avoided. This article reviews both the well-recognised and the less common ligamentous and musculotendinous anatomical variants within the knee and illustrates their imaging characteristics on MRI. (orig.)

Magnetic resonance imaging of anatomical variations in the knee. Part 1: ligamentous and musculotendinous

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Tyler, Philippa [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Imperial College Healthcare NHS Trust, Department of Radiology, St Mary' s Hospital, London (United Kingdom); Datir, Abhijit [Jackson Memorial Hospital, Department of Radiology, Miami, FL (United States); Saifuddin, Asif [The Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, The Institute of Orthopaedics and Musculoskeletal Sciences, London (United Kingdom)

2010-12-15

Magnetic resonance imaging (MRI) is now the modality of choice for the investigation of internal derangement of the knee. Technological advances, including the wider availability of stronger magnets and new sequences, allows improved visualisation of smaller structures. Normal variants must be recognised as such, so that both over-investigation and mis-diagnosis are avoided. This article reviews both the well-recognised and the less common ligamentous and musculotendinous anatomical variants within the knee and illustrates their imaging characteristics on MRI. (orig.)

Quantitative Comparison of 2D and 3D MRI Techniques for the Evaluation of Chondromalacia Patellae in 3.0T MR Imaging of the Knee

Directory of Open Access Journals (Sweden)

Ali Özgen

2016-09-01

Full Text Available INTRODUCTION: Chondromalacia patellae is a very common disorder of patellar cartilage. Magnetic resonance imaging (MRI is a powerful non-invasive tool to investigate patellar cartilage lesions. Although many MRI sequences have been used in MR imaging of the patellar cartilage and the optimal pulse sequence is controversial, fat-saturated proton density images have been considered very valuable to evaluate patellar cartilage. The purpose of this study is to quantitatively compare the diagnostic performance of various widely used 2D and 3D MRI techniques for the evaluation of chondromalacia patellae in 3.0T MR imaging of the knee using T2 mapping images as the reference standard. METHODS: Sevety-five knee MRI exams of 69 adult consecutive were included in the study. Fat-saturated T2-weighted (FST2, fat-saturated proton density (FSPD, water-only T2-weighted DIXON (T2mD, T2-weighted 3 dimensional steady state (3DT2FFE, merged multi-echo steady state (3DmFFE, and water selective T1-weighted fat-supressed (WATSc images were acquired. Quantitative comparison of grade 1 and grade 5 lesions were made using contrast-to-noise (CNR ratios. Grade 2-4 lesions were scored qualitatively and scorings of the lesions were compared statistically. Analysis of variance and Tukey’s tests were used to compare CNR data. Two sample z-test was used to compare the ratio of MR exams positive for grade 1 lesions noted on T2-mapping and other conventional sequences. Paired samples t-test was used to compare two different pulse sequences. RESULTS: In detecting grade 1 lesions, FSPD, FST2 and T2mD images were superior in comparison to other sequences. FSPD and FST2 images were statistically superior in detecting grade 2-4 lesions. Although all grade 5 lesions were noted in every single sequence, FST2 images have the highest mean CNR followed by 3DT2FFE images. DISCUSSION AND CONCLUSION: FST2 sequence is equal or superior in detecting every grade of patellar chondromalacia in

Diagnostic efficacy of standard knee magnetic resonance imaging and radiography in evaluating integrity of anterior cruciate ligament before unicompartmental knee arthroplasty.

Science.gov (United States)

Altınel, Levent; Er, Mehmet Serhan; Kaçar, Emre; Erten, Recep Abdullah

2015-01-01

The purpose of this study was to investigate the diagnostic efficacy of standard magnetic resonance imaging (MRI) and plain radiographs in determining the status of anterior cruciate ligament (ACL) for surgical decision-making processes in cases of medial unicompartmental knee arthroplasty (UKA). A total of 59 knees of 36 consecutive patients who underwent knee replacement surgery were analyzed retrospectively. MRI scans were assessed independently by 3 observers (radiologists), while the plain radiographs were evaluated by an independent radiologist. Results were compared with the intraoperative ACL status. Cross tabulation was used for descriptive statistics to analyze sensitivity, specificity, and accuracy of MRI and plain radiographs. When the same observer assessed and classified the MRI twice, the reproducibility of the classification system varied from moderate to excellent. However, the interobserver concordance was moderate. The sensitivity of MRI was 73% and the specificity was 81%, while the sensitivity and specificity of plain radiographs was 36% and 79%, respectively. The accuracy of MRI was 80%, while that of the radiographs was 71%. Detection of intact ACL may be possible on available plain radiographs without necessity for additional means such as MRI, which may cause increase costs and loss of time. In cases where there is uncertainty regarding ACL integrity in degenerative knees, although standard MRI provides additional information on ACL status, it is not of sufficient diagnostic value.

Costs and effectiveness of a brief MRI examination of patients with acute knee injury

International Nuclear Information System (INIS)

Oei, Edwin H.G.; Nikken, Jeroen J.; Ginai, Abida Z.; Krestin, Gabriel P.; Verhaar, Jan A.N.; Vugt, Arie B. van; Hunink, M.G.M.

2009-01-01

The aim of this study was to assess the costs and effectiveness of selective short magnetic resonance imaging (MRI) in patients with acute knee injury. A model was developed to evaluate the selective use of MRI in patients with acute knee injury and no fracture on radiography based on the results of a trial in which 208 patients were randomized between radiography only and radiography plus MRI. We analyzed medical (diagnostic and therapeutic) costs, quality of life, duration of diagnostic workup, number of additional diagnostic examinations, time absent from work, and time to convalescence during a 6-month follow-up period. Quality of life was lowest (EuroQol at 6 weeks 0.61 (95% CI 0.54-0.67)); duration of diagnostic workup, absence from work, and time to convalescence were longest; and the number of diagnostic examinations was largest with radiography only. These outcomes were more favorable for both MRI strategies (EuroQol at 6 weeks 0.72 (95% CI 0.67-0.77) for both). Mean total costs were 2,593 euros (95% CI 1,815-3,372) with radiography only, 2,116 euros (95% CI 1,488-2,743) with radiography plus MRI, and 1,973 euros (95% CI 1,401-2,543) with selective MRI. The results suggest that selective use of a short MRI examination saves costs and potentially increases effectiveness in patients with acute knee injury without a fracture on radiography. (orig.)

MR imaging of the knee

International Nuclear Information System (INIS)

Kramer, J.

2006-01-01

Full text: Although assessment of internal derangements of the knee begins with clinical evaluation including careful physical examination, imaging is fundamental to accurate diagnosis of many of these derangements. MRI has become a valuable diagnostic modality for the evaluation of neoplastic, traumatic, and inflammatory disorders of the musculoskeletal system. MRI not only depicts osseous lesions, but provides information on the cartilage, menisci, ligaments and surrounding soft-tissues. The menisci of the knee are composed of fibrocartilage. Advanced degeneration is observed during aging, although it is difficult to determine which changes are age-related alone and which are caused by prior overuse of trauma. Although meniscal tears may be discovered incidentally, they may have a variety of clinical manifestations. Two categories of meniscal tears commonly are identified: traumatic and degenerative. This categorization generally is based on analysis of the clinical history, the age of the patients, and the gross morphology of the meniscus at the time of arthroscopy. Sometimes torn meniscal fragments may be displaced and lead to restriction of movement in the knee joint. MRI is the method of choice in the preoperative diagnosis of meniscal injuries of the knee. Sensitivities and specificities for meniscal tears above 95% with a negative predictive value of almost 100% are reported. In the evaluation of postoperative menisci, however, the above mentioned criteria have proved more problematic if diagnosis is uncertain, therefore, MR-arthrography seems to be a reasonable alternative to repeat arthroscopy in patients who have had surgical treatment of meniscal tears. MR imaging diagnosis of injuries to the anterior acruciate ligament is based on direct signs and abnormalities in the surrounding structures (indirect or secondary signs). The two major alterations occurring within the ligament itself are changes in this morphology or courses and changes in its signal

Magnetic Resonance Imaging of Asymptomatic Knees in Collegiate Basketball Players: The Effect of One Season of Play.

Science.gov (United States)

Pappas, George P; Vogelsong, Melissa A; Staroswiecki, Ernesto; Gold, Garry E; Safran, Marc R

2016-11-01

To determine the prevalence of abnormal structural findings using 3.0-T magnetic resonance imaging (MRI) in the asymptomatic knees of male and female collegiate basketball players before and after a season of high-intensity basketball. Institutional review board-approved prospective case series. Asymptomatic knees of 24 NCAA Division I collegiate basketball players (12 male, 12 female) were imaged using a 3.0-T MRI scanner before and after the end of the competitive season. Three subjects did not undergo scanning after the season. Images were evaluated for prepatellar bursitis, fat pad edema, patellar and quadriceps tendinopathy, bone marrow edema, and articular cartilage and meniscal injury. Every knee imaged had at least 1 structural abnormality both preseason and postseason. A high preseason and postseason prevalence of fat pad edema (75% and 81%), patellar tendinopathy (83% and 90%), and quadriceps tendinopathy (75% and 90%) was seen. Intrameniscal signal change was observed in 50% preseason knees and 62% of postseason knees, but no discrete tears were found. Bone marrow edema was seen in 75% and 86% of knees in the preseason and postseason, respectively. Cartilage findings were observed in 71% and 81% of knees in the preseason and postseason, respectively. The cartilage injury score increased significantly in the postseason compared with the preseason (P = 0.0009). A high prevalence of abnormal knee MRI findings was observed in a population of asymptomatic young elite athletes. These preliminary data suggest that high-intensity basketball may have potentially deleterious effects on articular cartilage.

Magnetic resonance imaging in the evaluation of suspected osteonecrosis of the knee

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Pollack, M S; Dalinka, M K; Kressel, H Y; Spritzer, C E; Lotke, P A

1987-02-01

Magnetic resonance imaging (MRI) was performed on 19 patients with suspected or proven osteonecrosis of the knee. The results were compared to radionuclide and plain radiographic studies when possible. The patients were grouped into one of three categories: patients with disease predisposing them to osteonecrosis (e.g. systemic lupus erythematosus (SLE), steroid use, and renal transplants), older patients without risk factors with acute onset of symptoms, and patients with knee pain months or years following trauma. In six patients with symptoms and predisposing diseases, MRI was abnormal in four cases, all of whom had bilateral abnormalities. In the ten older patients with classical symptoms, MRI was abnormal in seven, and bilateral abnormalities were present in three patients. The three patients with a history of antecedent trauma had normal MRI studies. Two patients with history and scintigraphic evidence of osteonecrosis had negative MRI scans. MRI may be of value in patients with suspected or proven osteonecrosis of the knee by demonstrating bilateral disease in patients with unilateral symptoms, showing the extent of involvement, and establishing the presence or absence of bone marrow changes in patients with positive bone scans and negative plain films.

Imaging of the nerves of the knee region

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Damarey, B., E-mail: benjdam@hotmail.com [Service de Radiologie et d’Imagerie musculosquelettique, CCIAL, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France); Laboratoire d’anatomie, Faculté de médecine, CHRU de Lille, 1 Place de Verdun, 59045 Lille Cedex (France); Demondion, X. [Service de Radiologie et d’Imagerie musculosquelettique, CCIAL, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France); Laboratoire d’anatomie, Faculté de médecine, CHRU de Lille, 1 Place de Verdun, 59045 Lille Cedex (France); Wavreille, G. [Laboratoire d’anatomie, Faculté de médecine, CHRU de Lille, 1 Place de Verdun, 59045 Lille Cedex (France); Service d’orthopédie, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France); Pansini, V.; Balbi, V.; Cotten, A. [Service de Radiologie et d’Imagerie musculosquelettique, CCIAL, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France)

2013-01-15

Peripheral neuropathies are a frequent, but often underdiagnosed, cause of pain and functional impairment. The clinical symptoms can be subtle, and other neurologic or non neurologic clinical entities are often evoked. MRI and ultrasonography are the imaging modalities of choice for depicting nerves and assessing neuropathies. Common neuropathies in the knee area involve the saphenous, the tibial, the common peroneal and the sural nerves. The most frequent mechanisms of nerve injury in this area are nerve entrapment and nerve stretching. A perfect knowledge of the normal imaging anatomy is essential for accurate assessment of neuropathies. In this article, we will review the anatomy of the nerves around the knee, and their normal and pathological appearance.

Imaging of the nerves of the knee region

International Nuclear Information System (INIS)

Damarey, B.; Demondion, X.; Wavreille, G.; Pansini, V.; Balbi, V.; Cotten, A.

2013-01-01

Peripheral neuropathies are a frequent, but often underdiagnosed, cause of pain and functional impairment. The clinical symptoms can be subtle, and other neurologic or non neurologic clinical entities are often evoked. MRI and ultrasonography are the imaging modalities of choice for depicting nerves and assessing neuropathies. Common neuropathies in the knee area involve the saphenous, the tibial, the common peroneal and the sural nerves. The most frequent mechanisms of nerve injury in this area are nerve entrapment and nerve stretching. A perfect knowledge of the normal imaging anatomy is essential for accurate assessment of neuropathies. In this article, we will review the anatomy of the nerves around the knee, and their normal and pathological appearance

Benefits of sagittal-oblique MRI reconstruction of anterior cruciate ligament of the knee

International Nuclear Information System (INIS)

Nenezić, D.

2015-01-01

Full text: MRI examination of the anterior cruciate ligament (ACL) of the knee gives valuable information for conventional, physiatrist and/or arthroscopic microinvasiv treatment. three planar MRI examination and 3D reconstructions are highly precise in the analysis of the intra and periarticular structures, with exceptions of anterior cruciate ligament. Direct contact with the roof of the intercondilar fossa (in the full extension during the examination) and its specific orientation makes visualization of ACL diagnostically problematic. In a one year period precise protocol for MRI visualization of ACL was tested and applied as “Sagittal Oblique MRI Reconstruction”. In short, it has been Angled biplanar reconstruction in the parasagital and paratransversal planes (patientrelated and arbitrary selected in full extension), on T2, 2mm slice and 0,2 mm gap. 153 MRI examinations of the patients with lesions of the ACL were included in the study in the Clinical Center of Montenegro during 2005 year. Beside standard Knee MRI protocol all patients had the Sagittal Oblique MRI reconstruction of ACL and the Flexion MRI examination, to compare with. The Sagittal Oblique MRI reconstruction of ACL it is adapted to the concrete morphology of the patients ACL and it does not depend of the volume of the examined knee. In comparison with the Standard Knee MRI protocol and with the Flexion MRI examination, the Sagittal Oblique MRI reconstruction of ACL takes less time to perform, and the ligament is shown in fool length at three to five slices, which is more than with the both compared protocols. Sagittal Oblique MRI Reconstruction of ACL is therefore patient dependable, orientated in shape of concrete ligament of the patient’s knee. In combination with age, occupation, physical activity and level of patients while to contribute in healing process, the Sagittal Oblique MRI reconstruction of ACL contribute to scholastic approach, as highest benefit to patients with

MRI of radial displacement of the meniscus in the knee

International Nuclear Information System (INIS)

Chen Jian; Lv Houshan; Lao Shan; Guan Zhenpeng; Hong Nan; Liang Hao

2006-01-01

Objective: To describe the phenomenon of radial displacement of the meniscus of the knees in the study population with MR imaging, and to establish MRI diagnostic criteria for radial displacement of the meniscus and displacement index. Methods: MR signs of radial displacement of the meniscus were evaluated retrospectively in 398 patients with knee symptoms who were examined with non- weight bearing MR images from Jan. 2000 to Feb. 2004. The patients younger than 18 years old, with joint effusion or serious arthropathy were excluded and 312 patients were eligible to be enrolled in this study. The criterion for radial displacement of the meniscus was defined as the location of the edge of meniscal body beyond the femoral and tibial outer border line. A displacement index, defined as the ratio of meniscal overhang to meniscal width, was used to quantify meniscal displacement. Results: The prevalence of radial displacement of the meniscus was 16.7% (52/312) and 13.9% (21/151) in right knee and 19.3% (31/161 )in left knee, respectively. There was no significant difference between left and right knee (χ 2 =1.60, P>0.05) and the ratio between medial and lateral meniscus was 7.8:1. The average displacement index was 0.54±0.24. The displacement indices were significant higher in older group (F=3.63, P<0.05). The incidence and indices of radial displacement of the meniscus for patients under or above 50 year older were 12.0%(17/142), 0.46±0.22 and 20.6% (35/170), 0.64±0.20, respectively. Difference was highly significant (t=0.84, P<0.01). Conclusion: It was concluded that radial displacement of the meniscus in knees was not a rare finding with MR imaging in patients with knee symptoms. The incidence increased in older age group. Further investigations were recommended to understand the etiology and clinical significance of the phenomenon of radial displacement of the meniscus. (authors)

MRI evaluation of acute articular cartilage injury of knee

International Nuclear Information System (INIS)

Zhang Jun; Wu Zhenhua; Fan Guoguang; Pan Shinong; Guo Qiyong

2003-01-01

Objective: To study the MRI manifestation of acute articular cartilage injury of knee for evaluating the extension and degree of the injury and guiding treatment. Methods: MRI of 34 patients with acute articular cartilage injury of knee within one day to fifteen days confirmed by arthroscopy and arthrotomy was reviewed and analyzed, with emphasis on articular cartilage and subchondral lesion. And every manifestation on MRI and that of arthroscopy and operation was compared. Results: The articular cartilage injury was diagnosed on MRI in 29 of 34 cases. Cartilage signal changes were found only in 4. The changes of cartilage shape were variable. Thinning of focal cartilage was showed in 3, osteochondral impaction in 3, creases of cartilage in 3, disrupted cartilage with fissuring in 13, cracks cartilage in 2, and cracks cartilage with displaced fragment in 1. Bone bruise and occult fracture were found only on MRI. Conclusion: The assessment of MRI and arthroscopy in acute articular cartilage injury are consistent. Combined with arthroscopy, MRI can succeed in assessing the extension and degree of acute articular injury and allowing treatment planning

Radiography, computed tomography and magnetic resonance imaging at 0.5 Tesla of mechanically induced osteoarthritis in rabbit knees

International Nuclear Information System (INIS)

Torelli, S.R.; Rahal, R.S.; Volpi, R.S.; Yamashita, S.; Mamprim, M.J.; Crocci, A.J.

2004-01-01

In the present experimental study we assessed induced osteoarthritis data in rabbits, compared three diagnostic methods, i.e., radiography (XR), computed tomography (CT) and magnetic resonance imaging (MRI), and correlated the imaging findings with those obtained by macroscopic evaluation. Ten young female rabbits of the Norfolk breed were used. Seven rabbits had the right knee immobilized in extension for a period of 12 weeks (immobilized group), and three others did not have a limb immobilized and were maintained under the same conditions (control group). Alterations observed by XR, CT and MRI after the period of immobilization were osteophytes, osteochondral lesions, increase and decrease of joint space, all of them present both in the immobilized and non-immobilized contralateral limbs. However, a significantly higher score was obtained for the immobilized limbs (XT: P = 0.016, CT: P 0.031, MRI: P = 0.0156). All imaging methods were able to detect osteoarthritis changes after the 12 weeks of immobilization. Macroscopic evaluation identified increased thickening of joint capsule, proliferative and connective tissue in the femoropatellar joint, and irregularities of articular cartilage, especially in immobilized knees. The differences among XR, CT and MRI were not statistically significant for the immobilized knees. However, MRI using a 0.5 Tesla scanner was statistically different from CT and XR for the non-immobilized contralateral knees. We conclude that the three methods detected osteoarthritis lesions in rabbit knees, but MRI was less sensitive than XR and CT in detecting lesions compatible with initial osteoarthritis. Since none of the techniques revealed all the lesions, it is important to use all methods to establish an accurate diagnosis. (author)

Automatic analysis of trabecular bone structure from knee MRI

DEFF Research Database (Denmark)

Marques, Joselene; Granlund, Rabia; Lillholm, Martin

2012-01-01

We investigated the feasibility of quantifying osteoarthritis (OA) by analysis of the trabecular bone structure in low-field knee MRI. Generic texture features were extracted from the images and subsequently selected by sequential floating forward selection (SFFS), following a fully automatic......, uncommitted machine-learning based framework. Six different classifiers were evaluated in cross-validation schemes and the results showed that the presence of OA can be quantified by a bone structure marker. The performance of the developed marker reached a generalization area-under-the-ROC (AUC) of 0...

Magnetic resonance imaging reflects cartilage proteoglycan degradation in the rabbit knee

International Nuclear Information System (INIS)

Paul, P.K.; O'Byrne, E.; Blancuzzi, V.; Wilson, D.; Gunson, D.; Douglas, F.L.; Wang Jinzhao; Mezrich, R.S.

1991-01-01

Cartilage degeneration in osteoarthritis is initiated by a loss of proteoglycan. Intra-articular injection of papain causes a reversible loss of proteoglycan in rabbit knees. Rabbits were scanned with magnetic resonance imaging (MRI), using a 1.5T Signa superconducting magnet with 3 inch surface coil. Spin echo sequences were performed in the coronal and sagittal planes at 0, 24, 48, and 72 h after intra-articular injection of papain to abtain T 1 , proton density, and T 2 -weighted images. Cartilage proteoglycan content was measured biochemically and histochemically. Reduced articular cartilage thickness in the MR images of papain-treated knees corresponded to changes in cartilage proteoglycan content. (orig.)

MRI screening on bone ischemia of hip and knee in recovered SARS patients

International Nuclear Information System (INIS)

Cheng Xiaoguang; Qu Hui; Liu Wei; Sun Jing; Cheng Kebin; Feng Suchen; Li Xiaosong

2004-01-01

Objective: To screen ischemia in the hip and knee joints of recovered SARS patients with MRI, and to investigate the prevalence rate of bone ischemia in those patients and its relationship with the use of steroid. Methods: Hip and knee MRI examinations were performed in 76 recovered SARS patients. There were 17 males and 59 females. Eight patients were treated without steroid, while 68 patients with steroid. Dose and duration of steroid usage were available in 30 out of 68 patients. The MRI images were read by senior radiologists to determine whether bone ischemia and/or osteonecrosis was present. Appropriate statistic analysis was performed to determine the significance of difference between groups. Results: (1) The MRI appearance of osteonecrosis in femoral head and condyle and bone infarct in bone marrow found in SARS patients was identical to those caused by other conditions (including steroid usage in other diseases). (2) No one of 8 SARS without steroid developed osteonecrosis, while 25 out of 68 steroid users had osteonecrosis found by MRI screening, and the difference in prevalence of osteonecrosis between these 2 groups was significant. In 25 patients with osteonecrosis, 20 of them involved more than one joints. Osteonecrosis involved 32 femoral heads, 26 femoral condyles, and 6 in femoral and tibial shafts. Thirteen patients with osteonecrosis had greater total steroid dose, greater daily dose, and longer duration than those (17 patients) without osteonecrosis, however, the differences between the two groups were not statistically significant. Sixty-four patients out of 76 complained pain in joints, 50 of them had multiple joint pains. The pain was reported in hips in 40 cases, followed by knees in 36, low backs in 10, shoulders in 7, and wrists in 4, respectively. The differences in frequency of pain between steroid users and non-steroid users, as well as between osteonecrosis and non-osteonecrosis were not significant. Conclusion: MRI is recommended for

Knee Enthesitis and Synovitis on Magnetic Resonance Imaging in Patients with Psoriasis without Arthritic Symptoms

NARCIS (Netherlands)

Emad, Y.; Ragab, Y.; Gheita, Tamer; Anbar, Ashraf; Kamal, Hoda; Saad, Ahmed; Darweesh, Hanan; El Shaarawy, Nashwa; Azab, Amr; Ismail, Ahmed; Rasker, Johannes J.

2012-01-01

Objective. This case-control study was designed to evaluate magnetic resonance imaging (MRI) findings of knee joints in patients with psoriasis without clinical peripheral or axial joint involvement, and to correlate MRI findings with disease and demographic variables. Methods. In total 48 patients

Simple Methods for Scanner Drift Normalization Validated for Automatic Segmentation of Knee Magnetic Resonance Imaging

DEFF Research Database (Denmark)

Dam, Erik Bjørnager

2018-01-01

Scanner drift is a well-known magnetic resonance imaging (MRI) artifact characterized by gradual signal degradation and scan intensity changes over time. In addition, hardware and software updates may imply abrupt changes in signal. The combined effects are particularly challenging for automatic...... image analysis methods used in longitudinal studies. The implication is increased measurement variation and a risk of bias in the estimations (e.g. in the volume change for a structure). We proposed two quite different approaches for scanner drift normalization and demonstrated the performance...... for segmentation of knee MRI using the fully automatic KneeIQ framework. The validation included a total of 1975 scans from both high-field and low-field MRI. The results demonstrated that the pre-processing method denoted Atlas Affine Normalization significantly removed scanner drift effects and ensured...

Quantitative (23) Na MRI of human knee cartilage using dual-tuned (1) H/(23) Na transceiver array radiofrequency coil at 7 tesla.

Science.gov (United States)

Moon, Chan Hong; Kim, Jung-Hwan; Zhao, Tiejun; Bae, Kyongtae Ty

2013-11-01

To develop quantitative dual-tuned (DT) (1) H/(23) Na MRI of human knee cartilage in vivo at 7 Tesla (T). A sensitive (23) Na transceiver array RF coil was developed at 7T. B1 fields generated by the transceiver array coil were characterized and corrected in the (23) Na images. Point spread function (PSF) of the (23) Na images was measured, and the signal decrease due to partial-volume-effect was compensated in [(23) Na] quantification of knee cartilage. SNR and [(23) Na] in anterior femoral cartilage were measured from seven healthy subjects. SNR of (23) Na image with the transceiver array coil was higher than that of birdcage coil. SNR in the cartilage at 2-mm isotropic resolution was 26.80 ± 3.69 (n = 7). B1 transmission and reception fields produced by the DT coil at 7T were similar to each other. Effective full-width-half-maximum of (23) Na image was ∼5 mm at 2-mm resolution. Mean [(23) Na] was 288.13 ± 29.50 mM (n = 7) in the anterior femoral cartilage of normal subjects. We developed a new high-sensitivity (23) Na RF coil for knee MRI at 7T. Our (1) H/(23) Na MRI allowed quantitative measurement of [(23) Na] in knee cartilage by measuring PSF and cartilage thickness from (23) Na and (1) H image, respectively. Copyright © 2013 Wiley Periodicals, Inc.

MRI findings in bipartite patella

International Nuclear Information System (INIS)

Kavanagh, Eoin C.; Zoga, Adam; Omar, Imran; Ford, Stephanie; Eustace, Stephen; Schweitzer, Mark

2007-01-01

Bipartite patella is a known cause of anterior knee pain. Our purpose was to detail the magnetic resonance imaging (MRI) features of bipartite patella in a retrospective cohort of patients imaged at our institution. MRI exams from 53 patients with findings of bipartite patella were evaluated to assess for the presence of bone marrow edema within the bipartite fragment and for the presence of abnormal signal across the synchondrosis or pseudarthrosis. Any other significant knee pathology seen at MRI was also recorded. We also reviewed 400 consecutive knee MRI studies to determine the MRI prevalence of bipartite patella. Of the 53 patients with bipartite patella 40 (75%) were male; 35 (66%) had edema within the bipartite fragment. Of the 18 with no edema an alternative explanation for knee pain was found in 13 (72%). Edema within the bipartite fragment was the sole finding in 26 of 53 (49%) patients. Bipartite patella was seen in 3 (0.7%) of 400 patients. In patients with bipartite patella at knee MRI, bone marrow edema within the bipartite fragment was the sole finding on knee MRI in almost half of the patients in our series. (orig.)

Role of magnetic resonance imaging in the evaluation of articular cartilage in painful knee joint

Directory of Open Access Journals (Sweden)

Digish Shah

2014-01-01

Full Text Available Aim: The aim of this study was to determine the role of the magnetic resonance imaging (MRI in patients with atraumatic knee pain. Background and Objectives: Knee pain is one of the most common problems faced by people from time immemorial. There is a wide range of disease ranging from traumatic to degenerative causing knee pain in which articular cartilage is involved. Over the past 15 years, MRI has become the premier, first-line imaging study that should be performed in the evaluation of the painful knee in particular in tears of menisci, cruciate and collateral ligaments, osteochondral abnormalities (chondromalacia, osteoarthritis and osteochondral defects, synovial cysts and bone bruises. MRI, by virtue of its superior soft-tissue contrast, lack of ionizing radiation and multiplanar capabilities, is superior to more conventional techniques for the evaluation of articular cartilage. Materials and Methods: A prospective study was carried out on 150 patients in the Department of Radio-diagnosis, Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune over a period of 2 years from June 2011 to May 2013. Patients having fracture or dislocations of the knee joint were also excluded from the study. Detailed clinical history, physical and systemic examination findings of all patients were noted in addition to the laboratory investigations. All patients were subjected to radiograph of knee anterior-posterior and lateral view. MRI was performed with Siemens 1.5 Tesla MAGNETOM Avanto machine. Results: In our study of 150 patients with knee pain, articular cartilage defect was found in 90 patients (60%. Out of 90 patients with articular cartilage defect, 30 patients (20% had full thickness cartilage defects. Subchondral marrow edema was seen beneath 30 patients (20% with articular cartilage defects. 32 patients (21.1% had a complex or macerated meniscal tear. Complete anterior cruciate ligament tear was found in seven

A system for the registration of arthroscopic images to magnetic resonance images of the knee: for improved virtual knee arthroscopy

Science.gov (United States)

Hu, Chengliang; Amati, Giancarlo; Gullick, Nicola; Oakley, Stephen; Hurmusiadis, Vassilios; Schaeffter, Tobias; Penney, Graeme; Rhode, Kawal

2009-02-01

Knee arthroscopy is a minimally invasive procedure that is routinely carried out for the diagnosis and treatment of pathologies of the knee joint. A high level of expertise is required to carry out this procedure and therefore the clinical training is extensive. There are several reasons for this that include the small field of view seen by the arthroscope and the high degree of distortion in the video images. Several virtual arthroscopy simulators have been proposed to augment the learning process. One of the limitations of these simulators is the generic models that are used. We propose to develop a new virtual arthroscopy simulator that will allow the use of pathology-specific models with an increased level of photo-realism. In order to generate these models we propose to use registered magnetic resonance images (MRI) and arthroscopic video images collected from patients with a variety of knee pathologies. We present a method to perform this registration based on the use of a combined X-ray and MR imaging system (XMR). In order to validate our technique we carried out MR imaging and arthroscopy of a custom-made acrylic phantom in the XMR environment. The registration between the two modalities was computed using a combination of XMR and camera calibration, and optical tracking. Both two-dimensional (2D) and three-dimensional (3D) registration errors were computed and shown to be approximately 0.8 and 3 mm, respectively. Further to this, we qualitatively tested our approach using a more realistic plastic knee model that is used for the arthroscopy training.

The pediatric knee.

Science.gov (United States)

Orth, Robert C

2013-03-01

Knee pain is a common problem in children and adolescents, and MRI of the knee is the most commonly performed pediatric cross-sectional musculoskeletal imaging exam. The purpose of this pictorial review is to highlight differences between adult and pediatric knee imaging with an emphasis on normal developmental variants, injury and disease patterns unique to children and adolescents, and differences in response and presentation to conditions affecting both adults and children.

The early magnetic resonance imaging features of the knee in juvenile idiopathic arthritis

International Nuclear Information System (INIS)

Johnson, Karl; Wittkop, Berndt; Haigh, Fiona; Ryder, Clive; Gardner-Medwin, Janet M.

2002-01-01

AIMS: Early diagnosis of juvenile idiopathic arthritis (JIA) facilitates earlier more aggressive therapy, and improved outcome. Recognition of the features of early, untreated JIA on magnetic resonance imaging (MRI) will improve disease detection and expedite treatment. This study aims to highlight the relevant MRI features. METHODS: MRI examinations of the knee joint were performed on 11 children with clinically confirmed, early, untreated JIA. The MRI images were obtained at a mean of 2 months after symptom onset and independently evaluated by two consultant paediatric radiologists. RESULTS: Abnormalities were found on all MRI examinations. Synovial hypertrophy, joint effusions, popliteal lymph nodes and soft tissue swelling were present in all patients. Gadolinium DTPA enhancement improved the detection of synovial hyperplasia. Metaphyseal splaying and condylar overgrowth were seen in five cases (41%), oedema of the lateral collateral ligament in two cases (18%) and superficial cartilage thinning in one case. Bony erosions and deep cartilage destruction were not demonstrated. CONCLUSION: MRI of the knee joint identifies early joint changes which are distinct from those in later disease. The presence of these features should alert the radiologist to the possible diagnosis of JIA and post gadolinium DTPA sequences should be performed. Gadolinium DPTA enhancement increases the sensitivity for the detection of inflammatory changes in JIA. Johnson, K. et al. (2002)

Kinematic analysis of the knee joint by cine MRI

International Nuclear Information System (INIS)

Niitsu, Mamoru; Akisada, Masayoshi; Anno, Izumi; Matsumoto, Kunihiko; Kuno, Shin-ya; Miyakawa, Shunpei; Inouye, Tamon; Kose, Katsumi.

1989-01-01

In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author)

The association between reduced knee joint proprioception and medial meniscal abnormalities using MRI in knee osteoarthritis: results from the Amsterdam osteoarthritis cohort.

Science.gov (United States)

van der Esch, M; Knoop, J; Hunter, D J; Klein, J-P; van der Leeden, M; Knol, D L; Reiding, D; Voorneman, R E; Gerritsen, M; Roorda, L D; Lems, W F; Dekker, J

2013-05-01

Osteoarthritis (OA) of the knee is characterized by pain and activity limitations. In knee OA, proprioceptive accuracy is reduced and might be associated with pain and activity limitations. Although causes of reduced proprioceptive accuracy are divergent, medial meniscal abnormalities, which are highly prevalent in knee OA, have been suggested to play an important role. No study has focussed on the association between proprioceptive accuracy and meniscal abnormalities in knee OA. To explore the association between reduced proprioceptive accuracy and medial meniscal abnormalities in a clinical sample of knee OA subjects. Cross-sectional study in 105 subjects with knee OA. Knee proprioceptive accuracy was assessed by determining the joint motion detection threshold in the knee extension direction. The knee was imaged with a 3.0 T magnetic resonance (MR) scanner. Number of regions with medial meniscal abnormalities and the extent of abnormality in the anterior and posterior horn and body were scored according to the Boston-Leeds Osteoarthritis Knee Score (BLOKS) method. Multiple regression analyzes were used to examine whether reduced proprioceptive accuracy was associated with medial meniscal abnormalities in knee OA subjects. Mean proprioceptive accuracy was 2.9° ± 1.9°. Magnetic resonance imaging (MRI)-detected medial meniscal abnormalities were found in the anterior horn (78%), body (80%) and posterior horn (90%). Reduced proprioceptive accuracy was associated with both the number of regions with meniscal abnormalities (P knee complaints. This is the first study showing that reduced proprioceptive accuracy is associated with medial meniscal abnormalities in knee OA. The study highlights the importance of meniscal abnormalities in understanding reduced proprioceptive accuracy in persons with knee OA. Copyright © 2013 Osteoarthritis Research Society International. All rights reserved.

Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study

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Podlipská, Jana; Guermazi, Ali; Lehenkari, Petri; Niinimäki, Jaakko; Roemer, Frank W.; Arokoski, Jari P.; Kaukinen, Päivi; Liukkonen, Esa; Lammentausta, Eveliina; Nieminen, Miika T.; Tervonen, Osmo; Koski, Juhani M.; Saarakkala, Simo

2016-01-01

Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level. PMID:26926836

Knee joint examinations by magnetic resonance imaging: The correlation of pathology, age, and sex

OpenAIRE

Serhat Avcu; Ersan Altun; Ihsan Akpinar; Mehmet Deniz Bulut; Kemal Eresov; Tugrul Biren

2010-01-01

Aims: The aim of our study was to investigate the incidence and coexistence of multiple knee joint pathologies and the distribution of knee joint pathologies according to age and sex. Patients and Methods: A retrospective analysis was performed using the clinical data of patients evaluated with magnetic resonance imaging (MRI) of the knee joint. Data from 308 patients examined between August 2002 and July 2003 were included into this study. A Pearson correlation analysis was performed to exam...

The X-ray and MRI diagnosis of osteochondritis dissecans in the knee joint

International Nuclear Information System (INIS)

Ge Xihong; Wang Bin; Sun Xihe; Chang Guanghui

2002-01-01

Objective: To investigate the X-ray and MRI manifestations of osteochondritis dissecans (OCD) and to compare the sensitivity of detection among different sequences. Methods: Thirty-six OCD cases (thirty-eight knees) with complete data were selected and analyzed. The sagittal and coronal images were acquired on T 1 WI, T 2 WI, PDWI and FLASH T 2 WI. MRI manifestations were analyzed retrospectively with double blind contrast method. The radiography were obtained on the same day. The sensitivity of detection among different sequences was also compared. Results: (1) The medial femoral condyle was the most commonly affected location in the knee (63.2%). The proportion of classical type, expanded type, and infero-central type was 55.3%, 15.8% and 28.9%, respectively. (2) On radiographs, the lesions typically appeared as a well circumscribed area of sclerotic subchondral bone separated from the remainder of the epiphysis by a radiolucent line. (3) Subchondral bone lesion was displayed as small and crescent-shaped (n = 38) on the sagittal image and as wedge (14) or short bar (24) shape on coronal image. The signal of the lesion was hypointense or isointense on T 1 WI, surrounded by a hypointense or hyperintense (FLASH T 2 WI, T 2 WI) line. The subchondral plate disappeared or became thinner. Interruption or disappearance of the hyaline cartilage could be seen sometimes. (4) The detection rate on T 1 WI was higher than that of PDWI, T 2 WI and FLASH T 2 WI. Conclusion: (1) Osteochondritis dissecans has specific X-ray and MRI manifestations. The abnormality of the hyaline cartilage and the subchondral bone can be displayed by MRI. Thus a proper diagnosis can be made. (2) The detection rate on T 1 WI is higher than that of PDWI, T 2 WI and FLASH T 2 WI

Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee

International Nuclear Information System (INIS)

Vasilevska, Violeta; Szeimies, Ulrike; Staebler, Axel

2009-01-01

The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P ≤ 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF. Level 4 (Historic, non-randomized, retrospective, cohort study with a control group) (orig.)

Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee

Energy Technology Data Exchange (ETDEWEB)

Vasilevska, Violeta [University Surgical Clinic ' St. Naum Ohridski' , Skopje (Macedonia (The Former Yugoslav Republic of)); Szeimies, Ulrike; Staebler, Axel [Radiology in Muenchen Harlaching, Orthopedic Clinic Harlaching, Munich (Germany)

2009-09-15

The purpose of this retrospective study was to assess the frequency of magnetic resonance imaging (MRI) signs of iliotibial band friction (ITBF) in patients with advanced medial compartment knee osteoarthritis. Proton density-weighted (PDw) fat-saturated (fatsat) MR images (1.5 T, slice thickness (SL) 2.5-3 mm, eight-channel phased array coil) of 128 patients with isolated advanced osteoarthritis of the medial knee compartment and complete or subtotal (>80%) loss of cartilage were evaluated. There were 41 men and 87 women. Mean age was 63 years, range 34-89 years. The control group consisted of 94 patients with medial meniscus degeneration without cartilage loss (56 men and 38 women, mean age 50 years, range 16-89 years). MRI signs of ITBF were evaluated in both groups [poorly defined abnormalities of signal intensity and localized fluid collection lateral, distal or proximal to the lateral epicondyle; signal intensity abnormalities superficial to or deep by the iliotibial band (ITB)]. Transverse images were evaluated separately. Consensus evaluation using all imaging planes was performed. Of 128 patients with osteoarthritis, 95 had moderate or advanced MRI signs of ITBF (74.2%). Eighty-nine patients (69.5%) had advanced degeneration of the meniscus. In the control group, 26 of 94 patients had only moderate MRI signs of ITBF. There was a statistically significant difference between both groups for the presence of MR signs of ITBF (P {<=} 0.01). MRI signs of ITBF were frequently present in patients with severe medial compartment osteoarthritis of the knee. Joint space narrowing with varus knee deformity may be a cause of ITBF. Level 4 (Historic, non-randomized, retrospective, cohort study with a control group) (orig.)

MRI demonstrates the extension of juxta-articular venous malformation of the knee and correlates with joint changes

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Jans, L. [University of Melbourne, Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Victoria (Australia); Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium); Ditchfield, M.; Jaremko, J.L.; Stephens, N. [University of Melbourne, Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Victoria (Australia); Verstraete, K. [Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium)

2010-07-15

Juxta-articular venous malformations (VMs) are uncommon, but may cause early arthropathy of the knee in children and adolescents. We sought to describe the prevalence, extent and initial magnetic resonance imaging (MRI) features of knee arthropathy in children with VM adjacent to the knee joint. Thirty-five patients with VM adjacent to the knee who had MRI performed between 2000 and 2009 were identified through a keyword search of the radiology information system. VM extended to the joint in 17 of the 35 patients (5.4-21.5 years, mean 11.8 years). Most of these 17 patients had joint changes (15/17, 88%), most commonly haemosiderin deposition (14/17, 82%). Other findings included the presence of subchondral bone lesions (eight, 47%), cartilage loss (six, 35%), synovial thickening (six, 35%), marrow oedema (six, 35%), joint effusion (five, 29%), subchondral cysts (five, 29%) and one loose body (6%). VM location and size did not correlate with the degree of articular involvement. Joint changes were present in focal as well as non-discrete VM. We found that the frequency of arthropathy increased with extension of VM into the joint itself. This finding stresses the importance of early MRI evaluation of all juxta-articular VM. (orig.)

Hand joint space narrowing and osteophytes are associated with magnetic resonance imaging-defined knee cartilage thickness and radiographic knee osteoarthritis: data from the Osteoarthritis Initiative.

Science.gov (United States)

Haugen, Ida K; Cotofana, Sebastian; Englund, Martin; Kvien, Tore K; Dreher, Donatus; Nevitt, Michael; Lane, Nancy E; Eckstein, Felix

2012-01-01

To evaluate whether features of radiographic hand osteoarthritis (OA) are associated with quantitative magnetic resonance imaging (MRI)-defined knee cartilage thickness, radiographic knee OA, and 1-year structural progression. A total of 765 participants in Osteoarthritis Initiative (OAI; 455 women, mean age 62.5 yrs, SD 9.4) obtained hand radiographs (at baseline), knee radiographs (baseline and Year 1), and knee MRI (baseline and Year 1). Hand radiographs were scored for presence of osteophytes and joint space narrowing (JSN). Knee radiographs were scored according to the Kellgren-Lawrence (KL) scale. Cartilage thickness in the medial and lateral femorotibial compartments was measured quantitatively from coronal FLASHwe images. We examined the cross-sectional and longitudinal associations between features of hand OA (total osteophyte and JSN scores) and knee cartilage thickness, 1-year knee cartilage thinning (above smallest detectable change), presence of knee OA (KL grade ≥ 3), and progression of knee OA (KL change ≥ 1) by linear and logistic regression. Both hand OA features were included in a multivariate model (if p ≤ 0.25) adjusted for age, sex, and body mass index (BMI). Hand JSN was associated with reduced knee cartilage thickness (ß = -0.02, 95% CI -0.03, -0.01) in the medial femorotibial compartment, while hand osteophytes were associated with the presence of radiographic knee OA (OR 1.10, 95% CI 1.03-1.18; multivariate models) with both hand OA features as independent variables adjusted for age, sex, and BMI). Radiographic features of hand OA were not associated with 1-year cartilage thinning or radiographic knee OA progression. Our results support a systemic OA susceptibility and possibly different mechanisms for osteophyte formation and cartilage thinning.

Gadolinium-enhanced magnetic resonance imaging of the knee: an experimental approach

International Nuclear Information System (INIS)

Liu, Sirun; Shen, Si; Zhu, Tianyuan; Liang, Wenbin; Huang, Li; Chen, Hanfang; Wu, Hejia

2010-01-01

The purpose of this study was to examine gadolinium-enhanced magnetic resonance imaging (MRI) for monitoring cartilage degeneration. This is a proof-of-concept study in an animal model. Adult New Zealand rabbits were randomly stratified into five groups. Papain was injected intra-articularly in the right knee in four groups to establish the stages of cartilage degeneration. The left knee and group 5 served as controls. Bilateral MRI was performed 24 h after the initial injection of papain, and 1 week, 1 month, and 3 months following three papain injections. Injection of the contrast agent was followed by bilateral MRI examination immediately upon injection, and at 2 and 4 h post-injection. Signal intensities of articular cartilage and peripheral soft tissues were obtained before animals were sacrificed. Post-mortem bilateral cartilage specimens were studied histologically. Histopathology results verified the staged degeneration of papain-treated articular cartilage. Differences in cartilage signal intensity were significant for the staged model using a special three-dimensional MRI method (P 0.05). Contrast-enhanced MRI examination may be a viable tool for early diagnosis of osteoarticular disease. Prospective studies are warranted to evaluate the potential for clinical application. (orig.)

Radiological imaging of osteoarthritis of the knee; Radiologische Bildgebung der Kniegelenkarthrose

Energy Technology Data Exchange (ETDEWEB)

Wick, M.C.; Jaschke, W.; Klauser, A.S. [Medizinische Universitaet Innsbruck, Department Radiologie, Innsbruck (Austria)

2012-11-15

Osteoarthritis is the most common degenerative age-related joint disease leading to typical degradation of articular cartilage with severe pain and limitation of joint motion. Although knee radiographs are widely considered as the gold standard for the assessment of knee osteoarthritis in clinical and scientific settings they increasingly have significant limitations in situations when resolution and assessment of cartilage is required. Analysis of osteoarthritis of the knee with conventional x-ray is associated with many technical limitations and is increasingly being replaced by high-quality assessment using magnetic resonance imaging (MRI) or sonography both in the clinical routine and scientific studies. Novel imaging modalities such as MRI or ultrasound enable in vivo visualization of the quality of the cartilaginous structure and bone as well as all articular and periarticular tissue. Therefore, the limitations of radiographs in assessment of knee osteoarthritis could be overcome by these techniques. This review article aims to provide insights into the most important radiological features of knee osteoarthritis and systematic visualization with different imaging approaches. The demographic development in western industrialized countries predicts an increase of ageing-related osteoarthritis of the knee for the next decades. A systematic radiological evaluation of patients with knee osteoarthritis includes the assessment of the periarticular soft tissue, cartilaginous thickness, cartilage volume, possible cartilage defects, the macromodular network of hyaline cartilage, bone marrow edema, menisci and articular ligaments. Modern imaging modalities, such as MRI and sonography allow the limitations of conventional radiography to be overcome and to visualize the knee structures in great detail to quantitatively assess the severity of knee osteoarthritis. (orig.) [German] Die Arthrose ist die haeufigste chronische, altersassoziierte, degenerative Gelenkerkrankung

Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

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Nusman, Charlotte M.; Hemke, Robert [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Benninga, Marc A.; Kindermann, Angelika [University of Amsterdam, Department of Pediatric Gastroenterology, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W. [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Rossum, Marion A.J. van [University of Amsterdam, Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children' s Hospital AMC, Amsterdam (Netherlands); Reade, Department of Pediatric Rheumatology, Amsterdam (Netherlands); Maas, Mario [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands)

2016-04-15

To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients

International Nuclear Information System (INIS)

Nusman, Charlotte M.; Hemke, Robert; Benninga, Marc A.; Kindermann, Angelika; Schonenberg-Meinema, Dieneke; Berg, J.M. van den; Kuijpers, Taco W.; Rossum, Marion A.J. van; Maas, Mario

2016-01-01

To evaluate enhancing synovial thickness upon contrast-enhanced magnetic resonance imaging (MRI) of the knee in children unaffected by clinical arthritis compared with clinically active juvenile idiopathic arthritis (JIA) patients. A secondary objective was optimization of the scoring method based on maximizing differences on MRI between these groups. Twenty-five children without history of joint complaints nor any clinical signs of joint inflammation were age/sex-matched with 25 clinically active JIA patients with arthritis of at least one knee. Two trained radiologists, blinded for clinical status, independently evaluated location and extent of enhancing synovial thickness with the validated Juvenile Arthritis MRI Scoring system (JAMRIS) on contrast-enhanced axial fat-saturated T1-weighted MRI of the knee. Enhancing synovium (≥2 mm) was present in 13 (52 %) unaffected children. Using the total JAMRIS score for synovial thickening, no significant difference was found between unaffected children and active JIA patients (p = 0.091). Additional weighting of synovial thickening at the JIA-specific locations enabled more sensitive discrimination (p = 0.011). Mild synovial thickening is commonly present in the knee of children unaffected by clinical arthritis. The infrapatellar and cruciate ligament synovial involvement were specific for JIA, which - in a revised JAMRIS - increases the ability to discriminate between JIA and unaffected children. (orig.)

Texture analysis of articular cartilage traumatic changes in the knee calculated from morphological 3.0 T MR imaging

International Nuclear Information System (INIS)

Boutsikou, Konstantina; Kostopoulos, Spiros; Glotsos, Dimitris; Cavouras, Dionisis; Lavdas, Eleftherios; Oikonomou, Georgia; Malizos, Konstantinos; Fezoulidis, Ioannis V.; Vlychou, Marianna

2013-01-01

Objectives: In the present work, we aim to identify changes in the cartilage texture of the injured knee in young, physically active, patients by computer analysis of MRI images based on 3.0 T morphological sequences. Methods: Fifty-three young patients with training injury or trauma in one knee underwent MRI and arthroscopy. Textural features were computed from the MRI images of the knee-cartilages and two classes were formed of 28 normal and 16 with pathology only in the medial femoral condyle (MFC) cartilage. Results: Textural features with statistically significant differences between the two classes were found only at the MFC and the medial tibial condyle (MTC) areas. Three features-combinations, at the MFC or the MTC, maximized the between classes separation, thus, rendering alterations in cartilage texture due to injury more evident. The MFC cartilage in the pathology class was found more inhomogeneous in the distribution of gray-levels and of lower texture anisotropy and the opposed MTC cartilage, though normal on MRI and arthroscopy, was found to have lower texture anisotropy than cartilage in the normal class. Conclusion: Texture analysis may be used as an adjunct to morphological MR imaging for improving the detection of subtle cartilage changes and contributes to early therapeutic approach

Texture analysis of articular cartilage traumatic changes in the knee calculated from morphological 3.0 T MR imaging

Energy Technology Data Exchange (ETDEWEB)

Boutsikou, Konstantina [Department of Medical Radiologic Technology, Technological Educational Institute of Athens, Ag.Spyridonos, Egaleo, Athens 12210 (Greece); Kostopoulos, Spiros; Glotsos, Dimitris; Cavouras, Dionisis [Department of Medical Instruments Technology, Technological Educational Institute of Athens, Ag.Spyridonos, Egaleo, Athens 12210 (Greece); Lavdas, Eleftherios; Oikonomou, Georgia [Department of Medical Radiologic Technology, Technological Educational Institute of Athens, Ag.Spyridonos, Egaleo, Athens 12210 (Greece); Malizos, Konstantinos [Department of Orthopaedic Surgery, University of Thessaly, School of Health Sciences, University Hospital of Larissa, Biopolis, Larissa 41110 (Greece); Fezoulidis, Ioannis V. [Department of Radiology, University of Thessaly, School of Health Sciences, University Hospital of Larissa, Biopolis, Larissa 41110 (Greece); Vlychou, Marianna, E-mail: mvlychou@med.uth.gr [Department of Radiology, University of Thessaly, School of Health Sciences, University Hospital of Larissa, Biopolis, Larissa 41110 (Greece)

2013-08-15

Objectives: In the present work, we aim to identify changes in the cartilage texture of the injured knee in young, physically active, patients by computer analysis of MRI images based on 3.0 T morphological sequences. Methods: Fifty-three young patients with training injury or trauma in one knee underwent MRI and arthroscopy. Textural features were computed from the MRI images of the knee-cartilages and two classes were formed of 28 normal and 16 with pathology only in the medial femoral condyle (MFC) cartilage. Results: Textural features with statistically significant differences between the two classes were found only at the MFC and the medial tibial condyle (MTC) areas. Three features-combinations, at the MFC or the MTC, maximized the between classes separation, thus, rendering alterations in cartilage texture due to injury more evident. The MFC cartilage in the pathology class was found more inhomogeneous in the distribution of gray-levels and of lower texture anisotropy and the opposed MTC cartilage, though normal on MRI and arthroscopy, was found to have lower texture anisotropy than cartilage in the normal class. Conclusion: Texture analysis may be used as an adjunct to morphological MR imaging for improving the detection of subtle cartilage changes and contributes to early therapeutic approach.

Full-thickness knee articular cartilage defects in national football league combine athletes undergoing magnetic resonance imaging: prevalence, location, and association with previous surgery.

Science.gov (United States)

Nepple, Jeffrey J; Wright, Rick W; Matava, Matthew J; Brophy, Robert H

2012-06-01

To better define the prevalence and location of full-thickness articular cartilage lesions in elite football players undergoing knee magnetic resonance imaging (MRI) at the National Football League (NFL) Invitational Combine and assess the association of these lesions with previous knee surgery. We performed a retrospective review of all participants in the NFL Combine undergoing a knee MRI scan from 2005 to 2009. Each MRI scan was reviewed for evidence of articular cartilage disease. History of previous knee surgery including anterior cruciate ligament reconstruction, meniscal procedures, and articular cartilage surgery was recorded for each athlete. Knees with a history of previous articular cartilage restoration surgery were excluded from the analysis. A total of 704 knee MRI scans were included in the analysis. Full-thickness articular cartilage lesions were associated with a history of any previous knee surgery (P football players at the NFL Combine undergoing MRI. The lateral compartment appears to be at greater risk for full-thickness cartilage loss. Previous knee surgery, particularly meniscectomy, is associated with these lesions. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Anthropometric difference of the knee on MRI according to gender and age groups.

Science.gov (United States)

Han, Hyuksoo; Oh, Sohee; Chang, Chong Bum; Kang, Seung-Baik

2016-03-01

The purpose of this study was to analyze the anthropometric data from MRI images that were obtained from the non-arthritic knees in Asian adults, and to identify the existence of morphologic differences between age groups. This cross-sectional study included knee MR images of 535 patients (273 males, 262 females) taken for the evaluation of soft-tissue injuries, excluding cases with cartilage defect and malalignment. The age, gender, height, and BMI were also assessed. The patients were grouped into three different 20-year age groups (20-39, 40-59, and 60-79). The MRI analysis was performed on the anthropometric parameters of distal femur and posterior tibial slope. Age-related differences were found in femoral width, distance from the distal and posterior cartilage surface to the medial/lateral epicondyle, medial posterior condylar offset (PCO), and posterior condylar angle (PCA) (all P age groups was found in most parameters, but not in PCA, distance from the posterior cartilage surface to the medial epicondyle, or medial tibial slope. We found anthropometric differences among age groups exist in most of distal femoral parameters, but not in posterior tibial slope. The results of this study can be used by manufacturers to modify prostheses to be suitable for the future Asian elderly population.

MRI of the posterolateral corner of the knee, please have a look ...

African Journals Online (AJOL)

The knee PLC injuries are frequently seen, with other major knee injuries, such as ACL and PCL. Objective: This article aimed to clarify PLC injuries that could be diagnosed by MRI, and may have an impact on the management of the associated major knee injuries. Patient and methods: It was conducted through ...

MRI EVALUATION OF PAINFUL KNEE JOINT- THE CORRELATION OF MULTIPLE COEXISTING PATHOLOGIES, AGE AND SEX

Directory of Open Access Journals (Sweden)

Mukheswar Pame

2017-03-01

Full Text Available BACKGROUND 1. To evaluate the incidence and coexistence of multiple knee joint pathologies causing painful knee and their correlation to age and sex. 2. To evaluate the Magnetic Resonance Imaging (MRI features in various knee pathologies and to identify the common lesions. MATERIALS AND METHODS A retrospective study was performed using the clinical data of patients presenting with painful knee joint which were evaluated with MRI. Data from 200 patients examined between September 2015 and August 2016 were included into this study. The data was analysed statistically to evaluate the correlation between the MR pathological findings to age and sex of the patients. RESULTS The patient’s age ranged between 8 and 75 years (mean: 36 years. Anterior cruciate ligament (ACL tear was the commonest finding (60% followed by bursitis (55%, meniscal degeneration (54.6% and meniscal tear (52%. Primary signs of ACL tear were hyperintensity, discontinuity and nonvisualisation. Secondary signs like Posterior cruciate ligament (PCL buckling, PCL index of greater than 0.5, uncovered Lateral meniscus (LM and bone contusion assisted in diagnosis in indeterminate cases. Mid substance was the commonest site of ACL tear (64%. PCL tear accounted for only a small percentage (7%. Medial Meniscus (MM tear (35% was commoner than LM tear (17%. The posterior horn of meniscus was the commonest site of injury (86.5%. Age was significantly correlated with meniscal degeneration and tear, Medial collateral ligament (MCL degeneration, parameniscal cyst, and chondromalacia patellae. A significant correlation between male gender and ACL injury was noted. Meniscal injury was significantly correlated with bursitis, as well with MCL injury. Bone bruise was significantly correlated with ACL injury, MCL injury and Lateral collateral ligament (LCL injury. CONCLUSIONS MRI findings of certain pathologies in a painful knee can coexist and significantly correlate with each other, age and sex of

High-resolution magnetic resonance imaging of arthritic pathology in the rat knee

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Carpenter, T.A. (Herchel Smith Lab. for Medicinal Chemistry, Cambridge Univ. (United Kingdom)); Everett, J.R. (Smith Kline Beecham Pharmaceuticals, Betchworth (United Kingdom)); Hall, L.D. (Herchel Smith Lab. for Medicinal Chemistry, Cambridge Univ. (United Kingdom)); Harper, G.P. (Smith Kline Beecham Pharmaceuticals, Welwyn (United Kingdom)); Hodgson, R.J. (Herchel Smith Lab. for Medicinal Chemistry, Cambridge Univ. (United Kingdom)); James, M.F. (Smith Kline Beecham Pharmaceuticals, Harlow (United Kingdom)); Watson, P.J. (Herchel Smith Lab. for Medicinal Chemistry, Cambridge Univ. (United Kingdom))

1994-08-01

High-resolution magnetic resonance imaging (MRI) has been used to visualise the changes that occur in both soft tissue and bone during antigen-induced, monoarticular arthritis (AIMA) of the rat knee. Extensive optimisation studies were performed in order to minimise the time of the experiments and to maximise both the signal-to-noise ratio and the contrast in the MR images. The study was cross-sectional rather than longitudinal and at each of the 13 time points studied during the progression of the disease, corresponding X-radiographs and histological sections were obtained. Interpretation of the spin echo MR images was aided by the use of chemical shift-selective imaging, magnetisation transfer contrast and relaxation time experiments, as well as by correlation with the histology and X-radiography data. The MR images clearly show invasion of the synovium by an inflammatory pannus which spreads over the articular cartilage and invades the bone, leading to erosion and later remodelling. Two distinct types of bony erosion were observed: focal erosions, especially at the margins of the joint, and subchondral erosions. It is concluded that MRI provides a sensitive, non-invasive method for investigating both early-stage inflammatory changes and late-stage bony changes in the knee joints of the arthritic rat. (orig.)

High-resolution magnetic resonance imaging of arthritic pathology in the rat knee

International Nuclear Information System (INIS)

Carpenter, T.A.; Everett, J.R.; Hall, L.D.; Harper, G.P.; Hodgson, R.J.; James, M.F.; Watson, P.J.

1994-01-01

High-resolution magnetic resonance imaging (MRI) has been used to visualise the changes that occur in both soft tissue and bone during antigen-induced, monoarticular arthritis (AIMA) of the rat knee. Extensive optimisation studies were performed in order to minimise the time of the experiments and to maximise both the signal-to-noise ratio and the contrast in the MR images. The study was cross-sectional rather than longitudinal and at each of the 13 time points studied during the progression of the disease, corresponding X-radiographs and histological sections were obtained. Interpretation of the spin echo MR images was aided by the use of chemical shift-selective imaging, magnetisation transfer contrast and relaxation time experiments, as well as by correlation with the histology and X-radiography data. The MR images clearly show invasion of the synovium by an inflammatory pannus which spreads over the articular cartilage and invades the bone, leading to erosion and later remodelling. Two distinct types of bony erosion were observed: focal erosions, especially at the margins of the joint, and subchondral erosions. It is concluded that MRI provides a sensitive, non-invasive method for investigating both early-stage inflammatory changes and late-stage bony changes in the knee joints of the arthritic rat. (orig.)

Diagnosis of osteoarthritis by cartilage surface smoothness quantified automatically from knee MRI

DEFF Research Database (Denmark)

Tummala, Sudhakar; Bay-Jensen, Anne-Christine; Karsdal, Morten A.

2011-01-01

Objective: We investigated whether surface smoothness of articular cartilage in the medial tibiofemoral compartment quantified from magnetic resonance imaging (MRI) could be appropriate as a diagnostic marker of osteoarthritis (OA). Method: At baseline, 159 community-based subjects aged 21 to 81...... with normal or OA-affected knees were recruited to provide a broad range of OA states. Smoothness was quantified using an automatic framework from low-field MRI in the tibial, femoral, and femoral subcompartments. Diagnostic ability of smoothness was evaluated by comparison with conventional OA markers......, correlations between smoothness and pain values and smoothness loss and cartilage loss supported a link to progression of OA. Thereby, smoothness markers may allow detection and monitoring of OA-supplemented currently accepted markers....

Performance of a Machine Learning Classifier of Knee MRI Reports in Two Large Academic Radiology Practices: A Tool to Estimate Diagnostic Yield.

Science.gov (United States)

Hassanpour, Saeed; Langlotz, Curtis P; Amrhein, Timothy J; Befera, Nicholas T; Lungren, Matthew P

2017-04-01

The purpose of this study is to evaluate the performance of a natural language processing (NLP) system in classifying a database of free-text knee MRI reports at two separate academic radiology practices. An NLP system that uses terms and patterns in manually classified narrative knee MRI reports was constructed. The NLP system was trained and tested on expert-classified knee MRI reports from two major health care organizations. Radiology reports were modeled in the training set as vectors, and a support vector machine framework was used to train the classifier. A separate test set from each organization was used to evaluate the performance of the system. We evaluated the performance of the system both within and across organizations. Standard evaluation metrics, such as accuracy, precision, recall, and F1 score (i.e., the weighted average of the precision and recall), and their respective 95% CIs were used to measure the efficacy of our classification system. The accuracy for radiology reports that belonged to the model's clinically significant concept classes after training data from the same institution was good, yielding an F1 score greater than 90% (95% CI, 84.6-97.3%). Performance of the classifier on cross-institutional application without institution-specific training data yielded F1 scores of 77.6% (95% CI, 69.5-85.7%) and 90.2% (95% CI, 84.5-95.9%) at the two organizations studied. The results show excellent accuracy by the NLP machine learning classifier in classifying free-text knee MRI reports, supporting the institution-independent reproducibility of knee MRI report classification. Furthermore, the machine learning classifier performed well on free-text knee MRI reports from another institution. These data support the feasibility of multiinstitutional classification of radiologic imaging text reports with a single machine learning classifier without requiring institution-specific training data.

MRI diagnosis of knee joint injury: the clinical application with a report of 35 cases

International Nuclear Information System (INIS)

Zhao Quan; Tang Ni; Wu Xiaoyong; Zhao Ping; Guan Huanwen

2006-01-01

Objective: To study the MRI findings of knee joint injury and the pathalogical basis and clinical significance. Methods: MR images of the knee joint injury were investigated in 35 cases. Results: In 23 cases of meniscus damage, lesions were nodular, linear or radioactive fissure with hyperintense signal within the dark meniscus, extending to or beneath the articular cartilage surface. In 9 cases of cruciate ligament injury, the disorder was a hyperintense shadow which was hyperintense on T 1 WI and hypointense on T 2 WI within the stripe-like, hypointense ligament, accompanying with the alteration of the ligament, which was in a wave shape or discontinued. Dislocation of the tibia was also revealed. In 5 cases of the bilateral collateral ligament damage. The involved thickened ligament had increased signal and blurred edge. In 4 cases of obscure bone fracture, the lesion was located in the metaphysic, manifested a hypo-intense shadow on T 1 WI, diverse on T 2 WI. Conclusion: MRI plays an important role in the diagnosis of the injury of menicus, ligament, and the obscure fracture of knee joint, and provides detailed information for the clinical management. (authors)

The relationship between limited MRI section analyses and volumetric assessment of synovitis in knee osteoarthritis

International Nuclear Information System (INIS)

Rhodes, L.A.; Keenan, A.-M.; Grainger, A.J.; Emery, P.; McGonagle, D.; Conaghan, P.G.

2005-01-01

AIM: To assess whether simple, limited section analysis can replace detailed volumetric assessment of synovitis in patients with osteoarthritis (OA) of the knee using contrast-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: Thirty-five patients with clinical and radiographic OA of the knee were assessed for synovitis using gadolinium-enhanced MRI. The volume of enhancing synovium was quantitatively assessed in four anatomical sites (the medial and lateral parapatellar recesses, the intercondylar notch and the suprapatellar pouch) by summing the volumes of synovitis in consecutive sections. Four different combinations of section analysis were evaluated for their ability to predict total synovial volume. RESULTS: A total of 114 intra-articular sites were assessed. Simple linear regression demonstrated that the best predictor of total synovial volume was the analysis containing the inferior, mid and superior sections of each of the intra-articular sites, which predicted between 40-80% (r 2 =0.396, p 2 =0.818, p<0.001 for medial parapatellar recess) of the total volume assessment. CONCLUSIONS: The results suggest that a three-section analysis on axial post-gadolinium sequences provides a simple surrogate measure of synovial volume in OA knees

The relationship between limited MRI section analyses and volumetric assessment of synovitis in knee osteoarthritis

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Rhodes, L.A. [Academic Unit of Medical Physics, University of Leeds and Leeds General Infirmary, Leeds (United Kingdom)]. E-mail: lar@medphysics.leeds.ac.uk; Keenan, A.-M. [Academic Unit of Musculoskeletal Disease, University of Leeds and Leeds General Infirmary, Leeds (United Kingdom); Grainger, A.J. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom); Emery, P. [Academic Unit of Musculoskeletal Disease, University of Leeds and Leeds General Infirmary, Leeds (United Kingdom); McGonagle, D. [Academic Unit of Musculoskeletal Disease, University of Leeds and Leeds General Infirmary, Leeds (United Kingdom); Calderdale Royal Hospital, Salterhebble, Halifax (United Kingdom); Conaghan, P.G. [Academic Unit of Musculoskeletal Disease, University of Leeds and Leeds General Infirmary, Leeds (United Kingdom)

2005-12-15

AIM: To assess whether simple, limited section analysis can replace detailed volumetric assessment of synovitis in patients with osteoarthritis (OA) of the knee using contrast-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: Thirty-five patients with clinical and radiographic OA of the knee were assessed for synovitis using gadolinium-enhanced MRI. The volume of enhancing synovium was quantitatively assessed in four anatomical sites (the medial and lateral parapatellar recesses, the intercondylar notch and the suprapatellar pouch) by summing the volumes of synovitis in consecutive sections. Four different combinations of section analysis were evaluated for their ability to predict total synovial volume. RESULTS: A total of 114 intra-articular sites were assessed. Simple linear regression demonstrated that the best predictor of total synovial volume was the analysis containing the inferior, mid and superior sections of each of the intra-articular sites, which predicted between 40-80% (r {sup 2}=0.396, p<0.001 for notch; r {sup 2}=0.818, p<0.001 for medial parapatellar recess) of the total volume assessment. CONCLUSIONS: The results suggest that a three-section analysis on axial post-gadolinium sequences provides a simple surrogate measure of synovial volume in OA knees.

Magnetic Resonance Imaging Comparison of Intra-Articular Cavernous Synovial Hemangioma and Cystic Synovial Hyperplasia of the Knee

International Nuclear Information System (INIS)

De Filippo, M.; Rovani, C.; Sudberry, J. J.; Rossi, F.; Pogliacomi, F.; Zompatori, M.

2006-01-01

Purpose: To identify and compare magnetic resonance imaging (MRI) characteristics, with and without intravenous contrast medium, of cavernous synovial hemangiomas and cystic synovial hyperplasia. Material and Methods: Four cases of cavernous synovial hemangioma and five of cystic synovial hyperplasia of the knee were studied retrospectively. The patients (5 F and 4 M; 15-25 years of age) all had long-standing knee pain. At clinical examination we observed elastic swelling and pain without significant joint effusion. The patients underwent conventional radiography and MRI without and following intravenous contrast medium before arthroscopic biopsy. Results: The radiographs were interpreted as negative in all patients. MRI examination without contrast medium revealed a similar multicystic appearance for both lesions. Following intravenous contrast agent administration, cavernous synovial hemangiomas demonstrated avid, rather homogenous enhancement, whereas cystic synovial hyperplasia demonstrated less intense, peripheral enhancement only. Arthroscopy with histological examination of the lesions confirmed the MRI diagnosis in every case. Conclusion: In our experience, cavernous synovial hemangioma and cystic synovial hyperplasia have a similar appearance on unenhanced MRI, but can be reliably differentiated on the basis of enhancement characteristics following intravenous contrast administration. Keywords: Cavernous synovial hemangioma; cystic synovial hyperplasia; knee; MRI

Comparison of arthroscopy and magnetic resonance imaging in investigation of the knee joint

International Nuclear Information System (INIS)

Zazyirnij, Yi.M.; Rogozhin, V.O.; Ternovij, M.K.

2002-01-01

MRI was done in 41 patients aged 18-56 who were treated for stage 1 and 2 osteoarthrosis of the knee joint. The analysis of accuracy, sensitivity, specificity suggests that MRI facilitates assessment of the state of the knee cartilage and menisci. High negative preliminary data of MRI allow to avoid unnecessary arthroscopy of the knee joint

Forensic age assessment by 3.0T MRI of the knee: proposal of a new MRI classification of ossification stages.

Science.gov (United States)

Vieth, Volker; Schulz, Ronald; Heindel, Walter; Pfeiffer, Heidi; Buerke, Boris; Schmeling, Andreas; Ottow, Christian

2018-03-13

To explore the possibility of determining majority via a morphology-based examination of the epiphyseal-diaphyseal fusion by 3.0 T magnetic resonance imaging (MRI), a prospective cross-sectional study developing and applying a new stage classification was conducted. 344 male and 350 female volunteers of German nationality between the ages of 12-24 years were scanned between May 2013 and June 2015. A 3.0 T MRI scanner was used, acquiring a T1-weighted (T1-w) turbo spin-echo sequence (TSE) and a T2-weighted (T2-w) TSE sequence with fat suppression by spectral pre-saturation with inversion recovery (SPIR). The gathered information was sifted and a five-stage classification was formulated as a hypothesis. The images were then assessed using this classification. The relevant statistics were defined, the intra- and interobserver agreements were determined, and the differences between the sexes were analysed. The application of the new classification made it possible to correctly assess majority in both sexes by the examination of the epiphyses of the knee joint. The intra- and interobserver agreement levels were very good (κ > 0.80). The Mann-Whitney-U Test implied significant sex-related differences for most stages. Applying the presented MRI classification, it is possible to determine the completion of the 18th year of life in either sex by 3.0 T MRI of the knee joint. • Based on prospective referential data a new MRI classification was formulated. • The setting allows assessment of the age of an individual's skeletal development. • The classification scheme allows the reliable determination of majority in both sexes. • The staging shows a high reproducibility for instructed and trained professional personnel. • The proposed classification is likely to be adaptable to other long bone epiphyses.

Magnetic resonance imaging for the diagnosis of chondral, meniscal and cruciate ligaments injuries of the knee

International Nuclear Information System (INIS)

Karam, Francisco Consoli; Fridmann, Marcos William; Arbo, Rodrigo Di Mare; Vieira, Jose Francisco; Silva, Jefferson Luis Braga da; Pires, Luiz Antonio Simoes; Abreu, Armando; Abreu, Marcelo

2007-01-01

Objective: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) of the knee. Materials and methods: Seventy-two patients have been submitted to MRI previously to arthroscopy of the knee performed by a single surgeon and utilized as a comparative standard method. Sensitivity, specificity, values of likelihood and rate of interobserver agreement have been evaluated. Results: The kappa agreement coefficient between MRI and arthroscopy was very good for lesions in the anterior cruciate ligament (0.84), good for lateral meniscus (0.75), reasonable for medial meniscus (0.50) and poor for chondral lesions (< 0.50). MRI has demonstrated high sensitivity for tears in the anterior cruciate ligament (94%) and in the medial meniscus (92%), good sensitivity for lesions in the lateral meniscus (80%), and low sensitivity for lesions in all of the chondral zones (< 50%), while the specificity has been excellent for all the chondral, and ligamentous structures, besides the lateral menisci analyzed (more than 97%), and reasonable (65%) for the medial meniscus. Conclusion: MRI is an useful tool in the clinical diagnosis of intra-articular knee lesions, as already demonstrated by similar results reported both in the Brazilian and international literature. (author)

MR Imaging of Degenerative Cartilage Lesions of the Knee Joint in Floor Layers and Graphic Designers

DEFF Research Database (Denmark)

Rytter, Søren; Thomsen, Birthe Lykke; Christensen, Birgitte Schütt

2016-01-01

Introduction: Kneeling work leads to an additional risk of developing knee osteoarthritis (OA). Previous studies have primarily been based on radiography, but radiography is limited by its inability to visualize articular cartilage, in which the earliest signs of OA occur. The objective of this e......Introduction: Kneeling work leads to an additional risk of developing knee osteoarthritis (OA). Previous studies have primarily been based on radiography, but radiography is limited by its inability to visualize articular cartilage, in which the earliest signs of OA occur. The objective...... of this explorative study, based on available data, was to examine the prevalence of magnetic resonance imaging (MRI)-detected knee cartilage lesions in male floor layers exposed to kneeling work, as compared to non-exposed male graphic designers. Methods: MRI of the knees was conducted in 92 floor layers and 49...... tibiofemoral posterior area, the most strained area during kneeling and 2) the total knee. Presence of lesions was compared in floor layers and graphic designers after adjusting for age, BMI, seniority, knee injuries, and sports activity in logistic regression analyses for correlated data, and investigated...

Indications for and clinical procedures resulting from magnetic resonance imaging of the knee in older patients

Science.gov (United States)

Parent, Marc-Etienne; Vézina, François; Carrier, Nathalie; Masetto, Ariel

2018-01-01

Abstract Objective To analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients. Design We retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009. Setting Centre hospitalier universitaire de Sherbrooke in Quebec. Participants Patients 50 years of age and older who underwent a knee MRI in 2009. Main outcome measures The main outcome measure was an invasive procedure in the same knee that underwent an MRI. Medical charts were reviewed up to 2014 for patient characteristics, MRI indication, ordering physician specialty, radiography before MRI, MRI findings, and clinical procedures resulting from the MRI. Results The patients’ mean (SD) age was 60.6 (7.5) years. The main MRI indications were meniscopathy (148 [68.8%]) and chronic pain (92 [42.8%]). The main MRI findings were osteoarthritis (OA) (185 [86.0%]) and meniscal lesions (170 [79.1%]). Only 82 (38.1%) patients had a plain radiograph in the 24 months preceding the MRI, usually without a standing anteroposterior view. Findings on pre-MRI radiography (n = 201) demonstrated OA in 144 (71.6%) patients. Overall, 87 (40.5%) patients were seen by an orthopedic surgeon and 27 (31.0%) of these patients underwent an invasive intervention. Among the 81 patients with moderate to severe OA on MRI, 36 (44.4%) had radiographic evidence of moderate to severe OA and only 3 (3.7%) underwent arthroscopic meniscectomy. Conclusion Our study reproduces the known association between OA and degenerative meniscal changes in older patients. We have found a surprising underuse of the standing anteroposterior view on radiography. Most patients in our cohort could have been appropriately diagnosed and treated based on such radiographic information, as demonstrated by pre-MRI findings, thus avoiding the MRI and subsequent evaluation by an orthopedic surgeon. Meniscectomy was rarely performed

Interposition of the posterior cruciate ligament into the medial compartment of the knee joint on coronal magnetic resonance imaging

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Su; Yoon, Young Cheol; Park, Ki Jeong; Wang, Joon Ho [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Choe, Bong Keun [Dept. of Preventive Medicine, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

2016-04-15

The purpose of our study was to evaluate the overall prevalence and clinical significance of interposition of the posterior cruciate ligament (PCL) into the medial compartment of the knee joint in coronal magnetic resonance imaging (MRI). We retrospectively reviewed 317 consecutive patients referred for knee MRI at our institution between October 2009 and December 2009. Interposition of the PCL into the medial compartment of the knee joint on proton coronal MRI was evaluated dichotomously (i.e., present or absent). We analyzed the interposition according to its prevalence as well as its relationship with right-left sidedness, gender, age, and disease categories (osteoarthritis, anterior cruciate ligament tear, and medial meniscus tear). Prevalence of interposition of PCL into the medial compartment of the knee joint was 47.0% (149/317). There was no right (50.0%, 83/166) to left (43.7%, 66/151) or male (50.3%, 87/173) to female (43.1%, 62/144) differences in the prevalence. There was no significant association between the prevalence and age, or the disease categories. Interposition of the PCL into the medial compartment of the knee joint is observed in almost half of patients on proton coronal MRI of the knee. Its presence is not associated with any particular factors including knee pathology and may be regarded as a normal MR finding.

Imaging Bone–Cartilage Interactions in Osteoarthritis Using [18F]-NaF PET-MRI

Directory of Open Access Journals (Sweden)

Dragana Savic MSc

2016-12-01

Full Text Available Purpose: Simultaneous positron emission tomography–magnetic resonance imaging (PET-MRI is an emerging technology providing both anatomical and functional images without increasing the scan time. Compared to the traditional PET/computed tomography imaging, it also exposes the patient to significantly less radiation and provides better anatomical images as MRI provides superior soft tissue characterization. Using PET-MRI, we aim to study interactions between cartilage composition and bone function simultaneously, in knee osteoarthritis (OA. Procedures: In this article, bone turnover and remodeling was studied using [18F]-sodium fluoride (NaF PET data. Quantitative MR-derived T1ρ relaxation times characterized the biochemical cartilage degeneration. Sixteen participants with early signs of OA of the knee received intravenous injections of [18F]-NaF at the onset of PET-MR image acquisition. Regions of interest were identified, and kinetic analysis of dynamic PET data provided the rate of uptake (Ki and the normalized uptake (standardized uptake value of [18F]-NaF in the bone. Morphological MR images and quantitative voxel-based T1ρ maps of cartilage were obtained using an atlas-based registration technique to segment cartilage automatically. Voxel-by-voxel statistical parameter mapping was used to investigate the relationship between bone and cartilage. Results: Increases in cartilage T1ρ, indicating degenerative changes, were associated with increased turnover in the adjoining bone but reduced turnover in the nonadjoining compartments. Associations between pain and increased bone uptake were seen in the absence of morphological lesions in cartilage, but the relationship was reversed in the presence of incident cartilage lesions. Conclusion: This study shows significant cartilage and bone interactions in OA of the knee joint using simultaneous [18F]-NaF PET-MR, the first in human study. These observations highlight the complex biomechanical and

1. 5 MRT of the hyaline articular cartilage of the knee joint

Energy Technology Data Exchange (ETDEWEB)

Adam, G.; Bohndorf, K.; Krasny, R.; Guenther, R.W.; Prescher, A.

1988-06-01

MRI is a new method for imaging the knee joint. There is still some uncertainty regarding the extent and the signal from hyaline articular cartilage. MRI images were therefore compared with anatomical and histological preparations of the knee joint and the difference between MRI and the anatomical sections have been determined. It was shown that demonstration of hyaline cartilage was obscured by an artifact. Further investigations are required to determine the cause of this artifact and to achieve accurate imaging of hyaline cartilage by MRI.

An open 8-channel parallel transmission coil for static and dynamic 7T MRI of the knee and ankle joints at multiple postures.

Science.gov (United States)

Jin, Jin; Weber, Ewald; Destruel, Aurelien; O'Brien, Kieran; Henin, Bassem; Engstrom, Craig; Crozier, Stuart

2018-03-01

We present the initial in vivo imaging results of an open architecture eight-channel parallel transmission (pTx) transceive radiofrequency (RF) coil array that was designed and constructed for static and dynamic 7T MRI of the knee and ankle joints. The pTx coil has a U-shaped dual-row configuration (200 mm overall length longitudinally) that allows static and dynamic imaging of the knee and ankle joints at various postures and during active movements. This coil structure, in combination with B 1 shimming, allows flexible configuration of B 1 transmit profiles, with good homogeneity over 120-mm regions of interest. This coil enabled high-resolution gradient echo (e.g., 3D dual-echo steady state [DESS] and 3D multiecho data image combination [MEDIC]) and turbo spin echo (TSE) imaging (e.g., with proton density weighting [PDw], PDw with fat saturation, and T 1 and T 2 weightings) with local RF energy absorption rates well below regulatory limits. High-resolution 2D and 3D image series (e.g., 0.3 mm in-plane resolution for TSE, 0.47 mm isotropic for DESS and MEDIC) were obtained from the knee and ankle joints with excellent tissue contrast. Dynamic imaging during continuous knee and ankle flexion-extension cycles were successfully acquired. The new open pTx coil array provides versatility for high-quality static and dynamic MRI of the knee and ankle joints at 7T. Magn Reson Med 79:1804-1816, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Three-dimensional isotropic fat-suppressed proton density-weighted MRI at 3 tesla using a T/R-coil can replace multiple plane two-dimensional sequences in knee imaging

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Homsi, R.; Luetkens, J.A. [Bonn Univ. (Germany). Dept. of Radiology; Gieseke, J. [Philips Healthcare, Hamburg (Germany); and others

2016-10-15

To evaluate whether a 3D proton density-weighted fat-suppressed sequence (PDwFS) of the knee is able to replace multiplanar 2D-PDwFS. 52 patients (26 men, mean age: 41.9±14.5 years) underwent magnetic resonance imaging (MRI) of the knee at 3.0 Tesla using a T/R-coil. The imaging protocol included 3 planes of 2D-PDwFS (acquisition time (AT): 6:40 min; voxel sizes: 0.40-0.63 x 0.44-0.89 x 3 mm{sup 3}) and a 3D-PDwFS (AT: 6:31 min; voxel size: 0.63 x 0.68 x 0.63 mm{sup 3}). Homogeneity of fat suppression (HFS), artifacts, and image sharpness (IS) were evaluated on a 5-point scale (5[excellent] - 1[non-diagnostic]). The sum served as a measure for the overall image quality (OIQ). Contrast ratios (CR) compared to popliteal muscle were calculated for the meniscus (MEN), anterior (ACL) and posterior cruciate ligaments (PCL). In 13 patients who underwent arthroscopic knee surgery, two radiologists evaluated the presence of meniscal, ligamental and cartilage lesions to estimate the sensitivity and specificity of lesion detection. The CR was higher in the ACL, PCL and MEN in 3D- PDwFS compared to 2D-PDwFS (p<0.01 for ACL and PCL; p=0.07 for MEN). Compared to 2D images, the OIQ was rated higher in 3D-PDwFS images (p<0.01) due to fewer artifacts and HFS despite the lower IS (p<0.01). The sensitivity and specificity of lesion detection in 3D- and 2D-PDwFS were similar. Compared to standard multiplanar 2D-PDwFS knee imaging, isotropic high spatial resolution 3D-PDwFS of the knee at 3.0T can be acquired with high image quality in a reasonable scan time. Multiplanar reformations in arbitrary planes may serve as an additional benefit of 3D-PDwFS.

Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography

DEFF Research Database (Denmark)

Gudbergsen, H.; Boesen, M.; Lohmander, L. S.

2012-01-01

With an increasing prevalence of older and obese citizens, the problems of knee osteoarthritis (KOA) will escalate. Weight loss is recommended for obese KOA patients and in a majority of cases this leads to symptomatic relief. We hypothesized that pre-treatment structural status of the knee joint......, assessed by radiographs, 1.5 T magnetic resonance imaging (MRI) and knee-joint alignment, may influence the symptomatic changes following a significant weight reduction....

Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

Energy Technology Data Exchange (ETDEWEB)

Muhle, C. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Brossmann, J. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Melchert, U.H. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Schroeder, C. [Radiologische Abt., Universitaets-Kinderklinik, Christian-Albrechts-Universitaet, Kiel (Germany); Boer, R. de [Philips Medical Systems, Best (Netherlands); Spielmann, R.P. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany); Heller, M. [Klinik fuer Radiologische Diagnostik, Univ. Kiel (Germany)

1995-12-31

To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

Functional MRI of the patellofemoral joint: comparison of ultrafast MRI, motion-triggered cine MRI and static MRI

International Nuclear Information System (INIS)

Muhle, C.; Brossmann, J.; Melchert, U.H.; Schroeder, C.; Boer, R. de; Spielmann, R.P.; Heller, M.

1995-01-01

To evaluate the feasibility and usefulness of ultrafast MRI (u), patellar tracking from 30 of flexion to knee extension (0 ) was analysed and compared with motion-triggered cine MRI (m) and a static MRI technique (s). The different imaging methods were compared in respect of the patellofemoral relationship, the examination time and image quality. Eight healthy subjects and four patients (in total 18 joints) with patellar subluxation or luxation were examined. Significant differences between the static MRI series without quadriceps contraction and the functional MRI studies (motion-triggered cine MRI and ultrafast MRI) were found for the patellar tilt angle. In the dynamic joint studies there was no statistical difference of the regression coefficients between the motion-triggered cine MRI studies and the ultrafast MRI studies. The findings of the functional MRI studies compared with the static MRI images were significantly different for the lateralisation of the patella, expressed by the lateral patellar displacement and bisect offset. No significant differences in patellar lateralisation were found between motion-triggered cine MRI and ultrafast MRI. Ultrafast MRI was superior to motion-triggered cine MRI in terms of the reduction in imaging time and improvement of the image quality. (orig.)

Pre-authorization processes have no effect on patients undergoing knee MRI in a pediatric setting when evaluated by specialists

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Pierce, Drew; Kan, J.H.; Bisset, George S. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); May, Megan [Texas Children' s Hospital, Department of Sports Medicine, Houston, TX (United States)

2017-02-15

Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist. The study population included patients who underwent an insurance pre-authorization process and the control group consisted of those who did not. The results of the MRI and whether they were deemed surgically significant, in addition to surgical referral, were recorded and compared. The study and control groups showed no statistically significant difference in outcome with regard to surgically significant findings on MRI (p = 0.92) or whether the patient required surgery (p = 0.6). In this population, there is no difference in the likelihood of an abnormal knee MRI demonstrating surgically significant findings or referral to surgery in patients who did and those who did not undergo an insurance pre-authorization process when patients are referred from a pediatric orthopedic specialist. The insurance pre-authorization process does not appear to have an impact on patient diagnosis and treatment and may unnecessarily add bureaucracy and costs. (orig.)

MRI of degenerative bone marrow lesions in experimental osteoarthritis of canine knee joints

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Nolte-Ernsting, C.C.A. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Adam, G. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Buehne, M. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Aachen (Germany); Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany)

1996-07-01

Objective. The objective of this study was to determine the value of MRI in the detection of degenerative bone marrow abnormalities in an animal osteoarthritis model. Design. In 10 dogs with experimentally induced unilateral osteoarthritis of the knee, MRI was performed using two-dimensional spin-echo (2D-SE) and three-dimensional gradient-echo (3D-GE) imaging. Contrast enhanced T1-weighted 2D-SE sequences were also obtained after injection of gadolinium-DTPA. The results were compared with the gross and histopathologic findings and with radiography. Results. Histopathologic specimens revealed 21 osteosclerotic lesions and 5 intraosseous cysts. On 2D-SE images, 24 of 26 lesions were detected, while 21 of 26 lesions were identified on 2D-GE sequences. Radiography, including conventional tomography, demonstrated 9 of 26 lesions. Regardless of the sequence weighting, all osteosclerotic lesions appeared hypointense on MRI. Signal loss in bone sclerosis resulted primarily from the reduction of intact fat marrow, the increased bone density being of secondary importance. Quantitative signal analysis allowed approximate estimation of the grade of sclerosis. On postcontrast images, sclerotic bone remained hypointense, although significant but non-specific enhancement relative to the normal fat marrow was observed. The extent of contrast enhancement did not correlate with the grade of osteosclerosis. All five cysts were readily diagnosed by MRI. Cysts displayed either central or marginal contrast enhancement within their cavities. Conclusions. MRI provides a sensitive method for the diagnosis of osteoarthritic bone abnormalities, allowing their differentiation from most non-degenerative subarticular lesions. (orig.). With 1 tab.

MR imaging of cartilage and its repair in the knee - a review

International Nuclear Information System (INIS)

Trattnig, S.; Welsch, G.W.; Domayer, S.; Mosher, T.; Eckstein, F.

2009-01-01

Chondral injuries are common lesions of the knee joint, and many patients could benefit from cartilage repair. Widespread cartilage repair techniques require sophisticated noninvasive follow-up using MRI. In addition to the precise morphological assessment of this area of cartilage repair, the cartilage's biochemical constitution can be determined using biochemical MRI techniques. The combination of the clinical outcome after cartilage repair together with the morphological and biochemical description of the cartilage repair tissue as well as the surrounding cartilage can lead to an optimal follow-up evaluation. The present article on MR imaging techniques of cartilage repair focuses on morphological description and scoring using techniques from conventional 2D through advanced isotropic 3D MRI sequences. Furthermore the ultrastructure of the repair tissue and the surrounding cartilage is evaluated in-vivo by biochemical T1-delayed gadolinium enhanced MRI of cartilage (dGEMRIC), T2 relaxation, and diffusion-weighted imaging techniques. (orig.)

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

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Hofmann, Felix C. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Technical University of Munich, Department of Radiology, Munich (Germany); Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M. [University of California San Francisco, Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, Michael C.; McCulloch, Charles E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2018-01-15

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times. Data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Hofmann, Felix C.; Neumann, Jan; Heilmeier, Ursula; Joseph, Gabby B.; Link, Thomas M.; Nevitt, Michael C.; McCulloch, Charles E.

2018-01-01

To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities. (orig.)

The use of MRI in the investigation of lateral meniscal tear post medial unicompartmental knee replacement

Directory of Open Access Journals (Sweden)

Sanil H. Ajwani, MBChB, BSc (Hons, MRCS

2015-06-01

Full Text Available The evaluation of lateral knee pain in patients with a medial unicompartmental knee replacement (UKR is complex. The native lateral compartment structures are prone to the same injuries as patients with normal knees. Historical reports of lateral meniscal injury post medial UKR have argued MRI evaluation is obsolete due to artefact caused by the prosthesis. We report a case of lateral meniscal injury in a patient two years after successful medial UKR. We identified the offending pathology via utilization of MRI scanners adopting metal artefact reduction sequences (MARS. The MARS MRI protocol helps clinicians accurately and non-invasively evaluate soft tissue structures in knees with metal prostheses. It also allows surgeons to accurately counsel patients and provides a higher degree of certainty in treating the pathology.

Three-Dimensional Isotropic Fat-Suppressed Proton Density-Weighted MRI at 3 Tesla Using a T/R-Coil Can Replace Multiple Plane Two-Dimensional Sequences in Knee Imaging.

Science.gov (United States)

Homsi, R; Gieseke, J; Luetkens, J A; Kupczyk, P; Maedler, B; Kukuk, G M; Träber, F; Agha, B; Rauch, M; Rajakaruna, N; Willinek, W; Schild, H H; Hadizadeh, D R

2016-10-01

To evaluate whether a 3 D proton density-weighted fat-suppressed sequence (PDwFS) of the knee is able to replace multiplanar 2D-PDwFS. 52 patients (26 men, mean age: 41.9 ± 14.5years) underwent magnetic resonance imaging (MRI) of the knee at 3.0 Tesla using a T/R-coil. The imaging protocol included 3 planes of 2D-PDwFS (acquisition time (AT): 6:40 min; voxel sizes: 0.40 - 0.63 × 0.44 - 0.89 × 3mm³) and a 3D-PDwFS (AT: 6:31 min; voxel size: 0.63 × 0.68 × 0.63mm³). Homogeneity of fat suppression (HFS), artifacts, and image sharpness (IS) were evaluated on a 5-point scale (5[excellent] - 1[non-diagnostic]). The sum served as a measure for the overall image quality (OIQ). Contrast ratios (CR) compared to popliteal muscle were calculated for the meniscus (MEN), anterior (ACL) and posterior cruciate ligaments (PCL). In 13 patients who underwent arthroscopic knee surgery, two radiologists evaluated the presence of meniscal, ligamental and cartilage lesions to estimate the sensitivity and specificity of lesion detection. The CR was higher in the ACL, PCL and MEN in 3D- PDwFS compared to 2D-PDwFS (p Tesla Using a T/R-Coil Can Replace Multiple Plane Two-Dimensional Sequences in Knee Imaging. Fortschr Röntgenstr 2016; 188: 949 - 956. © Georg Thieme Verlag KG Stuttgart · New York.

MRI follow-up of conservatively treated meniscal knee lesions in general practice

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Oei, Edwin H.G.; Hunink, M.G.M. [University Medical Center Rotterdam, Program for the Assessment of Radiological Technology (ART Program), Erasmus MC, Rotterdam (Netherlands); University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); University Medical Center Rotterdam, Department of Epidemiology, Erasmus MC, Rotterdam (Netherlands); Koster, Ingrid M. [University Medical Center Rotterdam, Department of Radiology, Erasmus MC, Rotterdam (Netherlands); Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Hensen, Jan-Hein J.; Vroegindeweij, Dammis [Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Boks, Simone S. [University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Rotterdam (Netherlands); Maasstad Ziekenhuis, Department of Radiology, Rotterdam (Netherlands); Diaconessenhuis Meppel, Department of Radiology, Meppel (Netherlands); Wagemakers, Harry P.A.; Koes, Bart W.; Bierma-Zeinstra, Sita M.A. [University Medical Center Rotterdam, Department of General Practice, Erasmus MC, Rotterdam (Netherlands)

2010-05-15

To evaluate meniscal status change on follow-up MRI after 1 year, prognostic factors and association with clinical outcome in patients with conservatively treated knee injury. We analysed 403 meniscal horns in 101 conservatively treated patients (59 male; mean age 40 years) in general practice who underwent initial knee MRI within 5 weeks of trauma. We performed ordinal logistic regression analysis to analyse prognostic factors for meniscal change on follow-up MRI after 1 year, and we assessed the association with clinical outcome. On follow-up MRI 49 meniscal horns had deteriorated and 18 had improved. Age (odds ratio [OR] 1.3/decade), body weight (OR 1.2/10 kg), total anterior cruciate ligament (ACL) rupture on initial MRI (OR 2.4), location in the posterior horn of the medial meniscus (OR 3.0) and an initial meniscal lesion (OR 0.3) were statistically significant predictors of meniscal MRI appearance change after 1 year, which was not associated with clinical outcome. In conservatively treated patients, meniscal deterioration on follow-up MRI 1 year after trauma is predicted by higher age and body weight, initial total ACL rupture, and location in the medial posterior horn. Change in MRI appearance is not associated with clinical outcome. (orig.)

Knee MRI scan

Science.gov (United States)

... MRI and ultrasound. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic ... Magnetic resonance imaging. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic ...

Magnetic resonance imaging can accurately assess the long-term progression of knee structural changes in experimental dog osteoarthritis.

Science.gov (United States)

Boileau, C; Martel-Pelletier, J; Abram, F; Raynauld, J-P; Troncy, E; D'Anjou, M-A; Moreau, M; Pelletier, J-P

2008-07-01

Osteoarthritis (OA) structural changes take place over decades in humans. MRI can provide precise and reliable information on the joint structure and changes over time. In this study, we investigated the reliability of quantitative MRI in assessing knee OA structural changes in the experimental anterior cruciate ligament (ACL) dog model of OA. OA was surgically induced by transection of the ACL of the right knee in five dogs. High resolution three dimensional MRI using a 1.5 T magnet was performed at baseline, 4, 8 and 26 weeks post surgery. Cartilage volume/thickness, cartilage defects, trochlear osteophyte formation and subchondral bone lesion (hypersignal) were assessed on MRI images. Animals were killed 26 weeks post surgery and macroscopic evaluation was performed. There was a progressive and significant increase over time in the loss of knee cartilage volume, the cartilage defect and subchondral bone hypersignal. The trochlear osteophyte size also progressed over time. The greatest cartilage loss at 26 weeks was found on the tibial plateaus and in the medial compartment. There was a highly significant correlation between total knee cartilage volume loss or defect and subchondral bone hypersignal, and also a good correlation between the macroscopic and the MRI findings. This study demonstrated that MRI is a useful technology to provide a non-invasive and reliable assessment of the joint structural changes during the development of OA in the ACL dog model. The combination of this OA model with MRI evaluation provides a promising tool for the evaluation of new disease-modifying osteoarthritis drugs (DMOADs).

Evaluation of posterior lateral femoral condylar hypoplasia using axial MRI images in patients with complete discoid meniscus.

Science.gov (United States)

Xu, Zhihong; Chen, Dongyang; Shi, Dongquan; Dai, Jin; Yao, Yao; Jiang, Qing

2016-03-01

Hypoplasia of the lateral femoral condyle has been reported in discoid lateral meniscus patients, but associated imaging findings in the axial plane have not been characterized. In this study, we aimed to identify differences in the lateral femoral condyle between patients with discoid lateral meniscus and those with normal menisci using axial MRI images. Twenty-three patients (24 knees) with complete discoid lateral meniscus, 43 (45 knees) with incomplete discoid lateral meniscus, and 50 with normal menisci (50 knees) were enrolled and distributed into three groups. Two new angles, posterior lateral condylar angle (PLCA) and posterior medial condylar angle (PMCA), were measured on axial MRI images; the posterior condylar angle (PCA) was also measured. Differences between the three groups in the PLCA, PMCA, PCA, and PLCA/PMCA were analysed. The predictive value of PLCA and PLCA/PMCA for complete discoid lateral meniscus was assessed. In the complete discoid lateral meniscus group, PLCA and PLCA/PMCA were significantly smaller compared with the normal meniscus group and the incomplete discoid lateral meniscus group (P meniscus group compared with the incomplete discoid lateral meniscus group (P meniscus group (P meniscus. Hypoplasia of the posterior lateral femoral condyle is typically seen in patients with complete discoid lateral meniscus. PLCA and PLCA/PMCA can be measured from axial MRI images and used as excellent predictive parameters for complete discoid lateral meniscus. Diagnostic study, Level III.

MRI of the cartilages of the knee, 3-D imaging with a rapid computer system

Energy Technology Data Exchange (ETDEWEB)

Adam, G.; Bohndorf, K.; Prescher, A.; Drobnitzky, M.; Guenther, R.W.

1989-01-01

2-D spin-echo sequences were compared with 3-D gradient-echo sequences using normal and cadaver knee joints. The important advantages of 3-D-imaging are: sections of less than 1 mm, reconstruction in any required plane, which can be related to the complex anatomy of the knee joint, and very good distinction between intra-articular fluid, fibrocartilage and hyaline cartilage. (orig./GDG).

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

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Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto [Oulu University Hospital, Department of Radiology, Oulu (Finland); Lakovaara, Martti [Oulu Deaconess Institute, Department of Surgery, Oulu (Finland); Hyvoenen, Pekka; Lehenkari, Petri [Oulu University Hospital, Department of Surgery, Oulu (Finland)

2011-06-15

The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

MRI-guided percutaneous retrograde drilling of osteochondritis dissecans of the knee

International Nuclear Information System (INIS)

Ojala, Risto; Kerimaa, Pekka; Tervonen, Osmo; Blanco-Sequeiros, Roberto; Lakovaara, Martti; Hyvoenen, Pekka; Lehenkari, Petri

2011-01-01

The purpose of this study was to evaluate the feasibility of a new method for osteochondritis dissecans (OCD) treatment. Ten OCD lesions of the knee unresponsive to conservative management were treated with MRI-guided percutaneous retrograde drilling to reduce symptoms and promote ossification of the lesion. All lesions were located in distal femoral condyles. Only stable OCD lesions were included (preprocedural MRI grade I or II). Five lesions were of juvenile type and five lesions were of adult type OCD. All the patients had severe limitation of activity due to the OCD-related pain. By using a 0.23 T open MRI scanner and spinal anesthesia, percutaneous retrograde drilling of the OCD lesions was performed (3 mm cylindrical drill, one to three channels). Optical tracking and MRI imaging were used to guide instruments during the procedure. Mean postprocedural clinical follow-up time was 3 years. Eight patients had a post-procedural follow-up MRI within 1 year. All the OCD lesions were located and drilled using the 0.23 T open MRI scanner without procedural complications. All the patients had pain relief, mean visual analog score (VAS) declined from 6 to 2. Follow-up MRI showed ossification in all lesions. Eight patients could return to normal physical activity with no or minor effect on function (Hughston score 3-4). Treatment failed in two cases where the continuation of symptoms led to arthroscopy and transchondral fixation. MR-guided retrograde OCD lesion drilling is an accurate, feasible, and effective cartilage-sparing techique in OCD management. (orig.)

MRI evaluation of osteonecrosis in knee joints after intravenous administration of corticosteroids in patients with severe acute respiratory syndrome

International Nuclear Information System (INIS)

Gao Yong'an; Liu Hualiang; Dong Yanqing; Liu Ying; Li Kuncheng; Wang Zhongwei; Li Ping

2005-01-01

Objective: To evaluate MRI features of osteonecrosis in knee joints after intravenous administration of exogenous corticosteroids in patients with severe acute respiratory syndrome (SARS). Methods: MRI was done in 18 patients (medical staff from 4 hospitals) suffered from SARS and treated with intravenous use of exogenous corticosteroids in hip joints and knee joints to indicate the findings and characteristics of osteonecrosis as well as their relation with hormone amount. Results: Eleven patients showed lesions of osteonecrosis in knee joints with bilateral in 7 and unilateral in 4, and 3 patients were complicated with avascular necrosis in bilateral femoral heads. Among the 38 lesions in knee joints, 34 lesions were located in medial condylu, lateral condylus and shaft of femur, and 4 in medial condylus or lateral condylus of tibia. Large-middle lesions showed geographic focus of typically heterogeneous signal (low or intermediate signal intensity on T 1 WI and high or intermediate signal intensity T 2 WI) within the marrow that was surrounded by characteristic low signal intensity, serpentine border on T 1 , T 2 WI. This border showed a classic double-line sign on T 2 WI in 4 lesions. Small lesions showed low signal intensity on T 1 and low or high signal intensity on T 2 WI. Subchondral avascular necrosis in middle-upper femoral heads showed intermediate signal intensity on T 1 weighted images and high or complicated signal intensity on T 2 WI encircled with characteristic low signal intensity, serpentine border on T 1 and T 2 WI. This border showed a classic double-line sign on T 2 weighted images in avascular necrosis of bilateral femoral heads in 1 case. Conclusion: In these cases, osteonecrosis in knee joints was more than in femoral heads in patients with SARS after intravenous use of exogenous corticosteroids, mostly located in medial condylus, lateral condylus and shaft of femur as well as in medial condylus or lateral condylus of tibia. So, MRI should

Relationship between years in the trade and the development of radiographic knee osteoarthritis and MRI-detected meniscal tears and bursitis in floor layers. A cross-sectional study of a historical cohort

DEFF Research Database (Denmark)

Jensen, Lilli Kirkeskov; Rytter, Søren; Marott, Jacob Louis

2012-01-01

An increased risk of developing knee disorders including radiographic knee osteoarthritis (OA) have been shown among workers with kneeling working demands. There may also be a dose-related association between duration of employment in occupations with kneeling work and development of radiographic...... knee OA and magnetic resonance imaging (MRI)-detected meniscal tears and bursitis....

Quantitative MRI T2 relaxation time evaluation of knee cartilage: comparison of meniscus-intact and -injured knees after anterior cruciate ligament reconstruction.

Science.gov (United States)

Li, Hong; Chen, Shuang; Tao, Hongyue; Chen, Shiyi

2015-04-01

Associated meniscal injury is well recognized at anterior cruciate ligament (ACL) reconstruction, and it is a known risk factor for osteoarthritis. To evaluate and characterize the postoperative appearance of articular cartilage after different meniscal treatment in ACL-reconstructed knees using T2 relaxation time evaluation on MRI. Cohort study; Level of evidence, 3. A total of 62 consecutive patients who under ACL reconstruction were recruited in this study, including 23 patients undergoing partial meniscectomy (MS group), 21 patients undergoing meniscal repair (MR group), and 18 patients with intact menisci (MI group) at time of surgery. Clinical evaluation, including subjective functional scores and physical examination, was performed on the same day as the MRI examination and at follow-up times ranging from 2 to 4.2 years. The MRI multiecho sagittal images were segmented to determine the T2 relaxation time value of each meniscus and articular cartilage plate. Differences in each measurement were compared among groups. No patient had joint-line tenderness or reported pain or clicking on McMurray test or instability. There were also no statistically significant differences in functional scores or medial or lateral meniscus T2 values among the 3 groups (P > .05 for both). There was a significantly higher articular cartilage T2 value in the medial femorotibial articular cartilage for the MS group (P T2 value between the MS and MR groups (P > .05) in each articular cartilage plate. The medial tibial articular cartilage T2 value had a significant positive correlation with medial meniscus T2 value (r = 0.287; P = .024) CONCLUSION: This study demonstrates that knees with meniscectomy or meniscal repair had articular cartilage degeneration at 2 to 4 years postoperatively, with higher articular cartilage T2 relaxation time values compared with the knees with an intact meniscus. © 2015 The Author(s).

Quadriceps fat pad edema: significance on magnetic resonance images of the knee

International Nuclear Information System (INIS)

Shabshin, Nogah; Schweitzer, Mark E.; Morrison, William B.

2006-01-01

While clinically reading magnetic resonance (MR) images of the knees we have occasionally noted edema within the suprapatellar fat pad, with mass effect both on the suprapatellar joint recess posteriorly, and on the quadriceps tendon anteriorly. This MR appearance is analogous to Hoffa's disease described in the infrapatellar fat pad. We sought to evaluate the frequency and pattern of this finding and to provide clinical and histological correlation. The suprapatellar (quadriceps) fat pad was evaluated in 770 consecutive MR examinations (on 1.5 T and 0.3 T) in 736 patients (353 females and 383 males, age range 5-86 years, mean 44.3 years). The MR images were retrospectively evaluated by two observers in consensus for the presence of quadriceps fat pad edema with mass effect. In 46 patients who had intravenous administration of gadolinium, the presence of enhancement was also evaluated. Clinical correlation was performed in abnormal cases; in one patient, 1-year follow-up MRI was evaluated and in one patient a percutaneous biopsy as well as 2-year clinical follow-up was performed. Thirty-two (4.2%) knees in 29 patients showed quadriceps fat pad edema and mass effect. In five of these patients imaging of the contralateral knee was also performed and four of these showed symmetric edema. Another five cases had gadolinium-enhanced images with prominent enhancement. Most patients had clinical symptoms of meniscal tears (n=16, 55%) or anterior knee pain (n=8, 27.6%). (orig.)

Intravoxel incoherent motion magnetic resonance imaging of the knee joint in children with juvenile idiopathic arthritis

Energy Technology Data Exchange (ETDEWEB)

Hilbert, Fabian; Sauer, Alexander; Koestler, Herbert [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); Holl-Wieden, Annette [University Hospital Wuerzburg, Department of Paediatrics, Wuerzburg (Germany); Neubauer, Henning [University Hospital Wuerzburg, Department of Diagnostic and Interventional Radiology, Wuerzburg (Germany); University Hospital Ulm, Department of Diagnostic and Interventional Radiology, Ulm (Germany)

2017-05-15

MRI of synovitis relies on use of a gadolinium-based contrast agent. Diffusion-weighted MRI (DWI) visualises thickened synovium but is of limited use in the presence of joint effusion. To investigate the feasibility and diagnostic accuracy of diffusion-weighted MRI with intravoxel incoherent motion (IVIM) for diagnosing synovitis in the knee joint of children with juvenile idiopathic arthritis. Twelve consecutive children with confirmed or suspected juvenile idiopathic arthritis (10 girls, median age 11 years) underwent MRI with contrast-enhanced T1-weighted imaging and DWI at 1.5 T. Read-out segmented multi-shot DWI was acquired at b values of 0 s/mm{sup 2}, 200 s/mm{sup 2}, 400 s/mm{sup 2} and 800 s/mm{sup 2}. We calculated the IVIM parameters perfusion fraction (f) and tissue diffusion coefficient (D). Diffusion-weighted images at b=800 s/mm{sup 2}, f parameter maps and post-contrast T1-weighted images were retrospectively assessed by two independent readers for synovitis using the Juvenile Arthritis MRI Scoring system. Seven (58%) children showed synovial hypertrophy on contrast-enhanced imaging. Diagnostic ratings for synovitis on DWI and on f maps were fully consistent with contrast-enhanced imaging, the diagnostic reference. Two children had equivocal low-confidence assessments on DWI. Median f was 6.7±2.0% for synovitis, 2.1±1.2% for effusion, 5.0±1.0% for muscle and 10.6±5.7% for popliteal lymph nodes. Diagnostic confidence was higher based on f maps in three (25%) children and lower in one child (8%), as compared to DWI. DWI with IVIM reliably visualises synovitis of the knee joint. Perfusion fraction maps differentiate thickened synovium from joint effusion and hence increase diagnostic confidence. (orig.)

The Clinical Utility and Diagnostic Performance of MRI for Identification of Early and Advanced Knee Osteoarthritis: A Systematic Review

Science.gov (United States)

Quatman, Carmen E.; Hettrich, Carolyn M.; Schmitt, Laura C.; Spindler, Kurt P.

2013-01-01

Background Current diagnostic strategies for detection of structural articular cartilage abnormalities, the earliest structural signs of osteoarthritis, often do not capture the condition until it is too far advanced for the most potential benefit of non-invasive interventions. Purpose Systematically review the literature relative to the following questions: (1) Is MRI a valid, sensitive, specific, accurate and reliable instrument to identify knee articular cartilage abnormalities compared to arthroscopy? (2) Is MRI a sensitive tool that can be utilized to identify early cartilage degeneration? Study Design Systematic Review Methods A systematic search was performed in November 2010 using PubMed MEDLINE (from 1966), CINAHL (from 1982), SPORTDiscus (from 1985), and SCOPUS (from 1996) databases. Results Fourteen level I and 13 level II studies were identified that met inclusion criteria and provided information related to diagnostic performance of MRI compared to arthroscopic evaluation. The diagnostic performance of MRI demonstrated a large range of sensitivities, specificities, and accuracies. The sensitivity for identifying articular cartilage abnormalities in the knee joint was reported between 26–96%. Specificity and accuracy was reported between 50–100% and 49–94%, respectively. The sensitivity, specificity, and accuracy for identifying early osteoarthritis were reported between 0–86%, 48–95%, and 5–94%, respectively. As a result of inconsistencies between imaging techniques and methodological shortcomings of many of the studies, a meta-analysis was not performed and it was difficult to fully synthesize the information to state firm conclusions about the diagnostic performance of MRI. Conclusions There is evidence in some MRI protocols that MRI is a relatively valid, sensitive, specific, accurate, and reliable clinical tool for identifying articular cartilage degeneration. Due to heterogeneity of MRI sequences it is not possible to make definitive

Prospective comparison of 3D FIESTA versus fat-suppressed 3D SPGR MRI in evaluating knee cartilage lesions

International Nuclear Information System (INIS)

Li, X.; Yu, C.; Wu, H.; Daniel, K.; Hu, D.; Xia, L.; Pan, C.; Xu, A.; Hu, J.; Wang, L.; Peng, W.; Li, F.

2009-01-01

Aim: To prospectively compare the accuracy of three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences with that of fat-suppressed three-dimensional spoiled gradient-recalled (3D SPGR) in the diagnosis of knee articular cartilage lesions, using arthroscopy as the reference standard. Materials and methods: Fifty-eight knees in 54 patients (age range 21-82 years; mean 36 years) were prospectively evaluated by using sagittal 3D FIESTA and sagittal fat-suppressed 3D SPGR sequences. Articular cartilage lesions were graded on MRI and during arthroscopy with a modified Noyes scoring system. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with κ statistics. Results: The performance of 3D FIESTA sequences (sensitivity, specificity, and accuracy were 80, 94, and 92%, respectively, for reader 1 and 76, 94, and 90%, respectively, for reader 2) was similar to that of fat-suppressed 3D SPGR sequences (sensitivity, specificity, and accuracy were 82, 92, and 90%, respectively, for reader 1 and 82, 90, and 88%, respectively, for reader 2) in the detection of knee articular cartilage lesions. The interobserver agreement varied from fair to good to excellent (kappa values from 0.43-0.83). Conclusion: 3D FIESTA has good diagnostic performance, comparable with fat-suppressed 3D SPGR in evaluating knee cartilage lesions, and it can be incorporated into routine knee MRI protocols due to the short acquisition time.

Prospective comparison of 3D FIESTA versus fat-suppressed 3D SPGR MRI in evaluating knee cartilage lesions

Energy Technology Data Exchange (ETDEWEB)

Li, X.; Yu, C. [Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China); Wu, H. [Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China)], E-mail: lilyboston2002@163.com; Daniel, K. [Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston, MA 02115 (United States); Hu, D.; Xia, L.; Pan, C.; Xu, A.; Hu, J.; Wang, L.; Peng, W. [Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China); Li, F. [Department of Orthopaedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China)

2009-10-15

Aim: To prospectively compare the accuracy of three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences with that of fat-suppressed three-dimensional spoiled gradient-recalled (3D SPGR) in the diagnosis of knee articular cartilage lesions, using arthroscopy as the reference standard. Materials and methods: Fifty-eight knees in 54 patients (age range 21-82 years; mean 36 years) were prospectively evaluated by using sagittal 3D FIESTA and sagittal fat-suppressed 3D SPGR sequences. Articular cartilage lesions were graded on MRI and during arthroscopy with a modified Noyes scoring system. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with {kappa} statistics. Results: The performance of 3D FIESTA sequences (sensitivity, specificity, and accuracy were 80, 94, and 92%, respectively, for reader 1 and 76, 94, and 90%, respectively, for reader 2) was similar to that of fat-suppressed 3D SPGR sequences (sensitivity, specificity, and accuracy were 82, 92, and 90%, respectively, for reader 1 and 82, 90, and 88%, respectively, for reader 2) in the detection of knee articular cartilage lesions. The interobserver agreement varied from fair to good to excellent (kappa values from 0.43-0.83). Conclusion: 3D FIESTA has good diagnostic performance, comparable with fat-suppressed 3D SPGR in evaluating knee cartilage lesions, and it can be incorporated into routine knee MRI protocols due to the short acquisition time.

Synovitis assessed on static and dynamic contrast-enhanced magnetic resonance imaging and its association with pain in knee osteoarthritis

DEFF Research Database (Denmark)

Riis, Robert Gabriel Coumine; Gudbergsen, Henrik; Henriksen, Marius

2016-01-01

OBJECTIVES: To investigate the association between pain and peripatellar-synovitis on static and dynamic contrast-enhanced MRI in knee osteoarthritis. METHODS: In a cross-sectional setting, knee synovitis was assessed using 3-Tesla MRI and correlated with pain using the knee injury and osteoarthr......OBJECTIVES: To investigate the association between pain and peripatellar-synovitis on static and dynamic contrast-enhanced MRI in knee osteoarthritis. METHODS: In a cross-sectional setting, knee synovitis was assessed using 3-Tesla MRI and correlated with pain using the knee injury...

Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee

International Nuclear Information System (INIS)

Stomp, Wouter; Reijnierse, Monique; Bloem, Johan L.; Kloppenburg, Margreet; Mutsert, Renee de; Heijer, Martin den; Bovee, Judith V.M.G.

2015-01-01

The purpose was to determine prevalence of enchondromas and atypical cartilaginous tumour/chondrosarcoma grade 1 (ACT/CS1) of the knee on MRI in a large cohort study, namely the Netherlands Epidemiology of Obesity (NEO) study. Participants aged 45 to 65 years were prospectively included, oversampling overweight and obese persons. Within a subgroup of participants, MRI of the right knee was performed and screened for incidental cartilaginous tumours, as defined by their characteristic location and appearance. Forty-nine cartilaginous tumours were observed in 44 out of 1285 participants (estimated population prevalence 2.8 %, 95 % CI 2.0-4.0 %). Mean largest tumour diameter was 12 mm (range 2-31 mm). Eight participants with a tumour larger than 20 mm or a tumour with aggressive features were referred to rule out low-grade chondrosarcoma. One was lost to follow-up, three had histologically proven ACT/CS1 and four had dynamic contrast MRI findings consistent with benign enchondroma. Incidental cartilaginous tumours were relatively common on knee MRI and may be regarded as a normal concurrent finding. However, more tumours than expected were ACT/CS1. Because further examination was performed only when suspicion of chondrosarcoma was high, the actual prevalence might be even higher. (orig.)

Prevalence of cartilaginous tumours as an incidental finding on MRI of the knee

Energy Technology Data Exchange (ETDEWEB)

Stomp, Wouter; Reijnierse, Monique; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Leiden University Medical Center, Department of Clinical Epidemiology, Leiden (Netherlands); Mutsert, Renee de; Heijer, Martin den [Leiden University Medical Center, Department of Clinical Epidemiology, Leiden (Netherlands); Bovee, Judith V.M.G. [Leiden University Medical Center, Department of Pathology, Leiden (Netherlands); Collaboration: NEO study group

2015-12-15

The purpose was to determine prevalence of enchondromas and atypical cartilaginous tumour/chondrosarcoma grade 1 (ACT/CS1) of the knee on MRI in a large cohort study, namely the Netherlands Epidemiology of Obesity (NEO) study. Participants aged 45 to 65 years were prospectively included, oversampling overweight and obese persons. Within a subgroup of participants, MRI of the right knee was performed and screened for incidental cartilaginous tumours, as defined by their characteristic location and appearance. Forty-nine cartilaginous tumours were observed in 44 out of 1285 participants (estimated population prevalence 2.8 %, 95 % CI 2.0-4.0 %). Mean largest tumour diameter was 12 mm (range 2-31 mm). Eight participants with a tumour larger than 20 mm or a tumour with aggressive features were referred to rule out low-grade chondrosarcoma. One was lost to follow-up, three had histologically proven ACT/CS1 and four had dynamic contrast MRI findings consistent with benign enchondroma. Incidental cartilaginous tumours were relatively common on knee MRI and may be regarded as a normal concurrent finding. However, more tumours than expected were ACT/CS1. Because further examination was performed only when suspicion of chondrosarcoma was high, the actual prevalence might be even higher. (orig.)

Association between MRI-defined osteoarthritis, pain, function and strength 3-10 years following knee joint injury in youth sport.

Science.gov (United States)

Whittaker, Jackie L; Toomey, Clodagh M; Woodhouse, Linda J; Jaremko, Jacob L; Nettel-Aguirre, Alberto; Emery, Carolyn A

2017-10-10

Youth and young adults who participate in sport have an increased risk of knee injury and subsequent osteoarthritis. Improved understanding of the relationship between structural and clinical outcomes postinjury could inform targeted osteoarthritis prevention interventions. This secondary analysis examines the association between MRI-defined osteoarthritis and self-reported and functional outcomes, 3-10 years following youth sport-related knee injury in comparison to healthy controls. Participants included a subsample (n=146) of the Alberta Youth Prevention of Early Osteoarthritis cohort: specifically, 73 individuals with 3-10 years history of sport-related intra-articular knee injury and 73 age-matched, sex-matched and sport-matched controls with completed MRI studies. Outcomes included: MRI-defined osteoarthritis, radiographic osteoarthritis, Knee Injury and Osteoarthritis Outcome Score, Intermittent and Constant Osteoarthritis Pain, knee extensor/flexor strength, triple-hop and Y-balance test. Descriptive statistics and univariate logistic regression were used to compare those with and without MRI-defined osteoarthritis. Associations between MRI-defined osteoarthritis and each outcome were assessed using multivariable linear regression considering the influence of injury history, sex, body mass index and time since injury. Participant median age was 23 years (range 15-27), and 63% were female. MRI-defined osteoarthritis varied by injury history, injury type and surgical history and was not isolated to participants with ACL and/or meniscal injuries. Those with a previous knee injury had 10-fold (95% CI 2.3 to 42.8) greater odds of MRI-defined osteoarthritis than uninjured participants. MRI-defined osteoarthritis was independently significantly associated with quality of life, but not symptoms, strength or function. MRI-detected structural changes 3-10 years following youth sport-related knee injury may not dictate clinical symptomatology, strength or function

Typing of MRI in medial meniscus degeneration in relation to radiological grade in medial compartmental osteoarthritis of the knee

Energy Technology Data Exchange (ETDEWEB)

Nagata, Nobuhito; Koshino, Tomihisa; Saito, Tomoyuki; Sakai, Naotaka; Takagi, Toshitaka; Takeuchi, Ryohei [Yokohama City Univ. (Japan). School of Medicine

1998-10-01

The advancement of degeneration of 50 medial menisci in patients with medial compartmental osteoarthritic knees (OA) were evaluated with magnetic resonance imaging (MRI). The average age of the patients was 66.6 years (range, 39 to 86). According to a radiographical grading system, 6 knees were classified as Grade 1, 24 as Grade 2, 16 as Grade 3, and 4 as Grade 4. The extent and the location of a high intensity region in MRI were observed in 3 parts of the meniscus, namely, the anterior, middle and posterior part. In Grade 1, no high intensity region was observed in 3 knees, and a high intensity region was observed only in the posterior part in 2 knees. A high intensity region was observed from the medial to the posterior part in 13 knees, and only in the posterior part in 10 knees of Grade 2; from the medial to the posterior part in 12 knees, and only in the posterior part in 3 knees of Grade 3, and from the anterior to the posterior part in 2 knees of Grade 4. The shape of the high intensity region in the medial meniscus was classified into 5 types, as follows: Type 1, there was no high intensity region; Type 2, the high intensity region was observed to be restricted within the meniscus; Type 3, the high intensity region resembled a horizontal tear; Type 4, the high intensity region was observed as all of the medial joint space without a marginal area; Type 5, the high intensity region was observed as all of the medial joint space. In Grade 1, 3 knees were classified as Type 1, and 2 knees as Type 2; in Grade 2, 7 knees as Type 2, and 13 knees as Type 3, and 4 knees into Type 4; in Grade 3, 6 knees as Type 3, and 7 knees as Type 4; and in Grade 4, 2 knees as Type 4, and 2 knees as Type 5. These findings might suggest that the degeneration of medial meniscus in the medial type of OA was accelerated by mechanical stress due to varus deformity. (author)

Typing of MRI in medial meniscus degeneration in relation to radiological grade in medial compartmental osteoarthritis of the knee

International Nuclear Information System (INIS)

Nagata, Nobuhito; Koshino, Tomihisa; Saito, Tomoyuki; Sakai, Naotaka; Takagi, Toshitaka; Takeuchi, Ryohei

1998-01-01

The advancement of degeneration of 50 medial menisci in patients with medial compartmental osteoarthritic knees (OA) were evaluated with magnetic resonance imaging (MRI). The average age of the patients was 66.6 years (range, 39 to 86). According to a radiographical grading system, 6 knees were classified as Grade 1, 24 as Grade 2, 16 as Grade 3, and 4 as Grade 4. The extent and the location of a high intensity region in MRI were observed in 3 parts of the meniscus, namely, the anterior, middle and posterior part. In Grade 1, no high intensity region was observed in 3 knees, and a high intensity region was observed only in the posterior part in 2 knees. A high intensity region was observed from the medial to the posterior part in 13 knees, and only in the posterior part in 10 knees of Grade 2; from the medial to the posterior part in 12 knees, and only in the posterior part in 3 knees of Grade 3, and from the anterior to the posterior part in 2 knees of Grade 4. The shape of the high intensity region in the medial meniscus was classified into 5 types, as follows: Type 1, there was no high intensity region; Type 2, the high intensity region was observed to be restricted within the meniscus; Type 3, the high intensity region resembled a horizontal tear; Type 4, the high intensity region was observed as all of the medial joint space without a marginal area; Type 5, the high intensity region was observed as all of the medial joint space. In Grade 1, 3 knees were classified as Type 1, and 2 knees as Type 2; in Grade 2, 7 knees as Type 2, and 13 knees as Type 3, and 4 knees into Type 4; in Grade 3, 6 knees as Type 3, and 7 knees as Type 4; and in Grade 4, 2 knees as Type 4, and 2 knees as Type 5. These findings might suggest that the degeneration of medial meniscus in the medial type of OA was accelerated by mechanical stress due to varus deformity. (author)

Normal and pathological NMR imaging aspects of the posterolateral corner (PLC) of the knee

International Nuclear Information System (INIS)

Tardieu, M.; Lazennec, J.Y.; Christel, P.; Brasseur, J.L.; Roger, B.; Grenier, P.

1995-01-01

The purpose of the study is to compare normal PLC (limits lateral condyle anterior sub luxation) anatomy and its magnetic resonance imaging (MRI) appearance, with the various lesions observed in MRI, from the simple popliteus tendinous contusion to the complete PLC rupture. For this specific work on PLC lesions, we selected 61 examinations among the traumatic knees explored during the last 3 years. Surgical correlation is obtained for the 61 patients. MRI examinations are performed on a 0.5 T. unit. Normal PLC anatomy is compared to the dissection of 4 anatomic subjects. Normal MRI slices are evaluated with this reference analysis. The principle anatomical structures of the PLC include the lateral collateral ligament, the popliteus tendon, the arcuate ligament, the fabello fibular ligament, the posterolateral condylar capsule, and the posterior horn of the lateral meniscus. Surgical findings confirm PLC lesion for 58 patients with 3 false positive. Diagnosis of these lesions is important because chronical posterolateral laxity is secondary to the destabilization of lateral condyle. Unrecognized and untreated posterolateral instability may result in failure of ACL (limits lateral condyle posterior sub-luxation) reconstruction. When clinical tests are doubtful or complex, or the examination very painful, MRI evaluates completely the traumatic knee and particularly the PLC. (authors). 3 refs., 26 figs

Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings

Energy Technology Data Exchange (ETDEWEB)

Bui, Kimmie L. [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Cleveland Clinic, Department of Radiology, HB6, Cleveland, OH (United States); Ilaslan, Hakan; Sundaram, Murali [Cleveland Clinic, Department of Radiology, Cleveland, OH (United States); Parker, Richard D. [Cleveland Clinic, Department of Orthopaedics, Cleveland, OH (United States)

2008-07-15

Our objectives were to determine retrospectively the prevalence, patients' demographics, mechanism of injury, combination of torn ligaments, associated intra-articular and extra-articular injuries, fractures, bone bruises, femoral-tibial alignment and neurovascular complications of knee dislocations as evaluated by magnetic resonance (MR) imaging. From 17,698 consecutive knee examinations by magnetic resonance imaging (MRI) over a 6-year period, 20 patients with knee dislocations were identified. The medical records of these patients were subsequently reviewed for relevant clinical history, management and operative findings. The prevalence of knee dislocations was 0.11% [95% confidence interval (95% CI) 0.06-0.16]. There were 16 male patients and four female patients, with ages ranging from 15 years to 76 years (mean 31 years). Fifteen patients had low-velocity injuries (75%), of which 11 were amateur sports related and four were from falls. Four patients (20%) had suffered high-velocity trauma (motor vehicle accidents). One patient had no history available. Anatomic alignment was present at imaging in 16 patients (80%). Eighteen patients had three-ligament tears, two had four-ligament tears. The four-ligament tears occurred with low-velocity injuries. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were torn in every patient; the lateral collateral ligament (LCL) was torn in 50%, and the medial collateral ligament (MCL) in 60%. Intra-articular injuries included meniscal tears (five in four patients), fractures (eight in seven patients), bone bruises (15 patients), and patellar retinaculum tears (eight partial, two complete). The most common extra-articular injury was a complete biceps femoris tendon tear (five, 25%). There were two popliteal tendon tears and one iliotibial band tear. One patient had received a vascular injury following a motor vehicle accident (MVA) and had been treated prior to undergoing MRI. Bone bruises

US and MR imaging of the postoperative knee

International Nuclear Information System (INIS)

Czyrny, Zbigniew

2007-01-01

Constantly increasing number of surgical procedures on the soft tissues of and around the knee generates the need for postoperative soft tissue assessment. Sports medicine is constantly seeking new-faster, better, more efficient ways to help patients, especially competitive athletes to come back to their full activity as soon as possible. One of the important factors in that acceleration is postoperative tissue assessment. It helps the clinician making better decisions in terms of the rehabilitation stages, come back to basic and sport-specific training and finally in letting the patient put a full load on the operated structure. The healing of the collagen structure cannot only be guided by patient's pain. Diagnostic imaging methods such as US and MRI, which focus on the soft tissue assessment are best fitted to do the job. They also help in the diagnostics of the reinjuries of operated structures. Often criteria used for basic diagnostics do not fit the need of assessment of the structure which underwent an initial injury, was operated, healed and often reinjured again. Criteria used for regular injury diagnostics are in most cases seriously modified. Moreover the whole matter of structure evaluation after an injury and medical intervention leaves a lot of slippery ground and should be carefully studied before taking the challenge of judging the surgeon and the natural healing processes. Diagnostic judgment has much more impact on the operated patient than the primary injury diagnosis. Depending on the author both MRI and US are pointed out as the best imaging methods in terms of postoperative knee assessment. In fact both methods can be complementarily used in the postoperative follow up. Depending on the operated structure the choice of methods usually depends on local equipment availability and personal doctor's experience. MRI is probably best fitted for evaluation of the internal knee structures such as cruciate ligaments and hyaline cartilage on the tibia

US and MR imaging of the postoperative knee

Energy Technology Data Exchange (ETDEWEB)

Czyrny, Zbigniew [Imaging Department of the Carolina Medical Center, Warsaw (Poland)]. E-mail: Zbigniew.Czyrny@carolina.pl

2007-04-15

Constantly increasing number of surgical procedures on the soft tissues of and around the knee generates the need for postoperative soft tissue assessment. Sports medicine is constantly seeking new-faster, better, more efficient ways to help patients, especially competitive athletes to come back to their full activity as soon as possible. One of the important factors in that acceleration is postoperative tissue assessment. It helps the clinician making better decisions in terms of the rehabilitation stages, come back to basic and sport-specific training and finally in letting the patient put a full load on the operated structure. The healing of the collagen structure cannot only be guided by patient's pain. Diagnostic imaging methods such as US and MRI, which focus on the soft tissue assessment are best fitted to do the job. They also help in the diagnostics of the reinjuries of operated structures. Often criteria used for basic diagnostics do not fit the need of assessment of the structure which underwent an initial injury, was operated, healed and often reinjured again. Criteria used for regular injury diagnostics are in most cases seriously modified. Moreover the whole matter of structure evaluation after an injury and medical intervention leaves a lot of slippery ground and should be carefully studied before taking the challenge of judging the surgeon and the natural healing processes. Diagnostic judgment has much more impact on the operated patient than the primary injury diagnosis. Depending on the author both MRI and US are pointed out as the best imaging methods in terms of postoperative knee assessment. In fact both methods can be complementarily used in the postoperative follow up. Depending on the operated structure the choice of methods usually depends on local equipment availability and personal doctor's experience. MRI is probably best fitted for evaluation of the internal knee structures such as cruciate ligaments and hyaline cartilage on

The value of MRI, CAT-SCAN in evaluation of knee disorders

International Nuclear Information System (INIS)

Jerosch, J.; Castro, W.H.M.; Assheuer, J.

1990-01-01

A prospective study is presented containing 107 examined knees. All patients subsequently underwent arthroscopy. The findings of arthroscopy were compared with those of CT and MRI. (author). 13 refs.; 4 figs.; 1 tab

Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint

Energy Technology Data Exchange (ETDEWEB)

Stahl, Robert [University of California, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States); University Hospitals - Campus Grosshadern, Ludwig Maximilians University of Munich, Department of Clinical Radiology, Munich (Germany); Krug, Roland; Zuo, Jin; Majumdar, Sharmila; Link, Thomas M. [University of California, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States); Kelley, Douglas A.C. [General Electrics Healthcare Technologies, San Francisco, CA (United States); Ma, C.B. [University of California, Department of Orthopedic Surgery, San Francisco, CA (United States)

2009-08-15

The objectives of the study were to optimize three cartilage-dedicated sequences for in vivo knee imaging at 7.0 T ultra-high-field (UHF) magnetic resonance imaging (MRI) and to compare imaging performance and diagnostic confidence concerning osteoarthritis (OA)-induced changes at 7.0 and 3.0 T MRI. Optimized MRI sequences for cartilage imaging at 3.0 T were tailored for 7.0 T: an intermediate-weighted fast spin-echo (IM-w FSE), a fast imaging employing steady-state acquisition (FIESTA) and a T1-weighted 3D high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) sequence. Three healthy subjects and seven patients with mild OA were examined. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diagnostic confidence in assessing cartilage abnormalities, and image quality were determined. Abnormalities were assessed with the whole organ magnetic resonance imaging score (WORMS). Focal cartilage lesions and bone marrow edema pattern (BMEP) were also quantified. At 7.0 T, SNR was increased (p<0.05) for all sequences. For the IM-w FSE sequence, limitations with the specific absorption rate (SAR) required modifications of the scan parameters yielding an incomplete coverage of the knee joint, extensive artifacts, and a less effective fat saturation. CNR and image quality were increased (p<0.05) for SPGR and FIESTA and decreased for IM-w FSE. Diagnostic confidence for cartilage lesions was highest (p<0.05) for FIESTA at 7.0 T. Evaluation of BMEP was decreased (p < 0.05) at 7.0 T due to limited performance of IM-w FSE. Gradient echo-based pulse sequences like SPGR and FIESTA are well suited for imaging at UHF which may improve early detection of cartilage lesions. However, UHF IM-w FSE sequences are less feasible for clinical use. (orig.)

Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint

International Nuclear Information System (INIS)

Stahl, Robert; Krug, Roland; Zuo, Jin; Majumdar, Sharmila; Link, Thomas M.; Kelley, Douglas A.C.; Ma, C.B.

2009-01-01

The objectives of the study were to optimize three cartilage-dedicated sequences for in vivo knee imaging at 7.0 T ultra-high-field (UHF) magnetic resonance imaging (MRI) and to compare imaging performance and diagnostic confidence concerning osteoarthritis (OA)-induced changes at 7.0 and 3.0 T MRI. Optimized MRI sequences for cartilage imaging at 3.0 T were tailored for 7.0 T: an intermediate-weighted fast spin-echo (IM-w FSE), a fast imaging employing steady-state acquisition (FIESTA) and a T1-weighted 3D high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) sequence. Three healthy subjects and seven patients with mild OA were examined. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diagnostic confidence in assessing cartilage abnormalities, and image quality were determined. Abnormalities were assessed with the whole organ magnetic resonance imaging score (WORMS). Focal cartilage lesions and bone marrow edema pattern (BMEP) were also quantified. At 7.0 T, SNR was increased (p<0.05) for all sequences. For the IM-w FSE sequence, limitations with the specific absorption rate (SAR) required modifications of the scan parameters yielding an incomplete coverage of the knee joint, extensive artifacts, and a less effective fat saturation. CNR and image quality were increased (p<0.05) for SPGR and FIESTA and decreased for IM-w FSE. Diagnostic confidence for cartilage lesions was highest (p<0.05) for FIESTA at 7.0 T. Evaluation of BMEP was decreased (p < 0.05) at 7.0 T due to limited performance of IM-w FSE. Gradient echo-based pulse sequences like SPGR and FIESTA are well suited for imaging at UHF which may improve early detection of cartilage lesions. However, UHF IM-w FSE sequences are less feasible for clinical use. (orig.)

Novel magnetic resonance imaging evaluation for valgus instability of the knee caused by medial collateral ligament injury

International Nuclear Information System (INIS)

Ikuma, Hisanori; Abe, Nobuhiro; Furumatsu, Takayuki; Uchida, Youichiro; Fujiwara, Kazuo; Nishida, Keiichiro; Ozaki, Toshifumi

2008-01-01

Instability of the knee after the medial collateral ligament (MCL) injury is usually assessed with the manual valgus stress test, even though, in recent years, it has become possible to apply magnetic resonance imaging (MRI) to the assessment of the damage of the ligament. The valgus instability of 24 patients (12 isolated injuries and 12 multiple ligament injuries) who suffered MCL injury between 1993 and 1998 was evaluated with the Hughston and Eilers classification, which involves radiographic assessment under manual valgus stress to the injured knees. We developed a novel system for classifying the degree of injury to the MCL by calculating the percentage of injured area based on MRI and investigated the relationship between this novel MRI classification and the magnitude of valgus instability by the Hughston and Eilers classification. There was a significant correlation between the 2 classifications (p=0.0006). On the other hand, the results using other MRI based classification systems, such as the Mink and Deutsch classification and the Petermann classification, were not correlated with the findings by the Hughston and Eilers classification in these cases (p>0.05). Since MRI is capable of assessing the injured ligament in clinical practice, this novel classification system would be useful for evaluating the stability of the knee and choosing an appropriate treatment following MCL injury. (author)

Juvenile chronic arthritis: imaging of the knees and hips before and after intraarticular steroid injection

Energy Technology Data Exchange (ETDEWEB)

Eich, G.F. [Div. of Diagnostic Imaging and Radiology, Univ. Children`s Hospital, Zuerich (Switzerland); Halle, F. [Div. of Immunology and Hematology, Univ. Children`s Hospital, Zuerich (Switzerland); Hodler, J. [Div. of Radiology, Balgrist Orthopedic Univ. Clinic, Zuerich (Switzerland); Seger, R. [Div. of Immunology and Hematology, Univ. Children`s Hospital, Zuerich (Switzerland); Willi, U.V. [Div. of Diagnostic Imaging and Radiology, Univ. Children`s Hospital, Zuerich (Switzerland)

1994-12-01

Intraarticular steroid therapy in juvenile chronic arthritis (JCA) is performed because of high local efficacy with few side effects. Imaging is used for initial evaluation and for monitoring of treatment response. The aim of this study was to compare imaging findings in diseased hips and knees before and after therapy. A prospective study was performed on 10 patients (15 joints) scheduled for intraarticular therapy. Pretherapeutic assessment included clinical work-up, radiographs, ultrasound (US), and magnetic resonance imaging (MRI) of affected joints. Following therapy, clinical and sonographic examinations were performed at 1 week and 1 month. MRI was repeated at 1 month. MRI and US demonstrated pannus formation and effusion, but differentiation was less distinct on US. Popliteal cysts and lymph nodes were visible in both modalities. MRI additionally revealed articular cartilage loss and subchondral cysts, not shown by US. Epiphyseal overgrowth and osteopenia were best seen radiographically. At present MRI is the best tool to assess the inflammatory changes of the joints in JCA. Initial staging of the joints may be done with plain films and MRI. US is useful to assess effusion and pannus and may be used to monitor treatment response. (orig.)

Juvenile chronic arthritis: imaging of the knees and hips before and after intraarticular steroid injection

International Nuclear Information System (INIS)

Eich, G.F.; Halle, F.; Hodler, J.; Seger, R.; Willi, U.V.

1994-01-01

Intraarticular steroid therapy in juvenile chronic arthritis (JCA) is performed because of high local efficacy with few side effects. Imaging is used for initial evaluation and for monitoring of treatment response. The aim of this study was to compare imaging findings in diseased hips and knees before and after therapy. A prospective study was performed on 10 patients (15 joints) scheduled for intraarticular therapy. Pretherapeutic assessment included clinical work-up, radiographs, ultrasound (US), and magnetic resonance imaging (MRI) of affected joints. Following therapy, clinical and sonographic examinations were performed at 1 week and 1 month. MRI was repeated at 1 month. MRI and US demonstrated pannus formation and effusion, but differentiation was less distinct on US. Popliteal cysts and lymph nodes were visible in both modalities. MRI additionally revealed articular cartilage loss and subchondral cysts, not shown by US. Epiphyseal overgrowth and osteopenia were best seen radiographically. At present MRI is the best tool to assess the inflammatory changes of the joints in JCA. Initial staging of the joints may be done with plain films and MRI. US is useful to assess effusion and pannus and may be used to monitor treatment response. (orig.)

Contrast-enhanced MRI of subchondral cysts in patients with or at risk for knee osteoarthritis: The MOST study

International Nuclear Information System (INIS)

Crema, M.D.; Roemer, F.W.; Marra, M.D.; Niu, J.; Lynch, J.A.; Felson, D.T.; Guermazi, A.

2010-01-01

Objective: The aim of the study was (1) to evaluate contrast enhancement patterns of subchondral cysts on magnetic resonance imaging and (2) to discuss possible radiological explanations of cyst enhancement based on existing theories of subchondral cyst formation in osteoarthritis. Materials and methods: The Multicenter Osteoarthritis Study (MOST) is a NIH-funded longitudinal observational study for individuals who have or are at high risk for knee osteoarthritis. All subjects with available non-enhanced and contrast-enhanced MRI were included. The tibiofemoral and patellofemoral joints were divided in 14 subregions. The presence and size of subchondral cysts and bone marrow edema-like lesions (BMLs) were scored semiquantitatively in each subregion on non-contrast-enhanced MRI from 0 to 3. Enhancement of subchondral cysts was evaluated on contrast-enhanced MRI as grade 0 (absent), grade 1 (partial enhancement), or grade 2 (full enhancement). The adjacent articular cartilage was scored in each subregion on non-enhanced MRI as grade 0 (intact), grade 1 (partial thickness loss), or grade 2 (full thickness loss). Results: Four hundred knees were included (1 knee per person, 5600 subregions). Subchondral cysts were detected in 260 subregions (4.6%). After intravenous contrast administration, 245 cysts (94.2%) showed full enhancement, 12 (4.6%) showed partial enhancement and 3 (1.2%) showed no enhancement. Enhancing BMLs were found in 237 (91.2%) subregions containing cysts, which were located adjacent or in the middle of BMLs. In 121 subregions (46.5%) having cysts, no adjacent full thickness cartilage loss was detected. Conclusion: Most subchondral cysts demonstrated full or partial contrast enhancement, and were located adjacent or in the midst of enhancing BMLs. As pure cystic lesions are not expected to enhance on MRI, the term 'subchondral cyst-like bone marrow lesion' might be appropriate to describe these lesions.

Contrast-enhanced MRI of subchondral cysts in patients with or at risk for knee osteoarthritis: The MOST study

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Crema, M.D., E-mail: michelcrema@gmail.co [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States); Roemer, F.W., E-mail: frank.roemer@klinikum-augsburg.d [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States); Department of Radiology, Klinikum Augsburg, Stenglinstrasse 2, Augsburg 86156 (Germany); Marra, M.D., E-mail: monicadiasmarra@gmail.co [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States); Niu, J., E-mail: niujp@bu.ed [Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, X Building, Suite 200, Boston, MA 02118 (United States); Lynch, J.A., E-mail: jlynch@psg.ucsf.ed [Department of Epidemiology and Biostatistics, University of California at San Francisco, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA 94107 (United States); Felson, D.T., E-mail: dfelson@bu.ed [Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, 650 Albany Street, X Building, Suite 200, Boston, MA 02118 (United States); Guermazi, A., E-mail: ali.guermazi@bmc.or [Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118 (United States)

2010-07-15

Objective: The aim of the study was (1) to evaluate contrast enhancement patterns of subchondral cysts on magnetic resonance imaging and (2) to discuss possible radiological explanations of cyst enhancement based on existing theories of subchondral cyst formation in osteoarthritis. Materials and methods: The Multicenter Osteoarthritis Study (MOST) is a NIH-funded longitudinal observational study for individuals who have or are at high risk for knee osteoarthritis. All subjects with available non-enhanced and contrast-enhanced MRI were included. The tibiofemoral and patellofemoral joints were divided in 14 subregions. The presence and size of subchondral cysts and bone marrow edema-like lesions (BMLs) were scored semiquantitatively in each subregion on non-contrast-enhanced MRI from 0 to 3. Enhancement of subchondral cysts was evaluated on contrast-enhanced MRI as grade 0 (absent), grade 1 (partial enhancement), or grade 2 (full enhancement). The adjacent articular cartilage was scored in each subregion on non-enhanced MRI as grade 0 (intact), grade 1 (partial thickness loss), or grade 2 (full thickness loss). Results: Four hundred knees were included (1 knee per person, 5600 subregions). Subchondral cysts were detected in 260 subregions (4.6%). After intravenous contrast administration, 245 cysts (94.2%) showed full enhancement, 12 (4.6%) showed partial enhancement and 3 (1.2%) showed no enhancement. Enhancing BMLs were found in 237 (91.2%) subregions containing cysts, which were located adjacent or in the middle of BMLs. In 121 subregions (46.5%) having cysts, no adjacent full thickness cartilage loss was detected. Conclusion: Most subchondral cysts demonstrated full or partial contrast enhancement, and were located adjacent or in the midst of enhancing BMLs. As pure cystic lesions are not expected to enhance on MRI, the term 'subchondral cyst-like bone marrow lesion' might be appropriate to describe these lesions.

Indications for and clinical procedures resulting from magnetic resonance imaging of the knee in older patients: Are we choosing wisely?

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Parent, Marc-Etienne; Vézina, François; Carrier, Nathalie; Masetto, Ariel

2018-03-01

To analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients. We retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009. Centre hospitalier universitaire de Sherbrooke in Quebec. Patients 50 years of age and older who underwent a knee MRI in 2009. The main outcome measure was an invasive procedure in the same knee that underwent an MRI. Medical charts were reviewed up to 2014 for patient characteristics, MRI indication, ordering physician specialty, radiography before MRI, MRI findings, and clinical procedures resulting from the MRI. The patients' mean (SD) age was 60.6 (7.5) years. The main MRI indications were meniscopathy (148 [68.8%]) and chronic pain (92 [42.8%]). The main MRI findings were osteoarthritis (OA) (185 [86.0%]) and meniscal lesions (170 [79.1%]). Only 82 (38.1%) patients had a plain radiograph in the 24 months preceding the MRI, usually without a standing anteroposterior view. Findings on pre-MRI radiography (n = 201) demonstrated OA in 144 (71.6%) patients. Overall, 87 (40.5%) patients were seen by an orthopedic surgeon and 27 (31.0%) of these patients underwent an invasive intervention. Among the 81 patients with moderate to severe OA on MRI, 36 (44.4%) had radiographic evidence of moderate to severe OA and only 3 (3.7%) underwent arthroscopic meniscectomy. Our study reproduces the known association between OA and degenerative meniscal changes in older patients. We have found a surprising underuse of the standing anteroposterior view on radiography. Most patients in our cohort could have been appropriately diagnosed and treated based on such radiographic information, as demonstrated by pre-MRI findings, thus avoiding the MRI and subsequent evaluation by an orthopedic surgeon. Meniscectomy was rarely performed, particularly in patients with advanced OA. Educational and pragmatic measures must be emphasized

Imaging of knee arthroplasty

International Nuclear Information System (INIS)

Miller, Theodore T.

2005-01-01

Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty

Imaging of knee arthroplasty

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Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Blvd., Great Neck, NY 11021 (United States)]. E-mail: TMiller@NSHS.edu

2005-05-01

Knee replacement surgery, either with unicompartmental or total systems, is common. The purpose of this manuscript is to review the appearance of normal knee arthroplasty and the appearances of complications such as infection, polyethylene wear, aseptic loosening and particle-induced osteolysis, patellofemoral abnormalities, axial instability, and periprosthetic and component fracture. Knowledge of the potential complications and their imaging appearances will help the radiologist in the diagnostic evaluation of the patient with a painful knee arthroplasty.

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees

International Nuclear Information System (INIS)

Kang, Dong Joo; Lee, Sun Joo; Choo, Hye Jung; Her, Minyoung; Yoon, Hye Kyoung

2017-01-01

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees. (orig.)

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees

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Kang, Dong Joo; Lee, Sun Joo; Choo, Hye Jung [Busan Paik Hospital, Department of Radiology, Inje University College of Medicine, Busan (Korea, Republic of); Her, Minyoung [Busan Paik Hospital, Division of Rheumatology, Department of Internal Medicine, Inje University College of Medicine, Busan (Korea, Republic of); Yoon, Hye Kyoung [Busan Paik Hospital, Department of Pathology, Inje University College of Medicine, Busan (Korea, Republic of)

2017-02-15

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees. (orig.)

Morel-Lavallée Lesions of the Knee: MRI Findings Compared With Cadaveric Study Findings.

Science.gov (United States)

Vassalou, Evangelia E; Zibis, Aristeidis H; Raoulis, Vasileios A; Tsifountoudis, Ioannis P; Karantanas, Apostolos H

2018-05-01

The purpose of this study is to describe the MRI findings and treatment decisions and outcome for Morel-Lavallée lesions (MLLs) of the knee and to investigate whether evidence exists to support an increased frequency of such lesions on the medial or lateral side by performing a cadaveric experiment. In a 4-year period, 24 MRI studies of 24 consecutive patients (16 male patients and eight female patients) with knee MLLs were retrospectively reviewed. Patient demographic characteristics, treatment decisions and outcome, and associated injuries were recorded. The location of the MLL was categorized as medial, lateral, or global. Lesions were categorized according to an established MRI classification. During the cadaveric experiment, the compartmental pressures of the medial or lateral aspect of the knee were monitored in 20 cadaveric knees. The chi-square test, t test, and Pearson correlation were used for statistical analysis. MLLs were located medially in 16 patients, laterally in two patients, and globally in six patients. The medial location was significantly more common than a lateral or global location (p < 0.05). MLLs were classified as type I in 14 patients, type II in eight patients, and type III in two patients. MRI type was correlated with the chronicity of injury (r 2 = 0.614; p = 0.0014). Fractures were the most common associated injuries, occurring in seven of 24 patients. In 17 patients, all of whom had conservatively treated type I or type II lesions, complete resolution of the MLL occurred. The maximum compartmental pressures were significantly higher on the lateral side than on the medial side (p < 0.0001). Knee MLLs have a predilection for the medial side, which may be attributed to the lower resistance in this location, and they have variable patterns on MRI, which correlate with chronicity. Conservative treatment of type I and II lesions seems effective.

Intracapsular and paraarticular chondroma of the knee: case report

International Nuclear Information System (INIS)

Kim, Ji Chang; Lee, Yeon Soo; Ji, Jong Hun; Lee, Eun Hee; Kang, Si Won

2004-01-01

We report here on a case of intracapsular and paraaticular chondroma of the left knee in a patient with a 6-month history of knee pain and swelling. Magnetic resonance image (MRI) revealed a well-defined solid mass with central hemorrhagic necrosis in the infrapatellar area of the knee

Cartilage volume quantification with multi echo data image combination sequence in swine knee at 3.0 T MRI

International Nuclear Information System (INIS)

Zhang Lirong; Wang Dongqing; Wei Chuanshe; Ma Cong; Wang Dehang

2010-01-01

Objective: To investigate the accuracy and reproducibility of multi echo data imagine combination (MEDIC) sequence with water excitation at 3.0 T in swine knee cartilage. Methods: Sagittal MEDIC sequences (0.6 mm slice thickness, isotropic) were acquired twice at 3.0 T MRI in 30 swine knees. The knee cartilage was then removed and the volume was directly measured with water substitution method. The cartilage volume was also determined with a validated open source image software OsiriX by two observers (A and B). The cartilage volumes obtained by two methods were compared. The reproducibility of MEDIC for quantitative measurement was accessed by the root-mean-square (RMS) of variation coefficient. Interobserver and intraobserver precision errors were compared using a paired students t-test. The accuracy of MEDIC for quantitative measurement was determined by the random pairwise differences, systematic pairwise differences and the Pearson, correlation coefficients. Time of semiautomatic and manual segmentation were recorded. Results: Time was saved about 75% by using semiautomatic segmentation methods [(4.0± 1.5) min] versus manual segmentation [(16.0±0.9) min]. Interobserver precision errors (RMS CV% for paired analysis) between A and B for cartilage volume measurement were (2.66±0.82) ml and(2.61± 0.81) ml, t=0.24, P=0.81 (patella); (2.40±0.69) ml and (2.49±0.85) ml, t=-0.45, P=0.65 (medial femoral condyle); (2.28±0.74) ml and(2.41±0.78) ml, t=-0.66, P=0.51 (lateral femoral condyle); (3.43±1.28) ml and (3.51±1.08) ml, t=-0.26, P=0.79 (femora trochlea) with sagittal MEDIC. Intraobserver precision errors (RMS CV% for paired analysis) of observer A for the first and second cartilage volume measurement were (2.64±0.62) ml and (2.67±0.60) ml, t=-0.19, P=0.85 (patella); (2.43±0.60) ml and (2.39±0.59) ml, t=0.26, P=0.80 (medial femoral condyle); (2.26±0.56) ml and (2.30±0.57) ml, t=-0.27, P=0.78 (lateral femoral condyle); (3.40± 1.20) ml and (3.47±1

MRI imaging of displaced meniscal tears: Report of a case highlighting new potential pitfalls of the MRI signs

International Nuclear Information System (INIS)

Prasad, Abhishek; Brar, Rahat; Rana, Shaleen

2014-01-01

Magnetic resonance imaging (MRI) has been found to be an excellent imaging tool for meniscal injuries. Various MRI signs have been described to detect displaced meniscal injuries, specifically the bucket-handle tears. Although these signs are quite helpful in diagnosing meniscal tears, various pitfalls have also been reported for these signs. Double anterior cruciate ligament (ACL) sign refers to presence of a linear hypointense soft tissue anterior to the ACL, which represented the flipped bucket-handle tear of the meniscus. Disproportional posterior horn and flipped meniscus signs represent asymmetrically thickened horns of the menisci due to overlying displaced meniscal fragments. We report a case wherein MRI of the knee showed tear and displacement of the medial patellofemoral ligament (MPFL) and vastus medialis complex, medial collateral ligament (MCL), and posterior cruciate ligament (PCL) mimicking these signs. To our knowledge, internally displaced MPFL and MCLs have not been described as mimics for displaced meniscal fragments

MRI of the posterolateral corner of the knee, please have a look

Directory of Open Access Journals (Sweden)

Mahmoud Agha

2017-08-01

Full Text Available The knee PLC injuries are frequently seen, with other major knee injuries, such as ACL and PCL. Objective: This article aimed to clarify PLC injuries that could be diagnosed by MRI, and may have an impact on the management of the associated major knee injuries. Patient and methods: It was conducted through retrospective MRI revision of 1000 patients who were presented with post-traumatic knee complaints, from January 2011 to March 2016. Results: ITB band injuries were seen in 113 patients (11.3%, biceps tendon injury in 59 patients (5.9%, FCL injuries in 223 patients (22.3%, popliteus muscle injury in 53 patients (5.3%, PFL in 17 (1.7%, arcuate ligament injury in 38 patients (3.8% and arcuate bone fracture (fibular styloid fracture in 22 patients (2.2%. Overall PLC injuries recorded 283 patients, either as separate or combined PLC items. Of these 283 patients, 96 patients had associated ACL tear (33.9%, 19 had PCL tear (6.7%, 73 had medial corner injury (25.7%, 55 combined injuries (19.4% and 40 isolated PLC injuries (14.1%. Conclusion: Different types of PLC injuries may occur in association with other major knee sectorial injuries that may require repair before the associated injured major sector correction, in an attempt to avoid early ACL or PCL graft failure.

The relationship of antiresorptive drug use to structural findings and symptoms of knee osteoarthritis.

Science.gov (United States)

Carbone, Laura D; Nevitt, Michael C; Wildy, Kathryn; Barrow, Karen D; Harris, Fran; Felson, David; Peterfy, Charles; Visser, Marjolein; Harris, Tamara B; Wang, Benjamin W E; Kritchevsky, Stephen B

2004-11-01

To examine the cross-sectional association between use of medications that have a bone antiresorptive effect (estrogen, raloxifene, and alendronate) and both the structural features of knee osteoarthritis (OA), assessed by magnetic resonance imaging (MRI) and radiography, and the symptoms of knee OA in elderly women. Women in the Health, Aging and Body Composition Study underwent MRI and radiography of the knee if they reported symptoms of knee OA, and women without significant knee symptoms were selected as controls. MR images of the knee were assessed for multiple features of OA using the Whole-Organ MRI scoring method, and radiographs were read for Kellgren and Lawrence grade and individual features of OA. Concurrent medication use and knee symptoms were assessed by interview, and knee pain severity was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). There were 818 postmenopausal women from whom we obtained MR images of the knee and data on medication use. Among these women, 214 (26.2%) were receiving antiresorptive drugs. We found no significant association between overall use of antiresorptive drugs and the presence of knee pain and radiographic changes of OA of the knee. Use of alendronate, but not estrogen, was associated with less severity of knee pain as assessed by WOMAC scores. Both alendronate use and estrogen use were associated with significantly less subchondral bone attrition and bone marrow edema-like abnormalities in the knee as assessed by MRI, as compared with women who had not received these medications. Elderly women being treated with alendronate and estrogen had a significantly decreased prevalence of knee OA-related subchondral bone lesions compared with those reporting no use of these medications. Alendronate use was also associated with a reduction in knee pain according to the WOMAC scores.

Bone marrow abnormality associated with painful osteoarthritis of the knee. A cross-sectional study of magnetic resonance imaging findings with the radiographic stage and clinical findings

International Nuclear Information System (INIS)

Kubota, Mitsuaki; Kurosawa, Hisashi; Ikeda, Hiroshi; Takazawa, Yuji; Kawasaki, Takayuki; Ishijima, Muneaki; Kim, Song-Gon; Seto, Hiroaki

2009-01-01

Bone marrow abnormalities (BMAs) are frequently found in osteoarthritis (OA) of the knee with magnetic resonance imaging (MRI). Some reports have suggested BMA was correlated with the X-ray stage of OA and also with knee pain, but the reports depended on two-dimensional images without considering the spatial expansion of BMAs. To determine whether three-dimensional expansion of a BMA with MRI in patient with medial-type OA of the knee is correlated with the radiographic stage of OA and clinical findings using a semi-quantitative method. Cross-sectional study. This study enrolled 238 patients with medial-type OA. Radiography and MRI of the knee were taken in all participants. X-rays were graded using the Kellgren-Lawrence (K/L) grade (1-4). T2-weighted fat-suppressed MRI images were used to score the size of the BMA according to the whole-organ MRI score (WORMS). A new scoring system defined as the spatial BMA score (s-score), which specifically addressed the spatial expansion of BMAs, was examined to assess the size of the BMA. BMA frequency was examined in subdivisions of the articular surfaces of the knee according to the X-ray stages of the K/L grade and the correlation of the s-score to the clinical findings. BMA frequency in the medial femorotibial joint (MFTJ; 74%) was significantly higher than in the lateral femorotibial joint (LFTJ; 14%) and patellofemoral joint (PFJ; 14%; P<0.01). The s-score of the MFTJ was strongly correlated with the X-ray stage assessed by the K/L grade. The s-score of the MFTJ was also correlated with the clinical findings. The frequency and spatial expansion of BMAs in the MFTJ are strongly correlated with the X-ray stage of medial-type OA as well as the clinical findings. (author)

MRI (Magnetic Resonance Imaging)

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... Procedures Medical Imaging MRI (Magnetic Resonance Imaging) MRI (Magnetic Resonance Imaging) Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Magnetic Resonance Imaging (MRI) is a medical imaging procedure for ...

MR imaging of autologous chondrocyte implantation of the knee

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James, S.L.J.; Connell, D.A.; Saifuddin, A.; Skinner, J.A.; Briggs, T.W.R. [RNOH Stanmore, Department of Radiology, Stanmore, Middlesex (United Kingdom)

2006-05-15

Autologous chondrocyte implantation (ACI) is a surgical technique that is increasingly being used in the treatment of full-thickness defects of articular cartilage in the knee. It involves the arthroscopic harvesting and in vitro culture of chondrocytes that are subsequently implanted into a previously identified chondral defect. The aim is to produce a repair tissue that closely resembles hyaline articular cartilage that gradually becomes incorporated, restoring joint congruity. Over the long term, it is hoped that this will prevent the progression of full-thickness articular cartilage defects to osteoarthritis. This article reviews the indications and operative procedure performed in ACI. Magnetic resonance imaging (MRI) sequences that provide optimal visualization of articular cartilage in the post-operative period are discussed. Normal appearances of ACI on MRI are presented along with common complications that are encountered with this technique. (orig.)

Perfusion of subchondral bone marrow in knee osteoarthritis: A dynamic contrast-enhanced magnetic resonance imaging preliminary study

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Budzik, Jean-François, E-mail: Budzik.jean-francois@ghicl.net [Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille (France); PMOI Physiopathology of Inflammatory Bone Diseases, EA 4490, Lille (France); Ding, Juliette, E-mail: Ding.juliette@gmail.com [Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille (France); Norberciak, Laurène, E-mail: Norberciak.Laurene@ghicl.net [Lille Catholic Hospitals, Biostatistics Department, Lille Catholic University, Lille (France); Pascart, Tristan, E-mail: Pascart.tristan@ghicl.net [Lille Catholic Hospitals, Rheumatology Department, Lille Catholic University, Lille (France); Toumi, Hechmi, E-mail: hechmi.toumi@univ-orleans.fr [EA4708 I3MTO, Orleans Regional Hospital, University of Orleans, Orleans (France); Verclytte, Sébastien, E-mail: Verclytte.Sebastien@ghicl.net [Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille (France); Coursier, Raphaël, E-mail: Coursier.Raphael@ghicl.net [Lille Catholic Hospitals, Orthopaedic Surgery Department, Lille Catholic University, Lille (France)

2017-03-15

The role of inflammation in the pathogenesis of osteoarthritis is being given major interest, and inflammation is closely linked with vascularization. It was recently demonstrated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could identify the subchondral bone marrow vascularization changes occurring in osteoarthritis in animals. These changes appeared before cartilage lesions were visible and were correlated with osteoarthritis severity. Thus the opportunity to obtain an objective assessment of bone vascularization in non-invasive conditions in humans might help better understanding osteoarthritis pathophysiology and finding new biomarkers. We hypothesized that, as in animals, DCE-MRI has the ability to identify subchondral bone marrow vascularization changes in human osteoarthritis. We performed knee MRI in 19 patients with advanced knee osteoarthritis. We assessed subchondral bone marrow vascularization in medial and lateral femorotibial compartments with DCE-MRI and graded osteoarthritis lesions on MR images. Statistical analysis assessed intra- and inter-observer agreement, compared DCE-MRI values between the different subchondral zones, and sought for an influence of age, sex, body mass index, and osteoarthritis garde on these values. The intra- and inter-observer agreement for DCE-MRI values were excellent. These values were significantly higher in the femorotibial compartment the most affected by osteoarthritis, both in femur and tibia (p < 0.0001) and were significantly and positively correlated with cartilage lesions (p = 0.02) and bone marrow oedema grade (p < 0.0001) after adjustment. We concluded that, as in animals, subchondral bone marrow vascularization changes assessed with DCE-MRI were correlated with osteoarthritis severity in humans.

Perfusion of subchondral bone marrow in knee osteoarthritis: A dynamic contrast-enhanced magnetic resonance imaging preliminary study

International Nuclear Information System (INIS)

Budzik, Jean-François; Ding, Juliette; Norberciak, Laurène; Pascart, Tristan; Toumi, Hechmi; Verclytte, Sébastien; Coursier, Raphaël

2017-01-01

The role of inflammation in the pathogenesis of osteoarthritis is being given major interest, and inflammation is closely linked with vascularization. It was recently demonstrated that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) could identify the subchondral bone marrow vascularization changes occurring in osteoarthritis in animals. These changes appeared before cartilage lesions were visible and were correlated with osteoarthritis severity. Thus the opportunity to obtain an objective assessment of bone vascularization in non-invasive conditions in humans might help better understanding osteoarthritis pathophysiology and finding new biomarkers. We hypothesized that, as in animals, DCE-MRI has the ability to identify subchondral bone marrow vascularization changes in human osteoarthritis. We performed knee MRI in 19 patients with advanced knee osteoarthritis. We assessed subchondral bone marrow vascularization in medial and lateral femorotibial compartments with DCE-MRI and graded osteoarthritis lesions on MR images. Statistical analysis assessed intra- and inter-observer agreement, compared DCE-MRI values between the different subchondral zones, and sought for an influence of age, sex, body mass index, and osteoarthritis garde on these values. The intra- and inter-observer agreement for DCE-MRI values were excellent. These values were significantly higher in the femorotibial compartment the most affected by osteoarthritis, both in femur and tibia (p < 0.0001) and were significantly and positively correlated with cartilage lesions (p = 0.02) and bone marrow oedema grade (p < 0.0001) after adjustment. We concluded that, as in animals, subchondral bone marrow vascularization changes assessed with DCE-MRI were correlated with osteoarthritis severity in humans.

Bone bruise in magnetic resonance imaging strongly correlates with the production of joint effusion and with knee osteoarthritis

International Nuclear Information System (INIS)

Oda, Hiromi; Igarashi, Mitsuo; Sase, Hiroshi; Sase, Takeshi; Yamamoto, Seizo

2008-01-01

The findings of magnetic resonance imaging (MRI) have not been studied systematically in patients with osteoarthritis (OA). The objective here was to compare MRI findings with radiological findings in patients with knee pain and to identify factors that influence the progression of OA of the knee. Of 212 patients with knee pain and MRI of the knee joint, 161 patients were selected for the study after exclusion of cases of trauma and other arthritides. MRI was used to evaluate the presence and degree of bone bruise, hydrarthrosis, and injuries to the cruciate ligament and meniscus. Bone bruise was classified into four types, and hydrarthrosis into four grades. Radiologically, OA progression in the femorotibial and patellofemoral joints was analyzed according to the Kellgren-Lawrence classification. Age was divided into four groups based on distribution quartiles. Logistic regression analysis and a generalized linear model with Poisson regression were used to analyze correlations among these factors. Bone bruise was present in 87 cases, hydrarthrosis in 100, cruciate ligament injury in 20, and meniscus injury in 98. The presence of bone bruise was not related to age, cruciate ligament injury, meniscus injury, nor to OA of the patellofemoral joint, but was related to hydrarthrosis and to OA of the femorotibial joint. Femorotibial OA was much more strongly associated with bone bruise than with hydrarthrosis. Furthermore, analyzing the relation between the types of bone bruise and the degree of hydrarthrosis using a generalized linear model with Poisson regression, there was a positive correlation between the grade of bone bruise and the amount of hydrarthrosis. A factor associated with the degree of osteoarthritis of the knee is bone bruise observed on MRI. The degree of hydrarthrosis is related to the grade of bone bruise, but is not linked to the degree of osteoarthritis. (author)

Magnetic resonance tomography of the knee joint

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Puig, Stefan; Kuruvilla, Yojena Chittazhathu Kurian; Ebner, Lukas [University Hospital, University of Berne, Department of Interventional, Pediatric and Diagnostic Radiology Inselspital, Berne (Switzerland); Endel, Gottfried [Main Association of Austrian Social Insurance Institutions, Vienna (Austria)

2015-10-15

To compare the diagnostic performance of magnetic resonance imaging (MRI) in terms of sensitivity and specificity using a field strength of <1.0 T (T) versus ≥1.5 T for diagnosing or ruling out knee injuries or knee pathologies. The systematic literature research revealed more than 10,000 references, of which 1598 abstracts were reviewed and 87 full-text articles were retrieved. The further selection process resulted in the inclusion of four systematic reviews and six primary studies. No differences could be identified in the diagnostic performance of low- versus high-field MRI for the detection or exclusion of meniscal or cruciate ligament tears. Regarding the detection or grading of cartilage defects and osteoarthritis of the knee, the existing evidence suggests that high-field MRI is tolerably specific but not very sensitive, while there is literally no evidence for low-field MRI because only a few studies with small sample sizes and equivocal findings have been performed. We can recommend the use of low-field strength MRI systems in suspected meniscal or cruciate ligament injuries. This does, however, not apply to the diagnosis and grading of knee cartilage defects and osteoarthritis because of insufficient evidence. (orig.)

Magnetic resonance tomography of the knee joint

International Nuclear Information System (INIS)

Puig, Stefan; Kuruvilla, Yojena Chittazhathu Kurian; Ebner, Lukas; Endel, Gottfried

2015-01-01

To compare the diagnostic performance of magnetic resonance imaging (MRI) in terms of sensitivity and specificity using a field strength of <1.0 T (T) versus ≥1.5 T for diagnosing or ruling out knee injuries or knee pathologies. The systematic literature research revealed more than 10,000 references, of which 1598 abstracts were reviewed and 87 full-text articles were retrieved. The further selection process resulted in the inclusion of four systematic reviews and six primary studies. No differences could be identified in the diagnostic performance of low- versus high-field MRI for the detection or exclusion of meniscal or cruciate ligament tears. Regarding the detection or grading of cartilage defects and osteoarthritis of the knee, the existing evidence suggests that high-field MRI is tolerably specific but not very sensitive, while there is literally no evidence for low-field MRI because only a few studies with small sample sizes and equivocal findings have been performed. We can recommend the use of low-field strength MRI systems in suspected meniscal or cruciate ligament injuries. This does, however, not apply to the diagnosis and grading of knee cartilage defects and osteoarthritis because of insufficient evidence. (orig.)

Feasibility study of simultaneous physical examination and dynamic MR imaging of medial collateral ligament knee injuries in a 1.5-T large-bore magnet

International Nuclear Information System (INIS)

Studler, Ueli; White, Lawrence M.; Deslandes, Melanie; Sussman, Marshall S.; Geddes, Christopher; Theodoropoulos, John

2011-01-01

To determine the feasibility of evaluating medial knee joint laxity with dynamic magnetic resonance (MR) imaging and simultaneous physical joint examination in a large-bore 1.5-T system. The study included 10 patients (5 women, 5 men; mean age 35 years) with clinically diagnosed and categorized acute injuries of the medial collateral ligament (MCL). Intermittent valgus stress was applied separately to both the affected and the contralateral knee joint during dynamic MR imaging with a two-dimensional fast low-angle shot sequence. The width of the medial joint space and the opening angle between the femoral condyles and the tibial plateau were measured. Results obtained from dynamic MR imaging of the affected knee were compared with morphological MCL changes on static MRI, to kinematics of the contralateral side and to the clinical grading of MCL injuries. On clinical examination, all patients had grade 2 MCL injuries except one, who had a grade 1 lesion. Using morphological MRI criteria, 9 grade II and 1 grade III injuries were seen. Mean medial joint space width and opening angles of all affected knees were 2.8 mm and 2.7 respectively, compared with 1.7 mm and 2.1 on the contralateral side. The Wilcoxon signed rank test indicated that the differences in width (P = 0.005) and opening angle (P = 0.037) between the affected and contralateral knees were significant. Dynamic MR imaging and simultaneous physical joint examination is feasible. Our results suggest that this technique might enable the imaging documentation of medial ligamentous knee instability. (orig.)

18F-FDG PET imaging of rheumatoid knee synovitis correlates with dynamic magnetic resonance and sonographic assessments as well as with the serum level of metalloproteinase-3

International Nuclear Information System (INIS)

Beckers, Catherine; Foidart, Jacqueline; Hustinx, Roland; Jeukens, Xavier; Marcelis, Stefaan; Ribbens, Clio; Andre, Beatrice; Leclercq, Philippe; Kaiser, Marie-Joelle; Malaise, Michel G.

2006-01-01

The aim of this study was to assess rheumatoid arthritis (RA) synovitis with positron emission tomography (PET) and 18 F-fluorodeoxyglucose ( 18 F-FDG) in comparison with dynamic magnetic resonance imaging (MRI) and ultrasonography (US). Sixteen knees in 16 patients with active RA were assessed with PET, MRI and US at baseline and 4 weeks after initiation of anti-TNF-α treatment. All studies were performed within 4 days. Visual and semi-quantitative (standardised uptake value, SUV) analyses of the synovial uptake of FDG were performed. The dynamic enhancement rate and the static enhancement were measured after i.v. gadolinium injection and the synovial thickness was measured in the medial, lateral patellar and suprapatellar recesses by US. Serum levels of C-reactive protein (CRP) and metalloproteinase-3 (MMP-3) were also measured. PET was positive in 69% of knees while MRI and US were positive in 69% and 75%. Positivity on one imaging technique was strongly associated with positivity on the other two. PET-positive knees exhibited significantly higher SUVs, higher MRI parameters and greater synovial thickness compared with PET-negative knees, whereas serum CRP and MMP-3 levels were not significantly different. SUVs were significantly correlated with all MRI parameters, with synovial thickness and with serum CRP and MMP-3 levels at baseline. Changes in SUVs after 4 weeks were also correlated with changes in MRI parameters and in serum CRP and MMP-3 levels, but not with changes in synovial thickness. (orig.)

Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment.

Science.gov (United States)

Aysin, Idil Kurut; Askin, Ayhan; Mete, Berna Dirim; Guvendi, Ece; Aysin, Murat; Kocyigit, Hikmet

2018-02-01

The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI. Knee MRI images were evaluated by a radiologist for chondromalacia staging. Patients were divided into two groups as early stage (stage 1-2) and advanced stage (stage 3-4) chondromalacia. Patients' demographical data (age, sex, and occupation), clinical features, physical examination findings and patellofemoral pain severity scale, kujala patellofemoral scoring system, and functional index questionnaire scores were obtained from their medical records. Trochlear sulcus angle, sulcus depth, lateral patellofemoral angle, patellar translation, and Insall-Salvati index were measured using the MRI images. The mean patient age was higher in the advanced stage CMP group compared to the early stage CMP group (p=0.038). There was no statistically significant difference regarding other demographical data (p>0.05). MRI measurement parameters did not show difference between the groups (p>0.05). Patients in the advanced stage CMP group had higher patellofemoral pain severity score, lower kujala patellofemoral score, and lower functional index questionnaire score compared to the early stage CMP group. The differences were statistically significant (p=0.008, p=0.012, and p=0.026, respectively). As chondromalacia stage advances, the symptom severity worsens and knee functions decline; however, MRI measurements do not show difference between early and advanced stage CMP patients.

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

International Nuclear Information System (INIS)

Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L.; Bloem, Rolf M.; Napoleon, L.J.; Coene, M.N.; Luijt, Peter A. van; Lange, Sam de

2007-01-01

The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

Energy Technology Data Exchange (ETDEWEB)

Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Bloem, Rolf M. [Leiden University Medical Center, Department of Orthopaedic Surgery, Leiden (Netherlands); Napoleon, L.J.; Coene, M.N. [HAGA Hospital, Department of Orthopaedic Surgery, The Hague (Netherlands); Luijt, Peter A. van [Leiden University Medical Center, Department of Traumatology, Leiden (Netherlands); Lange, Sam de [Medical Center Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Department of Orthopaedic Surgery, Delft (Netherlands)

2007-12-15

The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

MRI findings associated with development of incident knee pain over 48 months: data from the osteoarthritis initiative

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Joseph, Gabby B.; Hou, Stephanie W.; Nardo, Lorenzo; Heilmeier, Ursula; Link, Thomas M. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, Michael C.; McCulloch, Charles E. [University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2016-05-15

The purpose of this nested case-control study was to identify baseline, incident, and progressive MRI findings visible on standard MRI clinical sequences that were associated with development of incident knee pain in subjects at risk for OA over a period of 48 months. We analyzed 60 case knees developing incident pain (WOMAC{sub pain} = 0 at baseline and WOMAC{sub pain} ≥ 5 at 48 months) and 60 control knees (WOMAC{sub pain} = 0 at baseline and WOMAC{sub pain} = 0 at 48 months) from the Osteoarthritis Initiative. 3 T knee MRIs were analyzed using a modified WORMS score (cartilage, meniscus, bone marrow) at baseline and after 48 months. Baseline and longitudinal findings were grouped into logistic regression models and compared using likelihood-ratio tests. For each model that was significant, a stepwise elimination was used to isolate significant MRI findings. One baseline MRI finding and three findings that changed from baseline to 48 months were associated with the development of pain: at baseline, the severity of a cartilage lesion in the medial tibia was associated with incident pain - (odds ratio (OR) for incident pain = 3.05; P = 0.030). Longitudinally, an incident effusion (OR = 9.78; P = 0.005), a progressive cartilage lesion of the patella (OR = 4.59; P = 0.009), and an incident medial meniscus tear (OR = 4.91; P = 0.028) were associated with the development of pain. Our results demonstrate that baseline abnormalities of the medial tibia cartilage as well as an incident joint effusion, progressive patella cartilage defects, and an incident medial meniscus tear over 48 months may be associated with incident knee pain. Clinically, this study helps identify MRI findings that are associated with the development of knee pain. (orig.)

MRI findings associated with development of incident knee pain over 48 months: data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Joseph, Gabby B.; Hou, Stephanie W.; Nardo, Lorenzo; Heilmeier, Ursula; Link, Thomas M.; Nevitt, Michael C.; McCulloch, Charles E.

2016-01-01

The purpose of this nested case-control study was to identify baseline, incident, and progressive MRI findings visible on standard MRI clinical sequences that were associated with development of incident knee pain in subjects at risk for OA over a period of 48 months. We analyzed 60 case knees developing incident pain (WOMAC pain = 0 at baseline and WOMAC pain ≥ 5 at 48 months) and 60 control knees (WOMAC pain = 0 at baseline and WOMAC pain = 0 at 48 months) from the Osteoarthritis Initiative. 3 T knee MRIs were analyzed using a modified WORMS score (cartilage, meniscus, bone marrow) at baseline and after 48 months. Baseline and longitudinal findings were grouped into logistic regression models and compared using likelihood-ratio tests. For each model that was significant, a stepwise elimination was used to isolate significant MRI findings. One baseline MRI finding and three findings that changed from baseline to 48 months were associated with the development of pain: at baseline, the severity of a cartilage lesion in the medial tibia was associated with incident pain - (odds ratio (OR) for incident pain = 3.05; P = 0.030). Longitudinally, an incident effusion (OR = 9.78; P = 0.005), a progressive cartilage lesion of the patella (OR = 4.59; P = 0.009), and an incident medial meniscus tear (OR = 4.91; P = 0.028) were associated with the development of pain. Our results demonstrate that baseline abnormalities of the medial tibia cartilage as well as an incident joint effusion, progressive patella cartilage defects, and an incident medial meniscus tear over 48 months may be associated with incident knee pain. Clinically, this study helps identify MRI findings that are associated with the development of knee pain. (orig.)

Prevalence of knee abnormalities in patients with osteoarthritis and anterior cruciate ligament injury identified with peripheral magnetic resonance imaging: a pilot study

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Wu, H. [McMaster Univ., Dept. of Medical Sciences, Hamilton, Ontario (Canada)]. E-mail: wuh5@mcmaster.ca; Webber, C. [Hamilton Health Sciences, Dept. of Nuclear Medicine, Hamilton, Ontario (Canada); McMaster Univ., Dept. of Radiology, Hamilton, Ontario (Canada); Fuentes, C.O. [Hamilton Health Sciences, Dept. of Radiology, Hamilton, Ontario (Canada); Benson, R.; Beattie, K. [McMaster Univ., Dept. of Medical Sciences, Hamilton, Ontario (Canada); Adachi, J.D.; Xie, X. [McMaster Univ., Dept. of Medical Sciences, Hamilton, Ontario (Canada); Jabbari, F. [Hamilton Health Sciences, Hamilton, Ontario (Canada); Levy, D.R. [McMaster Univ., Sports Medicine, Dept. of Family Medicine and Dept. of Medicine, Hamilton, Ontario (Canada)

2007-06-15

To assess, with a peripheral magnetic resonance imaging system (pMRI), the prevalence of bony and soft tissue abnormalities in the knee joints of normal subjects, osteoarthritis (OA) patients, and individuals who have suffered an anterior cruciate ligament (ACL) rupture; and 2) to compare the prevalence among groups. Magnetic resonance (MR) images of 28 healthy, 32 OA, and 26 ACL damaged knees were acquired with a 1.0-T pMRI system. Two radiologists grade the presence and severity of 9 MR image features: cartilage degeneration, osteophytes, subchondral cyst, bone marrow edema, meniscal abnormality, ligament integrity, loose bodies, popliteal cysts, and joint effusion. Ten of 28 healthy (35.7%), 24 of 26 ACL (92.3%), and all OA knees (100%) showed prevalent cartilage defects; 5 healthy (17.9%), 20 ACL (76.9%), and all OA knees (100%) had osteophytes; and 9 normal (32.1%), 21 ACL (80.8%), and 29 OA knees (90.6%) had meniscal abnormalities. One-half of the knees in the OA group (16 of 32, 50%) had subchondral cysts, and almost one-half had bone marrow edema (15 of 32, 46.9%). These features were not common in the ACL group (7.7%, and 11.5%, respectively) and were not observed in healthy knees. The OA group had the most severe cartilage defects, osteophytes, bone marrow edema, subchondral cysts, and meniscal abnormalities; the ACL group showed more severe cartilage defects, osteophytes, and meniscal abnormalities than did normal subjects. The results suggest that knees that have sustained ACL damage have OA-like features, most subjects (19 of 26, 73.1%) could be identified as in the early stage of OA. The prominent abnormalities present in ACL-damaged knees are cartilage defects, osteophytes, and meniscal abnormalities. (author)

Prevalence of knee abnormalities in patients with osteoarthritis and anterior cruciate ligament injury identified with peripheral magnetic resonance imaging: a pilot study

International Nuclear Information System (INIS)

Wu, H.; Webber, C.; Fuentes, C.O.; Benson, R.; Beattie, K.; Adachi, J.D.; Xie, X.; Jabbari, F.; Levy, D.R.

2007-01-01

To assess, with a peripheral magnetic resonance imaging system (pMRI), the prevalence of bony and soft tissue abnormalities in the knee joints of normal subjects, osteoarthritis (OA) patients, and individuals who have suffered an anterior cruciate ligament (ACL) rupture; and 2) to compare the prevalence among groups. Magnetic resonance (MR) images of 28 healthy, 32 OA, and 26 ACL damaged knees were acquired with a 1.0-T pMRI system. Two radiologists grade the presence and severity of 9 MR image features: cartilage degeneration, osteophytes, subchondral cyst, bone marrow edema, meniscal abnormality, ligament integrity, loose bodies, popliteal cysts, and joint effusion. Ten of 28 healthy (35.7%), 24 of 26 ACL (92.3%), and all OA knees (100%) showed prevalent cartilage defects; 5 healthy (17.9%), 20 ACL (76.9%), and all OA knees (100%) had osteophytes; and 9 normal (32.1%), 21 ACL (80.8%), and 29 OA knees (90.6%) had meniscal abnormalities. One-half of the knees in the OA group (16 of 32, 50%) had subchondral cysts, and almost one-half had bone marrow edema (15 of 32, 46.9%). These features were not common in the ACL group (7.7%, and 11.5%, respectively) and were not observed in healthy knees. The OA group had the most severe cartilage defects, osteophytes, bone marrow edema, subchondral cysts, and meniscal abnormalities; the ACL group showed more severe cartilage defects, osteophytes, and meniscal abnormalities than did normal subjects. The results suggest that knees that have sustained ACL damage have OA-like features, most subjects (19 of 26, 73.1%) could be identified as in the early stage of OA. The prominent abnormalities present in ACL-damaged knees are cartilage defects, osteophytes, and meniscal abnormalities. (author)

Diagnostic Value of History Taking and Physical Examination to Assess Effusion of the Knee in Traumatic Knee Patients in General Practice

NARCIS (Netherlands)

Kastelein, Marlous; Luijsterburg, Pim A.; Wagemakers, Harry A.; Bansraj, Santusha C.; Berger, Marjolein Y.; Koes, Bart W.; Bierma-Zeinstra, Sita M.

Objective: To assess the diagnostic value of history taking and physical examination for knee joint effusion in patients with a knee injury who consult their general practitioner (GP). In addition, to determine the association between effusion seen on magnetic resonance imaging (MRI) and internal

Arthroscopic knee anatomy in young achondroplasia patients

Science.gov (United States)

del Pilar Duque Orozco, M.; Record, N. C.; Rogers, K. J; Bober, M. B.; Mackenzie, W. G.; Atanda, A.

2017-01-01

Abstract Purpose Achondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy. Methods Records of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed. Bony, cartilaginous and ligamentous changes were noted. The trochlea sulcus angle was measured from intra-operative arthroscopic images. Results A total of 12 knee arthroscopies in nine patients were performed. The mean age at surgery was 16.9 years (12 to 22). In all patients, the indication for surgery was knee pain and/or mechanical symptoms that were refractory to non-operative treatment. Three anatomical variations involving the distal femur were found in all knees: a deep femoral trochlea; a high A-shaped intercondylar notch; and a vertically oriented anterior cruciate ligament. The average trochlea sulcus angle measured 123°. Pathology included: synovial plica (one knee); chondral lesions (three knees); discoid lateral meniscus (11 knees); and meniscal tears (six knees). All patients were pain-free and returned to normal activity at final follow-up. Conclusion Children with achondroplasia have characteristic distal femur anatomy noted during knee arthroscopy. These variations should be considered normal during knee arthroscopy in these patients. Arthroscopic findings confirmed previous MRI findings within this specific population with the addition of a deep trochlear groove which was not previously reported. PMID:28828058

Diagnostic performance of in vivo 3-T MRI for articular cartilage abnormalities in human osteoarthritic knees using histology as standard of reference

International Nuclear Information System (INIS)

Saadat, Ehsan; Jobke, Bjoern; Chu, Bill; Lu, Ying; Cheng, Jonathan; Li, Xiaojuan; Majumdar, Sharmila; Link, Thomas M.; Ries, Michael D.

2008-01-01

The purpose of this study was (1) to evaluate the sensitivity, specificity and accuracy of sagittal in vivo 3-T intermediate-weighted fast spin-echo (iwFSE) sequences in the assessment of knee cartilage pathologies using histology as the reference standard in patients undergoing total knee replacement, and (2) to correlate MR imaging findings typically associated with osteoarthritis such as bone marrow edema pattern (BMEP) and cartilage swelling with histological findings. Tibial plateaus and femoral condyles of eight knees of seven patients were resected during surgery, and sagittal histological sections were prepared for histology. Preoperative MRI findings were compared to the corresponding region in histological sections for thickness, surface integrity and signal pattern of cartilage, and histological findings in areas of BMEP and swelling were documented. The overall sensitivity, specificity and accuracy were 72%, 69% and 70% for thickness, 69%, 74% and 73% for surface and 36%, 62% and 45% for intracartilaginous signal pattern. For all cases of BMEP on MRI subchondral ingrowth of fibrovascular tissue and increased bone remodeling were observed. MRI using fat-saturated iwFSE sequences showed good performance in assessing cartilage thickness and surface lesions, while signal changes of cartilage were not suited to characterize the severity of cartilage degeneration as validated by histology. (orig.)

Diagnostic performance of in vivo 3-T MRI for articular cartilage abnormalities in human osteoarthritic knees using histology as standard of reference

Energy Technology Data Exchange (ETDEWEB)

Saadat, Ehsan [University of California San Francisco, School of Medicine and Department of Radiology, San Francisco, CA (United States); Jobke, Bjoern; Chu, Bill; Lu, Ying; Cheng, Jonathan; Li, Xiaojuan; Majumdar, Sharmila; Link, Thomas M. [University of California San Francisco, Department of Radiology, San Francisco, CA (United States); Ries, Michael D. [University of California San Francisco, Department of Orthopaedic Surgery, San Francisco, CA (United States)

2008-10-15

The purpose of this study was (1) to evaluate the sensitivity, specificity and accuracy of sagittal in vivo 3-T intermediate-weighted fast spin-echo (iwFSE) sequences in the assessment of knee cartilage pathologies using histology as the reference standard in patients undergoing total knee replacement, and (2) to correlate MR imaging findings typically associated with osteoarthritis such as bone marrow edema pattern (BMEP) and cartilage swelling with histological findings. Tibial plateaus and femoral condyles of eight knees of seven patients were resected during surgery, and sagittal histological sections were prepared for histology. Preoperative MRI findings were compared to the corresponding region in histological sections for thickness, surface integrity and signal pattern of cartilage, and histological findings in areas of BMEP and swelling were documented. The overall sensitivity, specificity and accuracy were 72%, 69% and 70% for thickness, 69%, 74% and 73% for surface and 36%, 62% and 45% for intracartilaginous signal pattern. For all cases of BMEP on MRI subchondral ingrowth of fibrovascular tissue and increased bone remodeling were observed. MRI using fat-saturated iwFSE sequences showed good performance in assessing cartilage thickness and surface lesions, while signal changes of cartilage were not suited to characterize the severity of cartilage degeneration as validated by histology. (orig.)

Predictive factors for new onset or progression of knee osteoarthritis one year after trauma: MRI follow-up in general practice

International Nuclear Information System (INIS)

Koster, Ingrid M.; Oei, Edwin H.G.; Hunink, M.G.M.; Hensen, Jan-Hein J.; Vroegindeweij, Dammis; Boks, Simone S.; Koes, Bart W.; Bierma-Zeinstra, Sita M.A.

2011-01-01

To prospectively evaluate prognostic factors for new onset or progression of degenerative change on follow-up MRI one year after knee trauma and the association with clinical outcome. Within a prospective observational cohort study in general practice, we studied a subgroup of 117 patients with acute knee trauma (mean age 41 years, 43% women). Degenerative change was scored on MRI at baseline and after one year follow-up. Multivariate logistic regression analysis was performed to evaluate prognostic factors for new onset or progressive degenerative change on follow-up MRI. Association between new or progressive degeneration and clinical outcome after one year was assessed. On follow-up MRI 15% of patients with pre-existing knee osteoarthritis showed progression and 26% of patients demonstrated new degenerative change. The only statistically significant prognostic variable in the multivariate analysis was bone marrow oedema on initial MRI (OR 5.29 (95% CI 1.64-17.1), p = 0.005). A significant association between new or progressive degenerative change and clinical outcome was found (p = 0.003). Bone marrow oedema on MRI for acute knee injury is strongly predictive of new onset or progression of degenerative change of the femorotibial joint on follow-up MRI one year after trauma, which is reflected in clinical outcome. (orig.)

Predictive factors for new onset or progression of knee osteoarthritis one year after trauma: MRI follow-up in general practice

Energy Technology Data Exchange (ETDEWEB)

Koster, Ingrid M. [Maasstad Ziekenhuis, Department of Radiology, Postbus 9100, Rotterdam (Netherlands); Erasmus MC, University Medical Center, Department of Radiology, Rotterdam (Netherlands); Oei, Edwin H.G.; Hunink, M.G.M. [Erasmus MC, University Medical Center, Program for the Assessment of Radiological Technology (ART Program), Rotterdam (Netherlands); Erasmus MC, University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam (Netherlands); Hensen, Jan-Hein J.; Vroegindeweij, Dammis [Maasstad Ziekenhuis, Department of Radiology, Postbus 9100, Rotterdam (Netherlands); Boks, Simone S. [Maasstad Ziekenhuis, Department of Radiology, Postbus 9100, Rotterdam (Netherlands); Erasmus MC, University Medical Center Rotterdam, Department of Epidemiology, Rotterdam (Netherlands); Koes, Bart W.; Bierma-Zeinstra, Sita M.A. [Erasmus MC, University Medical Center, Department of General Practice, Rotterdam (Netherlands)

2011-07-15

To prospectively evaluate prognostic factors for new onset or progression of degenerative change on follow-up MRI one year after knee trauma and the association with clinical outcome. Within a prospective observational cohort study in general practice, we studied a subgroup of 117 patients with acute knee trauma (mean age 41 years, 43% women). Degenerative change was scored on MRI at baseline and after one year follow-up. Multivariate logistic regression analysis was performed to evaluate prognostic factors for new onset or progressive degenerative change on follow-up MRI. Association between new or progressive degeneration and clinical outcome after one year was assessed. On follow-up MRI 15% of patients with pre-existing knee osteoarthritis showed progression and 26% of patients demonstrated new degenerative change. The only statistically significant prognostic variable in the multivariate analysis was bone marrow oedema on initial MRI (OR 5.29 (95% CI 1.64-17.1), p = 0.005). A significant association between new or progressive degenerative change and clinical outcome was found (p = 0.003). Bone marrow oedema on MRI for acute knee injury is strongly predictive of new onset or progression of degenerative change of the femorotibial joint on follow-up MRI one year after trauma, which is reflected in clinical outcome. (orig.)

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

International Nuclear Information System (INIS)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K.

2000-01-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

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Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K

2000-11-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

Effects of chondroitin sulfate on brain response to painful stimulation in knee osteoarthritis patients. A randomized, double-blind, placebo-controlled functional magnetic resonance imaging study.

Science.gov (United States)

Monfort, Jordi; Pujol, Jesús; Contreras-Rodríguez, Oren; Llorente-Onaindia, Jone; López-Solà, Marina; Blanco-Hinojo, Laura; Vergés, Josep; Herrero, Marta; Sánchez, Laura; Ortiz, Hector; Montañés, Francisco; Deus, Joan; Benito, Pere

2017-06-21

Knee osteoarthritis is causing pain and functional disability. One of the inherent problems with efficacy assessment of pain medication was the lack of objective pain measurements, but functional magnetic resonance imaging (fMRI) has emerged as a useful means to objectify brain response to painful stimulation. We have investigated the effect of chondroitin sulfate (CS) on brain response to knee painful stimulation in patients with knee osteoarthritis using fMRI. Twenty-two patients received CS (800mg/day) and 27 patients placebo, and were assessed at baseline and after 4 months of treatment. Two fMRI tests were conducted in each session by applying painful pressure on the knee interline and on the patella surface. The outcome measurement was attenuation of the response evoked by knee painful stimulation in the brain. fMRI of patella pain showed significantly greater activation reduction under CS compared with placebo in the region of the mesencephalic periaquecductal gray. The CS group, additionally showed pre/post-treatment activation reduction in the cortical representation of the leg. No effects of CS were detected using the interline pressure test. fMRI was sensitive to objectify CS effects on brain response to painful pressure on patellofemoral cartilage, which is consistent with the known CS action on chondrocyte regeneration. The current work yields further support to the utility of fMRI to objectify treatment effects on osteoarthritis pain. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Magnetic Resonance Imaging based Cartilage Loss in Painful Contra-Lateral Knees with and without Radiographic Joint Space Narrowing – Data from the Osteoarthritis Initiative (OAI)

Science.gov (United States)

Eckstein, Felix; Benichou, Olivier; Wirth, Wolfgang; Nelson, David R; Maschek, Susanne; Hudelmaier, Martin; Kwoh, C. Kent; Guermazi, Ali; Hunter, David

2010-01-01

Objective Magnetic resonance imaging (MRI) was used to assess whether knees with advanced radiographic disease (medial joint space narrowing = mJSN) encounter greater longitudinal cartilage loss than contra-lateral knees with earlier disease (no or less mJSN). Methods Participants were selected from 2678 cases in the Osteoarthritis Initiative, based on exhibition of bilateral pain, BMI>25, mJSN in one knee, no or less mJSN in the contra-lateral knee, and no lateral JSN in both knees. 80 participants (age 60.6±9.1 yrs) fulfilled these criteria. Medial tibial and femoral cartilage morphology was analyzed from baseline and 1-year follow-up sagittal DESSwe 3 Tesla MRI of both knees, by experienced readers blinded to the timepoint and mJSN status. Results Knees with more radiographic mJSN displayed greater medial cartilage loss (-80 μm), assessed by MRI, than contra-lateral knees with less mJSN (-57μm). The difference reached statistical significance in participants with mJSN grade 2 or 3 (p=0.005 to p=0.08), but not in participants with mJSN grade 1 (p=0.28 to 0.98). In knees with more mJSN, cartilage loss increased with higher grades of mJSN (p=0.003 in the medial femur). Knees with mJSN grade 2 or 3 displayed greater cartilage loss in the weight-bearing medial femur than in the posterior femur or in the medial tibia (p=0.048). Conclusion Knees with advanced mJSN displayed greater cartilage loss than contra-lateral knees with less mJSN. These data suggest that radiography can be used to stratify fast structural progressors, and that MRI cartilage thickness loss is more pronounced at advanced radiographic disease stage. PMID:19714595

Differentiation between grade 3 and grade 4 articular cartilage defects of the knee: Fat-suppressed proton density-weighted versus fat-suppressed three-dimensional gradient-echo MRI

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Lee, So Yeon; Jee, Won-Hee; Kim, Sun Ki (Dept. of Radiology, Seoul St Mary' s Hospital, Catholic Univ. of Korea, Seoul (Korea)), e-mail: whjee@catholic.ac.kr; Koh, In-Jun (Dept. of Joint Reconstruction Center, Seoul National Univ. Bundang Hospital, Seoul (Korea)); Kim, Jung-Man (Dept. of Orthopedic Surgery, Seoul St Mary' s Hospital, Catholic Univ. of Korea, Seoul (Korea))

2010-05-15

Background: Fat-suppressed (FS) proton density (PD)-weighted magnetic resonance imaging (MRI) and FS three-dimensional (3D) gradient-echo imaging such as spoiled gradient-recalled (SPGR) sequence have been established as accurate methods for detecting articular cartilage defects. Purpose: To retrospectively compare the diagnostic efficacy between FS PD-weighted and FS 3D gradient-echo MRI for differentiating between grade 3 and grade 4 cartilage defects of the knee with arthroscopy as the standard of reference. Material and Methods: Twenty-one patients who had grade 3 or 4 cartilage defects in medial femoral condyle at arthroscopy and knee MRI were included in this study: grade 3, >50% cartilage defects; grade 4, full thickness cartilage defects exposed to the bone. Sagittal FS PD-weighted MR images and FS 3D gradient-echo images with 1.5 T MR images were independently graded for the cartilage abnormalities of medial femoral condyle by two musculoskeletal radiologists. Statistical analysis was performed by Fisher's exact test. Inter-observer agreement in grading of cartilage was assessed using ? coefficients. Results: Arthroscopy revealed grade 3 defects in 17 patients and grade 4 defects in 4 patients in medial femoral condyles. For FS 3D gradient-echo images grade 3 defects were graded as grade 3 (n=15) and grade 4 (n=2), and all grade 4 defects (n=4) were correctly graded. However, for FS PD-weighted MR images all grade 3 defects were misinterpreted as grade 1 (n=1) and grade 4 (n=16), whereas all grade 4 defects (n=4) were correctly graded. FS 3D gradient-echo MRI could differentiate grade 3 from grade 4 defects (P=0.003), whereas FS PD-weighted imaging could not (P=1.0). Inter-observer agreement was substantial (?=0.70) for grading of cartilage using FS PD-weighted imaging, whereas it was moderate (?=0.46) using FS 3D gradient-echo imaging. Conclusion: FS 3D gradient-echo MRI is more helpful for differentiating between grade 3 and grade 4 cartilage

Value of radiographic examination of the knee joint for the orthopedic surgeon

International Nuclear Information System (INIS)

Pietsch, M.; Hofmann, S.

2006-01-01

Extended radiographic examinations offer excellent options for diagnosis and strategy for treatment of the knee joint. The whole-leg radiograph is indispensable in measuring alignment for osteotomy or total knee arthroplasty (TKA). Fluoroscopically assisted varus-valgus stress radiographs provide the possibility for verifying mechanical function of the implanted knee prosthesis. Ultrasound examinations have been widely replaced by magnetic resonance imaging (MRI). MRI is the golden standard to examine intra-articular structures of the knee (meniscus, ligaments, cartilage) and surrounding soft tissue. For evaluating femoral and tibial torsion and determining axial rotation of TKA, computed tomography (CT) is best qualified. Imaging of the patellofemoral joint (patella instability) is difficult; CT scans in combination with true lateral radiographs seem to be helpful. (orig.) [de

A new MRI grading system for chondromalacia patellae.

Science.gov (United States)

Özgen, Ali; Taşdelen, Neslihan; Fırat, Zeynep

2017-04-01

Background Chondromalacia patellae is a very common disorder. Although magnetic resonance imaging (MRI) is widely used to investigate patellar cartilage lesions, there is no descriptive MRI-based grading system for chondromalacia patellae. Purpose To propose a new MRI grading system for chondromalacia patellae with corresponding high resolution images which might be useful in precisely reporting and comparing knee examinations in routine daily practice and used in predicting natural course and clinical outcome of the patellar cartilage lesions. Material and Methods High resolution fat-saturated proton density (FS PD) images in the axial plane with corresponding T2 mapping images were reviewed. A detailed MRI grading system covering the deficiencies of the existing gradings has been set and presented on these images. Two experienced observers blinded to clinical data examined 44 knee MR images and evaluated patellar cartilage changes according to the proposed grading system. Inter- and intra-rater validity testing using kappa statistics were calculated. Results A descriptive and detailed grading system with corresponding FS PD and T2 mapping images has been presented. Inter-rater agreement was 0.80 (95% confidence interval [CI], 0.71-0.89). Intra-rater agreements were 0.83 (95% CI, 0.74-0.91) for observer A and 0.79 (95% CI, 0.70-0.88) for observer B (k-values). Conclusion We present a new MRI grading system for chondromalacia patellae with corresponding images and good inter- and intra-rater agreement which might be useful in reporting and comparing knee MRI examinations in daily practice and may also have the potential for using more precisely predicting prognosis and clinical outcome of the patients.

Tumor-like diseases of the knee joint; Tumoraehnliche Erkrankungen im Kniegelenk

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Freyschmidt, J. [Klinikum Bremen-Mitte, Beratungsstelle und Referenzzentrum fuer Osteoradiologie, Bremen (Germany)

2012-11-15

Radiological diagnostics of tumor-like lesions of the knee joint. Magnetic resonance imaging (MRI), computed tomography (CT) and X-ray imaging. Up to now there have been no studies regarding sensitivity and specificity of the various diagnostic tools (MRI, CT, X-ray) for the visualization of soft tissue tumors of the knee. The method of first choice for detecting soft tissue tumors and tumor-like lesions in the knee joint is MRI. (orig.) [German] Radiologische Diagnostik tumoraehnlicher Laesionen im Kniegelenk. Eingesetzte Verfahren sind die MRT, CT und Projektionsradiographie. Da es sich um Weichteiltumoren handelt, ist die MRT bei der Diagnostik dominierend. Sensitivitaet und Spezifitaet sind unserer Kenntnis nach bisher nicht untersucht worden. In manchen Faellen werden jedoch noch zusaetzliche Roentgen- oder CT-Bilder benoetigt. Bei Verdacht auf einen Tumor im Kniegelenk wird als erste Untersuchung eine MRT empfohlen. (orig.)

MRI as an accurate tool for the diagnosis and characterization of different knee joint meniscal injuries

Directory of Open Access Journals (Sweden)

Ayman F. Ahmed

2017-12-01

Conclusion: MRI of the knee will give the orthopedic surgeons ability to select suitable treatment and arthroscopic interference for their patients. MRI has high accuracy in meniscal tears diagnosis allowing accurate grading of them.

Use of dual-energy CT and virtual non-calcium techniques to evaluate post-traumatic bone bruises in knees in the subacute setting

International Nuclear Information System (INIS)

Ai, Songtao; Qu, Mingliang; Glazebrook, Katrina N.; Liu, Yu; Leng, Shuai; McCollough, Cynthia H.; Rhee, Peter C.

2014-01-01

The purpose of this study was to determine the ability of dual-energy computed tomography (DECT) and virtual non-calcium (VNCa) imaging to detect magnetic resonance imaging (MRI)-demonstrated bone bruises several weeks after unilateral knee injury. Patients with unilateral knee injury and MRI-confirmed bone bruises who had undergone a DECT scan of both knees were retrospectively identified. Two radiologists evaluated VNCa images for bruises in four regions per knee without knowing the MRI results. The mean CT numbers were calculated for the lesion-positive and lesion-negative regions of the injured knee, and the contralateral knee. Fourteen patients with a total of 36 regions positive for bone bruises on MRI were identified. The median delay between injury and DECT was 37 days (range, 11-99 days). The mean CT numbers in VNCa images for lesion-positive and lesion-negative regions were -7.6 ± 24.9 HU and -58.2 ± 19.5 HU, respectively. There were no significant differences in mean CT number between the lesion-negative regions in the injured knee and the contralateral knee. No resolution of bruising was seen before week 5, and bone bruising was still identifiable in one out of the two patients scanned at 10 weeks following injury. DECT and VNCa images can identify bone bruising for at least 10 weeks after injury. (orig.)

MR imaging of the knee

International Nuclear Information System (INIS)

Mink, J.H.

1987-01-01

There is increasing evidence that MR imaging of the knee can accurately evaluate the menisci and the cruciate and collateral ligaments with an accuracy equal to that of conventional anthrography. MR imaging can, as a simple test, definitively assess a wide spectrum of the causes of knee pain, including osteonecrosis/osteochondritis dissecans, chondral and bony fractures, abnormal plicae, and chondromalacia. The presentation focuses on the optimal imaging parameters that will ensure accuracy and maximize patient throughput. The etiology and significance of meniscal signal is discussed, and the criteria for an MR imaging-based diagnosis of meniscal tears, cruciate and collateral ligament and extensor mechanism abnormalities, osteonecrosis, and stress fractures are presented

[Guidelines for wise utilization of knee imaging].

Science.gov (United States)

Finestone, Aharon S; Eshed, Iris; Freedman, Yehuda; Beer, Yiftah; Bar-Sever, Zvi; Kots, Yavvgeni; Adar, Eliyahu; Mann, Gideon

2012-02-01

The knee is a complex structure afflicted with diverse pathologies. Correct management of knee complaints demands wise utilization of imaging modalities, considering their accuracy in the specific clinical situation, the patient's safety and availability and financial issues. Some of these considerations are universal, while others are local, depending on medical and insurance systems. There is controversy and unclearness regarding the best imaging modality in different clinical situations. To develop clinical guidelines for utilizing knee imaging. Leading physicians in specialties associated with knee disease and imaging were invited to participate in a panel on the guidelines. Controversies were settled in the main panel or in sub-panels. The panel agreed on the principles in choosing from the various modalities, primarily medical accuracy, followed by patient safety, availability and cost. There was agreement that the physician is responsible to choose the most appropriate diagnostic tool, consulting, when necessary, on the advantages, limitations and risks of the various imaging modalities. A comprehensive table was compiled with the importance of the different imaging modalities in various clinical situations. For the first time, Israeli guidelines on wise utilization of knee imaging are presented. They take into consideration the clinical situations and also availability and financial issues specific to Israel. These guidelines will serve physicians of several disciplines and medical insurers to improve patient management efficiently.

Imaging patellar complications after knee arthroplasty

International Nuclear Information System (INIS)

Melloni, Pietro; Valls, Rafael; Veintemillas, Maite

2008-01-01

The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious

Imaging patellar complications after knee arthroplasty

Energy Technology Data Exchange (ETDEWEB)

Melloni, Pietro [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)], E-mail: pmelloni@cspt.es; Valls, Rafael; Veintemillas, Maite [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

2008-03-15

The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious.

Scaphoid fracture: Bone marrow edema detected with dual-energy CT virtual non-calcium images and confirmed with MRI

Energy Technology Data Exchange (ETDEWEB)

Dareez, Nazeer M.; Engesland, Eirin; Lindland, Elisabeth S. [Department of Radiology, SSHF Arendal, Arendal (Norway); Dahlslett, Kristine H. [Haukelands Universitetssjukehus, Department of Radiology, Bergen (Norway)

2017-12-15

We aimed to determine whether bone marrow edema (BME) in acute traumatic scaphoid fracture could be demonstrated with dual-energy CT (DECT) using MRI as the gold standard. In recent years, virtual non-calcium (VNCa) images have been used to demonstrate BME in trauma cases, for example, in vertebral compression fractures, hip trauma to detect occult fractures and knee fractures. We present three cases of acute scaphoid trauma. Two patients had subtle or invisible fractures on x-ray and conventional CT images, while DECT VNCa images clearly visualized the BME, which was confirmed by MRI. One patient had negative findings on both VNCa and MRI images. The DECT VNCa algorithm is a promising technique to demonstrate BME in scaphoid fractures, with potential for increasing the diagnostic value of CT in this type of injury. (orig.)

Occupation-related squatting, kneeling, and heavy lifting and the knee joint: a magnetic resonance imaging-based study in men.

Science.gov (United States)

Amin, Shreyasee; Goggins, Joyce; Niu, Jingbo; Guermazi, Ali; Grigoryan, Mikayel; Hunter, David J; Genant, Harry K; Felson, David T

2008-08-01

We examined the relation between occupational exposures to frequent squatting/kneeling and/or heavy lifting with cartilage morphology, based on magnetic resonance imaging (MRI), at the tibiofemoral and patellofemoral joints in men and determined which compartments are most affected. We evaluated 192 men with symptomatic knee osteoarthritis (OA). The more symptomatic knee was imaged using MRI. Cartilage was scored using the Whole Organ MRI Score semiquantitative method at the medial and lateral tibiofemoral joint and patellofemoral joint. Occupational exposures to frequent squatting, kneeling, and/or heavy lifting were assessed using a validated questionnaire. Among the 192 men [mean (+/- standard deviation) age 69 +/- 9 yrs, body mass index (BMI) 30.8 +/- 4.7 kg/m(2)], those reporting occupational exposure to squatting/kneeling alone, heavy lifting alone, both squatting/kneeling and heavy lifting, or none of these activities numbered 7, 40, 47, and 98, respectively. Compared with men with no occupational exposure to these activities, and following adjustment for age, BMI, and history of knee injury or surgery, we found that men reporting occupational exposures to both squatting/kneeling and heavy lifting had a modest increased risk for worse cartilage morphology scores at the patellofemoral joint [odds ratio (OR) 1.8, 95% confidence interval (CI) 1.1 to 3.2] and medial tibiofemoral joint (OR 1.6, 95% CI 0.9, 3.0), although the latter did not reach statistical significance. Men with frequent occupational squatting/kneeling and heavy lifting have a greater likelihood for worse cartilage morphology scores at the patellofemoral joint. These findings add support to the important role of biomechanical loading on the pathogenesis of knee OA, particularly patellofemoral OA.

Quantitative Assessment of Degenerative Cartilage and Subchondral Bony Lesions in a Preserved Cadaveric Knee: Propagation-Based Phase-Contrast CT Versus Conventional MRI and CT.

Science.gov (United States)

Geith, Tobias; Brun, Emmanuel; Mittone, Alberto; Gasilov, Sergei; Weber, Loriane; Adam-Neumair, Silvia; Bravin, Alberto; Reiser, Maximilian; Coan, Paola; Horng, Annie

2018-04-09

The aim of this study was to quantitatively assess hyaline cartilage and subchondral bone conditions in a fully preserved cadaveric human knee joint using high-resolution x-ray propagation-based phase-contrast imaging (PBI) CT and to compare the performance of the new technique with conventional CT and MRI. A cadaveric human knee was examined using an x-ray beam of 60 keV, a detector with a 90-mm 2 FOV, and a pixel size of 46 × 46 μm 2 . PBI CT images were reconstructed with both the filtered back projection algorithm and the equally sloped tomography method. Conventional 3-T MRI and CT were also performed. Measurements of cartilage thickness, cartilage lesions, International Cartilage Repair Society scoring, and detection of subchondral bone changes were evaluated. Visual inspection of the specimen akin to arthroscopy was conducted and served as a standard of reference for lesion detection. Loss of cartilage height was visible on PBI CT and MRI. Quantification of cartilage thickness showed a strong correlation between the two modalities. Cartilage lesions appeared darker than the adjacent cartilage on PBI CT. PBI CT showed similar agreement to MRI for depicting cartilage substance defects or lesions compared with the visual inspection. The assessment of subchondral bone cysts showed moderate to strong agreement between PBI CT and CT. In contrast to the standard clinical methods of MRI and CT, PBI CT is able to simultaneously depict cartilage and bony changes at high resolution. Though still an experimental technique, PBI CT is a promising high-resolution imaging method to evaluate comprehensive changes of osteoarthritic disease in a clinical setting.

Quantitative magnetic resonance imaging as marker of synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy: a one year follow up study

DEFF Research Database (Denmark)

Østergaard, Mikkel; Ejbjerg, B; Stoltenberg, M

2001-01-01

OBJECTIVES: By repeated magnetic resonance imaging (MRI) to study synovial membrane regeneration and recurrence of synovitis after arthroscopic knee joint synovectomy in patients with rheumatoid arthritis (RA) and other (non-RA) causes of persistent knee joint synovitis. METHODS: Contrast enhanced...... at two months. No significant differences between volumes in RA and non-RA knees were seen. Synovial membrane volumes at two months were significantly inversely correlated with the duration of clinical remission, for all knees considered together (Spearman's correlation r(s)=-0.67; p

Association of MRI findings and expert diagnosis of symptomatic meniscal tear among middle-aged and older adults with knee pain.

Science.gov (United States)

Deshpande, Bhushan R; Losina, Elena; Smith, Savannah R; Martin, Scott D; Wright, R John; Katz, Jeffrey N

2016-04-11

Our aim was to examine the association between an expert clinician's impression of symptomatic meniscal tears and subsequent MRI in the context of middle-aged and older adults with knee pain. Patients older than 45 were eligible for this IRB-approved substudy if they had knee pain, had not undergone MRI and saw one of two orthopaedic surgeons experienced in the diagnosis of meniscal tear. The surgeon rated their confidence that the patient's symptoms were due to meniscal tear. The patient subsequently had a 1.5 or 3.0 T MRI within 6 months. We examined the association between presence of meniscal tear on MRI and the surgeon's confidence that the knee pain was due to meniscal tear using a χ(2) test for trend. Of 84 eligible patients, 63% were female, with a mean age of 64 years and a mean BMI of 27. The surgeon was confident that symptoms emanated from a tear among 39%. The prevalence of meniscal tear on MRI overall was 74%. Among subjects whose surgeon indicated high confidence that symptoms were due to meniscal tear, the prevalence was 80% (95% CI 63-90%). Similarly, the prevalence was 87% (95% CI 62-96%) among those whose surgeon had medium confidence and 64% (95% CI 48-77%) among those whose surgeon had low confidence (p = 0.12). Meniscal tears were frequently found on MRI even when an expert clinician was confident that a patient's knee symptoms were not due to a meniscal tear, indicating that providers should use MRI sparingly and cautiously to confirm or rule out the attribution of knee pain to meniscal tear.

Diagnostic value of MRI in meniscus injury. Comparison of MRI and arthrography

International Nuclear Information System (INIS)

Iso, Yoshinori; Nozaki, Hiroyuki; Emoto, Mari; Miyairi, Taro; Hirata, Aya; Hirasawa, Seiichi; Suguro, Toru; Igata, Atsuomi; Kudo, Yukihiko.

1995-01-01

Magnetic resonance imaging (MRI) and arthrography were performed on 90 knees to compare the diagnostic value for meniscus injury with these techniques. The diagnostic accuracy of MRI and arthrography was 89.1% and 87.1%, respectively. Imaging of the medial meniscus was somewhat better with arthrography, and delineation of the lateral meniscus was somewhat better with MRI. MRI was superior in diagnoses of horizontal and degenerative lacerations, but showed the shape of the injuries less clearly than arthrography. The diagnostic accuracy of MRI decreased with the age of the patients and was inferior to arthrography for patients in their forties or older. In conclusion, MRI is a less invasive approach with high diagnostic accuracy for meniscus injury and is a promising substitute for arthrography. (author)

MR imaging of the flexed knee: comparison to the extended knee in delineation of meniscal lesions

International Nuclear Information System (INIS)

Niitsu, M.; Itai, Y.; Endo, H.; Ikeda, K.

2000-01-01

The aim of this study was to obtain MR images in the flexed-knee position and to compare the diagnostic value to the extended position in delineation of the menisci. With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semi-flexed position (average 45 of flexion) within a 1.5-T superconducting magnet. Sets of sagittal MR images were obtained for both the extended- and flexed-knee positions. Using the arthroscopic results as gold standards, 97 menisci were evaluated. Two observers interpreted each MR image of the extended and flexed positions independently without knowledge of the arthroscopic results. Flexed-knee MR images revealed 22 of the 27 arthroscopically proven torn menisci and 69 of the 70 intact menisci, for a sensitivity of 81.5 %, a specificity of 98.6 %, and an accuracy of 93.8 %. Extended-knee MR images indicated a sensitivity of 81.5 %, a specificity of 92.9 %, and an accuracy of 89.7 %. No statistically significant difference was found between the two positions. To enhance MR visualization of all the knee components, we recommend examining the knee in a flexed position within the magnet. (orig.)

MR imaging of the flexed knee: comparison to the extended knee in delineation of meniscal lesions

Energy Technology Data Exchange (ETDEWEB)

Niitsu, M.; Itai, Y. [Dept. of Radiology, Institute of Clinical Medicine, University of Tsukuba Tennodai, Tsukuba, Ibaraki (Japan); Endo, H. [Tsukuba Medical Center Hospital, Ibaraki (Japan); Ikeda, K. [Dept. of Orthopedic Surgery, University of Tsukuba Tennodai, Tsukuba (Japan)

2000-11-01

The aim of this study was to obtain MR images in the flexed-knee position and to compare the diagnostic value to the extended position in delineation of the menisci. With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semi-flexed position (average 45 of flexion) within a 1.5-T superconducting magnet. Sets of sagittal MR images were obtained for both the extended- and flexed-knee positions. Using the arthroscopic results as gold standards, 97 menisci were evaluated. Two observers interpreted each MR image of the extended and flexed positions independently without knowledge of the arthroscopic results. Flexed-knee MR images revealed 22 of the 27 arthroscopically proven torn menisci and 69 of the 70 intact menisci, for a sensitivity of 81.5 %, a specificity of 98.6 %, and an accuracy of 93.8 %. Extended-knee MR images indicated a sensitivity of 81.5 %, a specificity of 92.9 %, and an accuracy of 89.7 %. No statistically significant difference was found between the two positions. To enhance MR visualization of all the knee components, we recommend examining the knee in a flexed position within the magnet. (orig.)

MR imaging of the knee joint plain, after intraarticular administration of gadolinium DTPA, common salt and air

International Nuclear Information System (INIS)

Baum, H.; Kuehnert, A.; Sundermeyer, R.

1987-01-01

Noninvasive MRI of the knee joint yields a great deal of information on soft parts (ligaments, capsule, free fluid, menisci, cartilage) and bones. The image is changed by intraarticular administration of air and of small quantities of fluids that supply many signals, such as gadolinium DTPA solution. The results and possibilities of application are discussed. (orig.) [de

Magnetic Resonance Imaging (MRI) -- Head

Science.gov (United States)

... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

Magnetic Resonance Imaging (MRI) -- Head

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Full Text Available ... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) - Head Magnetic resonance imaging (MRI) of the head uses a powerful ... the Head? What is MRI of the Head? Magnetic resonance imaging (MRI) is a noninvasive medical test that ...

Using Cartilage MRI T2-Mapping to Analyze Early Cartilage Degeneration in the Knee Joint of Young Professional Soccer Players.

Science.gov (United States)

Waldenmeier, Leonie; Evers, Christoph; Uder, Michael; Janka, Rolf; Hennig, Frank Friedrich; Pachowsky, Milena Liese; Welsch, Götz Hannes

2018-02-01

Objective To evaluate and characterize the appearance of articular cartilage in the tibiofemoral joint of young professional soccer players using T2-relaxation time evaluation on magnetic resonance imaging (MRI). Design In this study, we included 57 male adolescents from the youth academy of a professional soccer team. The MRI scans were acquired of the knee joint of the supporting leg. An "early unloading" (minute 0) and "late unloading" (minute 28) T2-sequence was included in the set of images. Quantitative T2-analysis was performed in the femorotibial joint cartilage in 4 slices with each 10 regions of interest (ROIs). Statistical evaluation, using Wilcoxon signed-rank tests, was primarily performed to compare the T2 values of the "early unloading" and "late unloading." Results When comparing "early unloading" with "late unloading," our findings showed a significant increase of T2-relaxation times in the weightbearing femoral cartilage of the medial ( P cartilage of the medial compartment ( P cartilage were found with a maximum in the medial condyle where the biomechanical load of the knee joint is highest, as well as where most of the chronic cartilage lesions occur. To avoid chronic damage, special focus should be laid on this region.

MRI follow-up of conservatively treated meniscal knee lesions in general practice

NARCIS (Netherlands)

E.H.G. Oei (Edwin); I.M. Koster (Ingrid); J.H.J. Hensen; S.S. Boks (Simone); H.P.A. Wagemakers (Harry); B.W. Koes (Bart); D. Vroegindeweij (Dammis); S.M. Bierma-Zeinstra (Sita); M.G.M. Hunink (Myriam)

2010-01-01

textabstractObjective: To evaluate meniscal status change on follow-up MRI after 1 year, prognostic factors and association with clinical outcome in patients with conservatively treated knee injury. Methods: We analysed 403 meniscal horns in 101 conservatively treated patients (59 male; mean age 40

Iron deposits in the knee joints of a thalassemic patient

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Charalambos P Economides

2013-02-01

Full Text Available The overall prognosis for patients with ß-thalassemia has improved considerably during the past decades mainly due to regular blood transfusions, improvements in chelation therapy, and enhanced surveillance with imaging studies examining iron overload and other clinical complications. However, the prolonged survival of these patients leads to the development of other health problems including degenerative diseases such as arthropathies, which require further attention since they have a significant impact on the quality of life. In the current case report, we present a 45-year-old white man with ß-thalassemia complaining of non-traumatic pain and restriction in the range of motion of both knees. Magnetic resonance imaging (MRI revealed a tear in the medial meniscus of the left knee as well as iron deposits in both knees. Histological findings confirmed the presence of hemosiderin in both joints. To our knowledge, this is the first reported case of macroscopically documented iron deposits in the knee joints of a patient with ß-thalassemia using MRI.

Magnetic resonance imaging of meniscal and anterior cruciate ligament injuries of the knee

International Nuclear Information System (INIS)

Kreitner, K.F.; Herrig, A.; Grebe, P.; Runkel, M.; Regentrop, H.J.

1998-01-01

To categorise discrepancies in findings of the menisci and anterior cruciate ligament (ACL) between arthroscopy and MRI. Materials and methods: The MRIs of 236 patients were retrospectively analysed by an experienced radiologist without knowledge of clinical and/for operative findings. Discrepancies in arthroscopic findings were reevaluated together with the arthroscopist to determine their cause of error. Results: The diagnostic accuracies for injuries of the medial and lateral meniscus and the ACL were 92.4%, 92.4%, and 94.1%. respectively. For the menisci, causes for discrepancies in findings (n=31) were: overinterpretation of central signal intensities with contact to the meniscal surface but without disturbance of the meniscal contour as a tear (n=12), insufficient arthroscopie evaluation of the knee joint (n=11), overlooked tears on MR imaging (n=6), misinterpretation of normal anatomic structures (n=1), ''magic angle'' phenomenon (n=1), and missed tears at MRI (n=1). Causes for discrepancies for the ACL (n=18) were: nearly complete versus complete rupture either at MRI or arthroscopy and vice versa (n=9), insufficient arthroscopic evaluation (n=6), insufficient MRI technique (n=2), and overlooked tear on MR imaging (n=1). Conclusions: Discrepant findings between MRI and arthroscopy may be also due to an insufficient arthroscopic evaluation in clinical routine. The close cooperation between surgeons and radiologists improves the understanding of the methods of each other. (orig.) [de

A study on MR images of the articular cartilage in medial-type osteoarthritis of the knee

International Nuclear Information System (INIS)

Miyazaki, Hiroyuki; Ishii, Yoshiaki; Hayashi, Mitsutoshi; Kotani, Akihiro

2001-01-01

Changes in the articular cartilage of 88 knees of 73 cases (age range 40-78) diagnosed clinically and radiologically as OA (osteoarthritis) were studied by obtaining fat-suppressed MR images of the knee. On 27 knees out of the 88, moreover, macroscopic observation was performed to make a comparative study between the directly-observed findings and MR findings. Fat-suppressed MR images were obtained sagittally by 3D-FLASH (fast low angle shot) sequence. The examined regions consisted of the following 4 sites; the medial condyle of the femur, its lateral condyle, the medial condyle of the tibia, and its lateral condyle. The revealed conditions of the cartilage were morphologically classified into 4 Stages. The evidence of cartilage defect on MR images was most frequently found at the medial condyle of the femur, with the medial condyle of the tibia, the lateral condyle of the femur, and the lateral condyle of the tibia following in a less frequent order. Fat-suppressed MRI's sensitivity to cartilage defect against macroscopy was 94.5%, specificity 95.4%, and accuracy 95.2%. MR imaging using fat-suppression can reveal cartilaginous degeneration and defect so well that this technique provides an important indication for selecting a proper method of treatment. (author)

Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

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Rennie, W.J. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom); University College London, Institute of Orthopaedics and Musculoskeletal Sciences (United Kingdom)

2005-07-01

To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

Pes anserine bursitis: incidence in symptomatic knees and clinical presentation

International Nuclear Information System (INIS)

Rennie, W.J.; Saifuddin, A.

2005-01-01

To determine the prevalence and associated clinical symptoms of pes anserine bursitis in symptomatic adult knees. A retrospective review was performed of the reports of 509 knee MRI studies obtained from July 1998 to June 2004 on 488 patients presenting to an orthopaedic clinic with knee pain suspected to be due to internal derangement. The MRI studies and case histories of all patients reported to have pes anserine bursitis were reviewed. The management of these patients was also noted. The prevalence of pes anserine bursitis as detected on MRI is 2.5%. The commonest clinical presentation was pain along the medial joint line mimicking a medial meniscal tear. We suggest that an accurate diagnosis of pes anserine bursitis on MRI will help prevent unnecessary arthroscopy and possibly initiate early treatment of the condition. Axial imaging is important in these cases to differentiate the bursa from other medial fluid collections. (orig.)

Magnetic resonance findings in knee dislocation: pictorial essay

International Nuclear Information System (INIS)

Coates, M.; Stewart, N.; Morganti, V.; Twaddle, B.

2000-01-01

The role of MRI in the preoperative assessment of knee dislocation is well documented. e present our experience with a series of images graphically displaying the spectrum of abnormalities associated with these injuries. These images were derived from a local internal audit reviewing the preoperative MRI and correlating this with the surgical findings. Twenty-two cases between April 1997 and April 1999 were reviewed. Traumatic dislocation of the knee is rare, although many believe it is often unrecognized because of spontaneous reduction.' The injury may present as (i) frank dislocation; (ii) a knee that is dislocated while under anaesthesia; or (iii) a pattern of soft-tissue injury which suggests dislocation. Dislocation is described by the position of the tibia relative to the femur and may be anterior, posterior, lateral, medial or rotatory. Conservative management has traditionally been advocated and in this setting clinical examination and plain radiographs are adequate. Because of the trend toward increased surgical intervention, however, the more accurate characterization of soft-tissue injuries provided by MRI aids the planning of ligamentous reconstruction and the operative approach. Copyright (1999) Blackwell Science Pty Ltd

Magnetic Resonance Imaging (MRI) Safety

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... News Physician Resources Professions Site Index A-Z Magnetic Resonance Imaging (MRI) Safety What is MRI and how ... What is MRI and how does it work? Magnetic resonance imaging, or MRI, is a way of obtaining ...

Magnetic resonance imaging of the femoral trochlea: evaluation of anatomical landmarks and grading articular cartilage in cadaveric knees

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Muhle, Claus [Marienhospital Vechta, Department of Radiology, Vechta (Germany); Veterans Affairs Medical Center, Department of Radiology, San Diego, CA (United States); Mo Ahn, Joong [University of Iowa, Department of Radiology, Iowa, IA (United States); Trudell, Debra; Resnick, Donald [Veterans Affairs Medical Center, Department of Radiology, San Diego, CA (United States)

2008-06-15

The purpose of the study was to define magnetic resonance imaging (MRI) findings before and after contrast medium opacification of the knee joint in cadaveric specimens to demonstrate anatomical landmarks of the trochlear surface in relation to the neighboring structures, and to evaluate different MRI sequences in the detection of cartilage defects of the trochlear and patellar surface of the knee. The morphology and relationship of the proximal trochlear surface to the prefemoral fat of the distal femur were investigated by use of different MR sequences before and after intra-articular gadolinium administration into the knee joint in ten cadaveric knees. Anatomic sections were subsequently obtained. In addition, evaluation of the articular surface of the trochlea was performed by two independent observers. The cartilage surfaces were graded using a 2-point system, and results were compared with macroscopic findings. Of 40 cartilage surfaces evaluated, histopathologic findings showed 9 normal surfaces, 20 containing partial-thickness defects, and 11 containing full-thickness defects. Compared with macroscopic data, sensitivity of MR sequences for the two reviewers was between 17 and 90%; specificity, 75 and 100%; positive predictive value, 75 and 100%; negative predictive value, 20 and 100%, depending on patellar or trochlea lesions. Interobserver variability for the presence of disease, which was measured using the kappa statistic, was dependent on the MR sequence used between 0.243 and 0.851. Magnetic resonance imaging sequences can be used to evaluate the cartilage of the trochlear surface with less accuracy when compared with the results of grading the articular cartilage of the patella. (orig.)

MRI findings in renal transplant recipients with hip and knee pain

Energy Technology Data Exchange (ETDEWEB)

Donmez, Fuldem Yildirim [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: fuldemyildirim@yahoo.com; Basaran, Ceyla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: ceylab@baskent-ank.edu.tr; Ulu, Esra Meltem Kayahan [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: emkayahanulu@yahoo.com; Uyusur, Arzu [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: arzuuyusur@yahoo.com; Tarhan, Nefise Cagla [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: caglat@baskent-ank.edu.tr; Muhtesem Agildere, A. [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Caddesi 10. sokak no: 45, Bahcelievler 06490, Ankara (Turkey)], E-mail: amuhtesem@superonline.com

2009-09-15

Purpose: To evaluate and demonstrate the MRI findings of renal transplant recipients with hip and knee pain and to investigate the most common etiology of pain. Materials and methods: 69 hip MRIs of 57 patients with hip pain and 30 knee MRIs of 24 patients with knee pain with no history of trauma were retrospectively evaluated by two radiologists. Results: In the evaluation of hip MRIs, 24 patients had avascular necrosis and effusion, 2 patients had bone marrow edema consistent with early stage of avascular necrosis. 18 patients had only intraarticular effusion, 6 patients had tendinitis, 6 patients had bursitis and 1 patient had soft tissue abscess. Five patients had muscle edema and five patients had muscle atrophy as additional findings to the primary pathologies. Among patients with knee pain, nine patients had degenerative joint disease. Seven patients had chondromalacia, five had bone marrow edema, six had meniscal tear, six had ligament rupture and two had bone infarct. Three of the patients had muscle edema accompanying to other pathologies. Conclusion: The most common etiology of hip pain in renal transplant recipients is avascular necrosis as expected, intraarticular effusion is found to be Second reason for pain. However, knee pain is explained by ligament pathology, meniscal tear, chondromalacia or degenerative joint disease rather than osteonecrosis.

MRI findings in renal transplant recipients with hip and knee pain

International Nuclear Information System (INIS)

Donmez, Fuldem Yildirim; Basaran, Ceyla; Ulu, Esra Meltem Kayahan; Uyusur, Arzu; Tarhan, Nefise Cagla; Muhtesem Agildere, A.

2009-01-01

Purpose: To evaluate and demonstrate the MRI findings of renal transplant recipients with hip and knee pain and to investigate the most common etiology of pain. Materials and methods: 69 hip MRIs of 57 patients with hip pain and 30 knee MRIs of 24 patients with knee pain with no history of trauma were retrospectively evaluated by two radiologists. Results: In the evaluation of hip MRIs, 24 patients had avascular necrosis and effusion, 2 patients had bone marrow edema consistent with early stage of avascular necrosis. 18 patients had only intraarticular effusion, 6 patients had tendinitis, 6 patients had bursitis and 1 patient had soft tissue abscess. Five patients had muscle edema and five patients had muscle atrophy as additional findings to the primary pathologies. Among patients with knee pain, nine patients had degenerative joint disease. Seven patients had chondromalacia, five had bone marrow edema, six had meniscal tear, six had ligament rupture and two had bone infarct. Three of the patients had muscle edema accompanying to other pathologies. Conclusion: The most common etiology of hip pain in renal transplant recipients is avascular necrosis as expected, intraarticular effusion is found to be Second reason for pain. However, knee pain is explained by ligament pathology, meniscal tear, chondromalacia or degenerative joint disease rather than osteonecrosis.

Middle-aged patients with an MRI-verified medial meniscal tear report symptoms commonly associated with knee osteoarthritis

DEFF Research Database (Denmark)

Hare, Kristoffer B.; Stefan Lohmander, L.; Kise, Nina Jullum

2017-01-01

Background and purpose — No consensus exists on when to perform arthroscopic partial meniscectomy in patients with a degenerative meniscal tear. Since MRI and clinical tests are not accurate in detecting a symptomatic meniscal lesion, the patient’s symptoms often play a large role when deciding...... when to perform surgery. We determined the prevalence and severity of self-reported knee symptoms in patients eligible for arthroscopic partial meniscectomy due to a degenerative meniscal tear. We investigated whether symptoms commonly considered to be related to meniscus injury were associated...... with early radiographic signs of knee osteoarthritis. Patients and methods — We included individual baseline items from the Knee injury and Osteoarthritis Outcome Score collected in 2 randomized controlled trials evaluating treatment for an MRI-verified degenerative medial meniscal tears in 199 patients aged...

Anatomy of the distal knee joint and pyarthrosis following external fixation.

Science.gov (United States)

Hyman, J; Moore, T

1999-05-01

To determine the limits of the distal synovial reflection of the human knee joint. Six paired knees studied by magnetic resonance imaging (MRI), fluoroscopic arthrography, and gross dissection. The right knees of five patients with chronic idiopathic knee effusions were studied by MRI. Cadaveric knees were injected with saline prior to MRI. The joint capsules were dissected to visualize local anatomy and check for capsular tears. In each modality (MRI, fluoroscopy, and dissection), the most distal extent of knee synovial fluid was measured. The right versus left agreement for paired specimens was generally two to three millimeters. Some specimens showed asymmetric capsular reflection. Medial fluid was identified at distances greater than forty-nine millimeters from the subchondral bone in seven knees and less than fifteen millimeters in four knees (range 0 to 70 millimeters, mean thirty-three millimeters). Laterally, the range was ten to thirty-five millimeters (mean twenty-three millimeters). In six of the twelve cadaveric specimens, there was evidence of a communication between the knee joint and the proximal tibiofibularjoint. In the knees of volunteers, joint fluid tracked medially to a range of ten to fifty millimeters and laterally to a range of six to fifteen millimeters, with means of twenty-six and eleven millimeters, respectively. The knees of the volunteers had no evidence of tibiofibular joint communication with the knee. Insertion of external fixation pins within sixty to seventy millimeters of the proximal articular surface of the tibia is associated with a high probability of synovial penetration and possibly provides a conduit for the introduction of bacteria, which may be etiologic in iatrogenic pyarthrosis.

Clinical and MRI outcome of an osteochondral scaffold plug for the treatment of cartilage lesions in the knee.

Science.gov (United States)

Dhollander, Aad; Verdonk, Peter; Almqvist, Karl Fredrik; Verdonk, Rene; Victor, Jan

2015-12-01

Conflicting clinical outcomes have been reported recently with the use of an osteochondral scaffold plugs for cartilage repair in the knee. In this study, twenty patients were consecutively treated for their cartilage lesions with the synthetic plug technique. These patients were prospectively clinically evaluated with a mean follow-up of 34.15 months. Magnetic resonance imaging (MRI) was used for morphologic analysis of the cartilage repair. The patients included in this study showed a significant gradual clinical improvement after the osteochondral scaffold plug. However, this clinical improvement was not confirmed by the MRI findings of this cohort study. Subchondral bone changes were seen in all patients on MRI and deficient filling of the defect was noticed in in 30.7% of the cases at 24 months of follow-up. There was no evidence found to support osteoconductive bone ingrowth. Therefore, the use of this type of osteochondral scaffold plug in osteochondral repair is questionable. Level of evidence: IV.

The Evaluation of Changes in The Knee Meniscus in vivo at 3T MRI Scanner

Directory of Open Access Journals (Sweden)

Lenka Horňáková

2015-08-01

Full Text Available Noninvasive imagining of the knee meniscus without the use of the contrast agents is more difficult compared to articular cartilage. Despite the lower signal intensity of the knee meniscus, MRI is considered the best non-invasive imaging method. Thanks to the lower water content in the meniscus compared to the surrounding tissues, it can be distinguished from the environment, but the determination of the boundaries is more complicated than in articular cartilage. There are many studies dealing with the MR imaging of the loaded and also unloaded knee, but they have mainly observed quantitative and geometric changes (movement or deformation of tissue, not targeted qualitative changes in the extracellular matrix (ECM. These changes can be evaluated with T2 relaxation times, which are more sensitive to the interaction of water molecules and the concentration of macromolecules and structures of the ECM, especially in the interaction based on the content, orientation and anisotropy of collagen fibers. Fluid and tissues with the higher water content level have long relaxation time T2. In the healthy meniscus these times are shorter; the reason is a highly organized structure of collagen and lower content of proteoglycans. To quantitatively detect changes, it is necessary to assure a sufficiently high resolution of images throughout choosing appropriate pulse sequences. After that, the acquired data can be processed to produce the T2 maps, to portray non-invasive collagen content, architecture of the ROI, changes in the water content (distribution of interstitial water in the solid matrix and the spatial variation in depth. The aim of this work is firstly to introduce the meaning of T2 relaxation and methods for calculating T2 relaxation times. Further, the aim of this work is to give a brief description of the current pulse sequences used to display menisci.

PET/MRI of metabolic activity in osteoarthritis: A feasibility study.

Science.gov (United States)

Kogan, Feliks; Fan, Audrey P; McWalter, Emily J; Oei, Edwin H G; Quon, Andrew; Gold, Garry E

2017-06-01

To evaluate positron emission tomography / magnetic resonance imaging (PET/MRI) knee imaging to detect and characterize osseous metabolic abnormalities and correlate PET radiotracer uptake with osseous abnormalities and cartilage degeneration observed on MRI. Both knees of 22 subjects with knee pain or injury were scanned at one timepoint, without gadolinium, on a hybrid 3.0T PET-MRI system following injection of 18 F-fluoride or 18 F-fluorodeoxyglucose (FDG). A musculoskeletal radiologist identified volumes of interest (VOIs) around bone abnormalities on MR images and scored bone marrow lesions (BMLs) and osteophytes using a MOAKS scoring system. Cartilage appearance adjacent to bone abnormalities was graded with MRI-modified Outerbridge classifications. On PET standardized uptake values (SUV) maps, VOIs with SUV greater than 5 times the SUV in normal-appearing bone were identified as high-uptake VOI (VOI High ). Differences in 18 F-fluoride uptake between bone abnormalities, BML, and osteophyte grades and adjacent cartilage grades on MRI were identified using Mann-Whitney U-tests. SUV max in all subchondral bone lesions (BML, osteophytes, sclerosis) was significantly higher than that of normal-appearing bone on MRI (P subchondral bone on MRI. Furthermore, many small grade 1 osteophytes (40 of 82 [49%]), often described as the earliest signs of osteoarthritis (OA), did not show high uptake. Lastly, PET SUV max in subchondral bone adjacent to grade 0 cartilage was significantly lower compared to that of grades 1-2 (P subchondral bone, which appear normal on MRI. 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;45:1736-1745. © 2016 International Society for Magnetic Resonance in Medicine.

Chronic medial knee pain without history of prior trauma: correlation of pain at rest and during exercise using bone scintigraphy and MR imaging

International Nuclear Information System (INIS)

Buck, Florian M.; Hoffmann, Alexander; Hofer, Bernhard; Allgayer, Bernhard; Pfirrmann, Christian W.A.

2009-01-01

The objective of this study was to correlate chronic medial knee pain at rest and during exercise with bone scintigraphic uptake, bone marrow edema pattern (BMEP), cartilage lesions, meniscal tears, and collateral ligament pathologies on magnetic resonance MR imaging (MRI). Fifty consecutive patients with chronic medial knee pain seen at our institute were included in our study. Pain level at rest and during exercise was assessed using a visual analog scale (VAS). On MR images, BMEP volume was measured, and the integrity of femoro-tibial cartilage, medial meniscus, and medial collateral ligament (MCL) were assessed. Semiquantitative scintigraphic tracer uptake was measured. Multivariate linear regression analysis was performed. At the day of examination, 40 patients reported medial knee pain at rest, 49 when climbing stairs (at rest mean VAS 33 mm, range 0-80 mm; climbing stairs mean VAS, 60 mm, range 20-100 mm). Bone scintigraphy showed increased tracer uptake in 36 patients (uptake factor, average 3.7, range 2.4-18.0). MRI showed BMEP in 31 studies (mean volume, 4,070 mm 3 ; range, 1,200-39,200 mm 3 ). All patients with BMEP had abnormal bone scintigraphy. Ten percent of patients with pain at rest and 8% of patients with pain during exercise showed no BMEP but tracer uptake in scintigraphy. Tracer uptake and signal change around MCL predicted pain at rest significantly (tracer uptake p=0.004; MCL signal changes p=0.002). Only MCL signal changes predicted pain during exercise significantly (p=0.001). In chronic medial knee pain, increased tracer uptake in bone scintigraphy is more sensitive for medial knee pain than BMEP on MRI. Pain levels at rest and during exercise correlate with signal changes in and around the MCL. (orig.)

Cine MR imaging of internal derangements of the knee

International Nuclear Information System (INIS)

Niitsu, M.; Anno, I.; Ishikawa, N.; Akisada, M.; Fukubayashi, T.

1990-01-01

This paper assesses internal derangements of the knee joint by a new method of cine MR imaging. Cine MR imaging, involving cine acquisition of kinematic sagittal images during knee movement, was used to evaluate 51 symptomatic patients and 19 healthy subjects. Cine MR images of cruciate ligament fears showed disappearance of low-intensity bundles during knee movement, periodic appearance of joint fluid in the area of the ligament, and irregular tibial movement. Cine MR images of meniscal tears showed independent movement of meniscal fragments and periodic tear opening and closing. Twenty-seven of the 28 anterior cruciate ligament (ACL) tears confirmed arthroscopically were correctly identified with cine MR imaging, with a sensitivity of 96% and a specificity of 92%

Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects - a 3.0 T magnetic resonance imaging study

International Nuclear Information System (INIS)

Stahl, Robert; Luke, Anthony; Ma, C.B.; Krug, Roland; Steinbach, Lynne; Majumdar, Sharmila; Link, Thomas M.

2008-01-01

To determine the prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects. To compare the diagnostic performance of cartilage-dedicated magnetic resonance imaging (MRI) sequences at 3.0 T. Ten marathon runners underwent 3.0 T MRI 2-3 days before and after competition. Twelve physically active asymptomatic subjects not performing long-distance running were examined as controls. Pathologic condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were quantified. Visualization of cartilage pathology was assessed with intermediate-weighted fast spin-echo (IM-w FSE), fast imaging employing steady-state acquisition (FIESTA) and T1-weighted three-dimensional (3D) high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) MRI sequences. Eight of ten marathon runners and 7/12 controls showed knee abnormality. Slightly more and larger cartilage abnormalities, and BMEP, in marathon runners yielded higher but not significantly different WORMS (P > 0.05) than in controls. Running a single marathon did not alter MR findings substantially. Cartilage abnormalities were best visualized with IM-w FSE images (P < 0.05). A high prevalence of knee abnormalities was found in marathon runners and also in active subjects participating in other recreational sports. IM-w FSE sequences delineated more cartilage MR imaging abnormalities than did FIESTA and SPGR sequences. (orig.)

Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects - a 3.0 T magnetic resonance imaging study

Energy Technology Data Exchange (ETDEWEB)

Stahl, Robert [University of California, San Francisco, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States); Ludwig Maximilians University of Munich, Department of Clinical Radiology, University Hospitals-Campus Grosshadern, Munich (Germany); Luke, Anthony [University of California, San Francisco, Department of Orthopedic Surgery, San Francisco, CA (United States); University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA (United States); Ma, C.B. [University of California, San Francisco, Department of Orthopedic Surgery, San Francisco, CA (United States); Krug, Roland; Steinbach, Lynne; Majumdar, Sharmila; Link, Thomas M. [University of California, San Francisco, Musculoskeletal and Quantitative Imaging Group, Department of Radiology, San Francisco, CA (United States)

2008-07-15

To determine the prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects. To compare the diagnostic performance of cartilage-dedicated magnetic resonance imaging (MRI) sequences at 3.0 T. Ten marathon runners underwent 3.0 T MRI 2-3 days before and after competition. Twelve physically active asymptomatic subjects not performing long-distance running were examined as controls. Pathologic condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were quantified. Visualization of cartilage pathology was assessed with intermediate-weighted fast spin-echo (IM-w FSE), fast imaging employing steady-state acquisition (FIESTA) and T1-weighted three-dimensional (3D) high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) MRI sequences. Eight of ten marathon runners and 7/12 controls showed knee abnormality. Slightly more and larger cartilage abnormalities, and BMEP, in marathon runners yielded higher but not significantly different WORMS (P > 0.05) than in controls. Running a single marathon did not alter MR findings substantially. Cartilage abnormalities were best visualized with IM-w FSE images (P < 0.05). A high prevalence of knee abnormalities was found in marathon runners and also in active subjects participating in other recreational sports. IM-w FSE sequences delineated more cartilage MR imaging abnormalities than did FIESTA and SPGR sequences. (orig.)

Incidence of chronic knee lesions in long-distance runners based on training level: Findings at MRI

International Nuclear Information System (INIS)

Schueller-Weidekamm, Claudia; Schueller, Gerd; Uffmann, Martin; Bader, Till

2006-01-01

Purpose: The purpose of this study was to evaluate the incidence of chronic knee changes in long-distance runners based on the training status, including distance, running frequency, training pace, and running experience. Methods: MRI of the knee was performed in 26 non-professional runners 5 days after their last training unit. Lesions of the menisci and cartilage (5-point scale), bone marrow and ligaments (3-point scale), and joint effusion were evaluated. A total score comprising all knee lesions in each runner was evaluated. The incidence of the knee changes was correlated with the training level, gender, and age of the runners. Results: Grade 1 lesions of the menisci were found in six runners with a high training level, and in only four runners with a low training level. Grade 1 cartilage lesions were found in three high-trained runners and in one low-trained runner, and grade 2 lesions were found in one high-trained runner and in two low-trained runners, respectively. Grade 1 anterior cruciate ligament lesions were seen in three runners with a high- and in two runners with a low-training level. Runners with a higher training level showed a statistically significant higher score for all chronic knee lesions than those with a lower training level (p < 0.05). Conclusions: MRI findings indicate that a higher training level in long-distance runners is a risk factor for chronic knee lesions

Incidence of chronic knee lesions in long-distance runners based on training level: Findings at MRI

Energy Technology Data Exchange (ETDEWEB)

Schueller-Weidekamm, Claudia [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: claudia.schueller-weidekamm@meduniwien.ac.at; Schueller, Gerd [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Uffmann, Martin [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Bader, Till [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

2006-05-15

Purpose: The purpose of this study was to evaluate the incidence of chronic knee changes in long-distance runners based on the training status, including distance, running frequency, training pace, and running experience. Methods: MRI of the knee was performed in 26 non-professional runners 5 days after their last training unit. Lesions of the menisci and cartilage (5-point scale), bone marrow and ligaments (3-point scale), and joint effusion were evaluated. A total score comprising all knee lesions in each runner was evaluated. The incidence of the knee changes was correlated with the training level, gender, and age of the runners. Results: Grade 1 lesions of the menisci were found in six runners with a high training level, and in only four runners with a low training level. Grade 1 cartilage lesions were found in three high-trained runners and in one low-trained runner, and grade 2 lesions were found in one high-trained runner and in two low-trained runners, respectively. Grade 1 anterior cruciate ligament lesions were seen in three runners with a high- and in two runners with a low-training level. Runners with a higher training level showed a statistically significant higher score for all chronic knee lesions than those with a lower training level (p < 0.05). Conclusions: MRI findings indicate that a higher training level in long-distance runners is a risk factor for chronic knee lesions.

Multiparametric and molecular imaging of breast tumors with MRI and PET/MRI

International Nuclear Information System (INIS)

Pinker, K.; Marino, M.A.; Meyer-Baese, A.; Helbich, T.H.

2016-01-01

Magnetic resonance imaging (MRI) of the breast is an indispensable tool in breast imaging for many indications. Several functional parameters with MRI and positron emission tomography (PET) have been assessed for imaging of breast tumors and their combined application is defined as multiparametric imaging. Available data suggest that multiparametric imaging using different functional MRI and PET parameters can provide detailed information about the hallmarks of cancer and may provide additional specificity. Multiparametric and molecular imaging of the breast comprises established MRI parameters, such as dynamic contrast-enhanced MRI, diffusion-weighted imaging (DWI), MR proton spectroscopy ( 1 H-MRSI) as well as combinations of radiological and MRI techniques (e.g. PET/CT and PET/MRI) using radiotracers, such as fluorodeoxyglucose (FDG). Multiparametric and molecular imaging of the breast can be performed at different field-strengths (range 1.5-7 T). Emerging parameters comprise novel promising techniques, such as sodium imaging ( 23 Na MRI), phosphorus spectroscopy ( 31 P-MRSI), chemical exchange saturation transfer (CEST) imaging, blood oxygen level-dependent (BOLD) and hyperpolarized MRI as well as various specific radiotracers. Multiparametric and molecular imaging has multiple applications in breast imaging. Multiparametric and molecular imaging of the breast is an evolving field that will enable improved detection, characterization, staging and monitoring for personalized medicine in breast cancer. (orig.) [de

The Normal Value of Tibial Tubercle Trochlear Groove Distance in Patients With Normal Knee Examinations Using MRI

Directory of Open Access Journals (Sweden)

Mohammad Sobhanardekani

2017-10-01

Full Text Available Patellar instability is a multifactorial common knee pathology that has a high recurrence rate, and the symptoms continue and ultimately predispose the patient to chondromalacia and osteoarthritis. Tibial tuberosity-trochlear groove distance (TTTG is very important in the assessment of patellofemoral joint instability. The purpose of this study was to report the normal value of TTTG in males and females in different age groups and to assess the reliability of MRI in measuring TTTG. All patients presenting with knee pain and normal examinations of the knee joint, with a normal MRI report, referring to Shahid Sadoughi hospital of Yazd, Iran, from April 2014 to September 2014, were included in the study. MR images were studied once by two radiologists and for the second time by one radiologist. Mean value of TTTG was reported for males and females and in three age groups. Intra- and inter-observer reliability was calculated. A total of 98 patients were eligible to evaluate during 6 months (68 male and 30 female. Mean TTTG was 10.9±2.5 mm in total, which was 10.8±2.8 mm and 11.3±2.3 mm in males and females, respectively (P>0.05. Mean TTTG in males ≤30 years, 30-50 years and, ≥51-year-old were 10.8±2.6 mm, 10.8±2.7 mm, and 10.8±2.6 mm, respectively; that was 12.1±3.4 mm, 11.4±1.9 mm, and 10.5±1.7 mm in females ≤30 years, 31-50 years and, ≥51-year-old, respectively (95% CI. The coefficient of variation was <10% for both intra- and interobserver analysis. The results of the present study showed no significant difference in TTTG value between males and females in different age groups. In addition, it demonstrated that MRI is a reliable method in assessment of TTTG and identified normal value for TTTG at 10.9±2.5 mm.

Comparison of image quality in magnetic resonance imaging of the knee at 1.5 and 3.0 Tesla using 32-channel receiver coils

International Nuclear Information System (INIS)

Schoth, F.; Kraemer, N.; Niendorf, T.; Hohl, C.; Gunther, R.W.; Krombach, G.A.

2008-01-01

We examined to what degree the visualization of anatomic structures in the human knee is improved using 3.0-T magnetic resonance imaging (MRI) and many element RF receive coils as compared to 1.5 T. We imaged 20 knees at 1.5 and 3.0 T using T2-weighted STIR, T2-weighted gradient echo, T1-weighted spin-echo, true-FISP and T2-weighted fast spin echo techniques in conjunction with 32-element RF coil arrays. The 3.0-T examination was considerably faster than its 1.5-T counterpart. A superior subjective visibility at 3.0 T vs 1.5 T was found in 27 of 50 evaluated structures (meniscus, ligaments) with the exception of true-FISP techniques. The 3.0-T examination provided a better visibility (evaluated by blinded consensus-reading by two radiologists) of small structures such as the ligamentum transversum genu. Also, cartilage was better delineated at 3.0 T. A 23% increased average signal-to-noise ratio as assessed using a temporal filter was observed at 3.0 T as compared to 1.5 T. At 3.0 T, imaging of the human knee is faster and results in a subjective visibility of anatomic structures that is superior to and competitive with 1.5 T. (orig.)

The DAMASK trial protocol: a pragmatic randomised trial to evaluate whether GPs should have direct access to MRI for patients with suspected internal derangement of the knee

Science.gov (United States)

Brealey, Stephen D; Atwell, Christine; Bryan, Stirling; Coulton, Simon; Cox, Helen; Cross, Ben; Fylan, Fiona; Garratt, Andrew; Gilbert, Fiona J; Gillan, Maureen GC; Hendry, Maggie; Hood, Kerenza; Houston, Helen; King, David; Morton, Veronica; Orchard, Jo; Robling, Michael; Russell, Ian T; Torgerson, David; Wadsworth, Valerie; Wilkinson, Clare

2006-01-01

Background Though new technologies like Magnetic Resonance Imaging (MRI) may be accurate, they often diffuse into practice before thorough assessment of their value in diagnosis and management, and of their effects on patient outcome and costs. MRI of the knee is a common investigation despite concern that it is not always appropriate. There is wide variation in general practitioners (GPs) access to, and use of MRI, and in the associated costs. The objective of this study was to resolve uncertainty whether GPs should refer patients with suspected internal derangement of the knee for MRI or to an orthopaedic specialist in secondary care. Methods/Design The design consisted of a pragmatic multi-centre randomised trial with two parallel groups and concomitant economic evaluation. Patients presenting in general practice with suspected internal derangement of the knee and for whom their GP was considering referral to an orthopaedic specialist in secondary care were eligible for inclusion. Within practices, GPs or practice nurses randomised eligible and consenting participants to the local radiology department for an MRI examination, or for consultation with an orthopaedic specialist. To ensure that the waiting time from GP consultation to orthopaedic appointment was similar for both trial arms, GPs made a provisional referral to orthopaedics when requesting the MRI examination. Thus we evaluated the more appropriate sequence of events independent of variations in waiting times. Follow up of participants was by postal questionnaires at six, twelve and 24 months after randomisation. This was to ensure that the evaluation covered all events up to and including arthroscopy. Discussion The DAMASK trial should make a major contribution to the development of evidence-based partnerships between primary and secondary care professionals and inform the debate when MRI should enter the diagnostic pathway. PMID:17040558

The DAMASK trial protocol: a pragmatic randomised trial to evaluate whether GPs should have direct access to MRI for patients with suspected internal derangement of the knee

Directory of Open Access Journals (Sweden)

Orchard Jo

2006-10-01

Full Text Available Abstract Background Though new technologies like Magnetic Resonance Imaging (MRI may be accurate, they often diffuse into practice before thorough assessment of their value in diagnosis and management, and of their effects on patient outcome and costs. MRI of the knee is a common investigation despite concern that it is not always appropriate. There is wide variation in general practitioners (GPs access to, and use of MRI, and in the associated costs. The objective of this study was to resolve uncertainty whether GPs should refer patients with suspected internal derangement of the knee for MRI or to an orthopaedic specialist in secondary care. Methods/Design The design consisted of a pragmatic multi-centre randomised trial with two parallel groups and concomitant economic evaluation. Patients presenting in general practice with suspected internal derangement of the knee and for whom their GP was considering referral to an orthopaedic specialist in secondary care were eligible for inclusion. Within practices, GPs or practice nurses randomised eligible and consenting participants to the local radiology department for an MRI examination, or for consultation with an orthopaedic specialist. To ensure that the waiting time from GP consultation to orthopaedic appointment was similar for both trial arms, GPs made a provisional referral to orthopaedics when requesting the MRI examination. Thus we evaluated the more appropriate sequence of events independent of variations in waiting times. Follow up of participants was by postal questionnaires at six, twelve and 24 months after randomisation. This was to ensure that the evaluation covered all events up to and including arthroscopy. Discussion The DAMASK trial should make a major contribution to the development of evidence-based partnerships between primary and secondary care professionals and inform the debate when MRI should enter the diagnostic pathway.

MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans

International Nuclear Information System (INIS)

Partezani Helito, Camilo; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Kawamura Demange, Marco; Partezani Helito, Paulo Victor; Pereira Costa, Hugo; Bordalo-Rodrigues, Marcelo

2014-01-01

This study evaluated the ability of routine 1.5-T MRI scans to visualize the anterolateral ligament (ALL) and describe its path and anatomic relations with lateral knee structures. Thirty-nine 1.5-T MRI scans of the knee were evaluated. The scans included an MRI knee protocol with T1-weighted sequences, T2-weighted sequences with fat saturation, and proton density (PD)-weighted fast spin-echo sequences. Two radiologists separately reviewed all MRI scans to evaluate interobserver reliability. The ALL was divided into three portions for analyses: femoral, meniscal, and tibial. The path of the ALL was evaluated with regard to known structural parameters previously studied in this region. At least a portion of the ALL was visualized in 38 (97.8 %) cases. The meniscal portion was most visualized (94.8 %), followed by the femoral (89.7 %) and the tibial (79.4 %) portions. The three portions of the ALL were visualized in 28 (71.7 %) patients. The ALL was characterized with greater clarity on the coronal plane and was visualized as a thin, linear structure. The T1-weighted sequences showed a statistically inferior ligament visibility frequency. With regard to the T2 and PD evaluations, although the visualization frequency in PD was higher for the three portions of the ligament, only the femoral portion showed significant values. The ALL can be visualized in routine 1.5-T MRI scans. Although some of the ligament could be depicted in nearly all of the scans (97.4 %), it could only be observed in its entirety in about 71.7 % of the tests. (orig.)

MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans

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Partezani Helito, Camilo; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Kawamura Demange, Marco [University of Sao Paulo, Faculty of Medicine, Institute of Orthopedics and Traumatology, Knee Surgery Division, Sao Paulo (Brazil); Partezani Helito, Paulo Victor; Pereira Costa, Hugo; Bordalo-Rodrigues, Marcelo [University of Sao Paulo, Faculty of Medicine, Institute of Orthopedics and Traumatology, Musculoskeletal Radiology Department, Sao Paulo (Brazil)

2014-10-15

This study evaluated the ability of routine 1.5-T MRI scans to visualize the anterolateral ligament (ALL) and describe its path and anatomic relations with lateral knee structures. Thirty-nine 1.5-T MRI scans of the knee were evaluated. The scans included an MRI knee protocol with T1-weighted sequences, T2-weighted sequences with fat saturation, and proton density (PD)-weighted fast spin-echo sequences. Two radiologists separately reviewed all MRI scans to evaluate interobserver reliability. The ALL was divided into three portions for analyses: femoral, meniscal, and tibial. The path of the ALL was evaluated with regard to known structural parameters previously studied in this region. At least a portion of the ALL was visualized in 38 (97.8 %) cases. The meniscal portion was most visualized (94.8 %), followed by the femoral (89.7 %) and the tibial (79.4 %) portions. The three portions of the ALL were visualized in 28 (71.7 %) patients. The ALL was characterized with greater clarity on the coronal plane and was visualized as a thin, linear structure. The T1-weighted sequences showed a statistically inferior ligament visibility frequency. With regard to the T2 and PD evaluations, although the visualization frequency in PD was higher for the three portions of the ligament, only the femoral portion showed significant values. The ALL can be visualized in routine 1.5-T MRI scans. Although some of the ligament could be depicted in nearly all of the scans (97.4 %), it could only be observed in its entirety in about 71.7 % of the tests. (orig.)

Loading of the knee during 3.0 T MRI is associated with significantly increased medial meniscus extrusion in mild and moderate osteoarthritis

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Stehling, Christoph, E-mail: christoph.stehling@radiology.ucsf.edu [Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA (United States); Department of Clinical Radiology, University of Muenster, Muenster (Germany); Souza, Richard B. [Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA (United States); Graverand, Marie-Pierre Hellio Le; Wyman, Bradley T. [Pfizer Inc. New London, CT (United States); Li, Xiaojuan; Majumdar, Sharmila; Link, Thomas M. [Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA (United States)

2012-08-15

Purpose: Standard knee MRI is performed under unloading (ULC) conditions and not much is known about changes of the meniscus, ligaments or cartilage under loading conditions (LC). The aim is to study the influence of loading of different knee structures at 3 Tesla (T) in subjects with osteoarthritis (OA) and normal controls. Materials and methods: 30 subjects, 10 healthy and 20 with radiographic evidence of OA (10 mild and 10 moderate) underwent 3 T MRI under ULC and LC at 50% body weight. All images were analyzed by two musculoskeletal radiologists identifying and grading cartilage, meniscal, ligamentous abnormalities. The changes between ULC and LC were assessed. For meniscus, cartilage and ligaments the changes of lesions, signal and shape were evaluated. In addition, for the meniscus changes in extrusion were examined. A multivariate regression model was used for correlations to correct the data for the impact of age, gender, BMI. A paired T-Test was performed to calculate the differences in meniscus extrusion. Results: Subjects with degenerative knee abnormalities demonstrated significantly increased meniscus extrusion under LC when compared to normal subjects (p = 0.0008-0.0027). Subjects with knee abnormalities and higher KL scores showed significantly more changes in lesion, signal and shape of the meniscus (80% (16/20) vs. 20% (2/10); p = 0.0025), ligaments and cartilage during LC. Conclusion: The study demonstrates that axial loading has an effect on articular cartilage, ligament, and meniscus morphology, which is more significant in subjects with degenerative disease and may serve as an additional diagnostic tool for disease diagnosis and assessing progression in subjects with knee OA.

Loading of the knee during 3.0 T MRI is associated with significantly increased medial meniscus extrusion in mild and moderate osteoarthritis

International Nuclear Information System (INIS)

Stehling, Christoph; Souza, Richard B.; Graverand, Marie-Pierre Hellio Le; Wyman, Bradley T.; Li, Xiaojuan; Majumdar, Sharmila; Link, Thomas M.

2012-01-01

Purpose: Standard knee MRI is performed under unloading (ULC) conditions and not much is known about changes of the meniscus, ligaments or cartilage under loading conditions (LC). The aim is to study the influence of loading of different knee structures at 3 Tesla (T) in subjects with osteoarthritis (OA) and normal controls. Materials and methods: 30 subjects, 10 healthy and 20 with radiographic evidence of OA (10 mild and 10 moderate) underwent 3 T MRI under ULC and LC at 50% body weight. All images were analyzed by two musculoskeletal radiologists identifying and grading cartilage, meniscal, ligamentous abnormalities. The changes between ULC and LC were assessed. For meniscus, cartilage and ligaments the changes of lesions, signal and shape were evaluated. In addition, for the meniscus changes in extrusion were examined. A multivariate regression model was used for correlations to correct the data for the impact of age, gender, BMI. A paired T-Test was performed to calculate the differences in meniscus extrusion. Results: Subjects with degenerative knee abnormalities demonstrated significantly increased meniscus extrusion under LC when compared to normal subjects (p = 0.0008–0.0027). Subjects with knee abnormalities and higher KL scores showed significantly more changes in lesion, signal and shape of the meniscus (80% (16/20) vs. 20% (2/10); p = 0.0025), ligaments and cartilage during LC. Conclusion: The study demonstrates that axial loading has an effect on articular cartilage, ligament, and meniscus morphology, which is more significant in subjects with degenerative disease and may serve as an additional diagnostic tool for disease diagnosis and assessing progression in subjects with knee OA.

The wrinkled patellar tendon: An indication of abnormality in the extensor mechanism of the knee

International Nuclear Information System (INIS)

Berlin, R.C.; Levinsohn, E.M.; Chrisman, H.

1991-01-01

Rupture of the quadriceps tendon is an uncommon condition which requires early diagnosis and treatment to avert prolonged disability. In four patients who had surgically confirmed quadriceps tendon rupture, lateral radiographs of the knee and/or sagittal magnetic resonance (MR) images demonstrated a corrugated appearance to the patellar tendon. Sagittal MR images of the knee following patellectomy in one patient and radiographs of a transverse fracture of the patella in another also demonstrated this appearance. MRI has superb contrast resolution which provides optimal visualization of the contour of the patellar tendon on sagittal images. A retrospective review of 50 consecutive knee MRI examinations was carried out to evaluate the appearance of the normal patellar tendon. In 49 of 50 patients, the sagittal images demonstrated a straight or nearly straight patellar tendon. A corrugated appearance of the patellar tendon on sagittal images indicates a reduction in the normal tensile force applied to it and indicates the need for careful evaluation of the patella and quadriceps tendon mechanism. (orig.)

Bucket-handle meniscal tears of the knee: sensitivity and specificity of MRI signs

International Nuclear Information System (INIS)

Dorsay, Theodore A.; Helms, Clyde A.

2003-01-01

To determine the sensitivity and specificity of reported MRI signs in the evaluation of bucket-handle tears of the knee.Design and patients A retrospective analysis of 71 knee MR examinations that were read as displaying evidence of a bucket-handle or ''bucket-handle type'' tear was performed. We evaluated for the presence or absence of the absent bow tie sign, the coronal truncation sign, the double posterior cruciate ligament (PCL) sign, the anterior flipped fragment sign, and a fragment displaced into the intercondylar notch. Sensitivity and specificity were calculated relative to the gold standard of arthroscopy. Forty-three of 71 cases were surgically proven as bucket-handle tears. The absent bow tie sign demonstrated a sensitivity of 88.4%. The presence of at least one of the displaced fragment signs had a sensitivity of 90.7%. A finding of both the absent bow tie sign and one of the displaced fragment signs demonstrated a specificity of 85.7%. The double PCL sign demonstrated a specificity of 100%. The anterior flipped meniscus sign had a specificity of 89.7%. Bucket-handle tears of the menisci, reported in about 10% of most large series, have been described by several signs with MRI. This report gives the sensitivity and specificity of MRI for bucket-handle tears using each of these signs independently and in combination. MRI is shown to be very accurate for diagnosing bucket-handle tears when two or more of these signs coexist. (orig.)

Magnetic resonance imaging of articular cartilage in the knee. Evaluation of 3D-fat-saturation FLASH sequence in normal volunteer and patient with osteoarthritis

International Nuclear Information System (INIS)

Sato, Katsuhiko

1996-01-01

MR imaging of normal and abnormal articular cartilage of the knee was performed using 3D-fat-saturation FLASH sequence (FSF). Contrast-to-noise ratios between the cartilage and fluid, and cartilage and bone marrow were evaluated respectively in 10 normal volunteers. The optimal imaging parameters were determined as flip angle of 40deg and TE of 10 ms. Good correlation was noted between MR images and macroscopic appearance of the hyaline cartilages in the cadaver knees. Comparison of MR and radiographic findings was made in 39 cases of osteoarthritis. MR was significantly more sensitive than radiography in detecting cartilage abnormalities. In patient with radiographically normal joint spaces, cartilage abnormality was detected by MRI in the medial compartment of 13 cases and the lateral compartment of 19 cases. Signal intensity of joint effusion was sufficiently suppressed and did not hamper evaluation of the cartilages. FSF method was considered as a valuable imaging technique in the evaluation of cartilage abnormalities of the knee. (author)

Magnetic resonance imaging of articular cartilage in the knee. Evaluation of 3D-fat-saturation FLASH sequence in normal volunteer and patient with osteoarthritis

Energy Technology Data Exchange (ETDEWEB)

Sato, Katsuhiko [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

1996-07-01

MR imaging of normal and abnormal articular cartilage of the knee was performed using 3D-fat-saturation FLASH sequence (FSF). Contrast-to-noise ratios between the cartilage and fluid, and cartilage and bone marrow were evaluated respectively in 10 normal volunteers. The optimal imaging parameters were determined as flip angle of 40deg and TE of 10 ms. Good correlation was noted between MR images and macroscopic appearance of the hyaline cartilages in the cadaver knees. Comparison of MR and radiographic findings was made in 39 cases of osteoarthritis. MR was significantly more sensitive than radiography in detecting cartilage abnormalities. In patient with radiographically normal joint spaces, cartilage abnormality was detected by MRI in the medial compartment of 13 cases and the lateral compartment of 19 cases. Signal intensity of joint effusion was sufficiently suppressed and did not hamper evaluation of the cartilages. FSF method was considered as a valuable imaging technique in the evaluation of cartilage abnormalities of the knee. (author)

Evaluation of Chondrocalcinosis and Associated Knee Joint Degeneration Using MR Imaging: Data from the Osteoarthritis Initiative.

Science.gov (United States)

Gersing, Alexandra S; Schwaiger, Benedikt J; Heilmeier, Ursula; Joseph, Gabby B; Facchetti, Luca; Kretzschmar, Martin; Lynch, John A; McCulloch, Charles E; Nevitt, Michael C; Steinbach, Lynne S; Link, Thomas M

2017-06-01

To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (r T1GE  = 0.73, P  0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage. • Magnetic resonance imaging is useful for assessing burden of calcium-containing crystals (CaC). • Gradient-echo sequences are superior to fast spin echo sequences for CaC imaging. • Presence of CaC is associated with meniscus and cartilage degradation.

MRI study of avascular necrosis of the knee

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Simizu, Koh; Suguro, Toru; Tsuchiya, Akihiro; Moriya, Hideshige; Nishikawa, Satoru; Arimizu, Noboru [Chiba Univ. (Japan). School of Medicine

1990-10-01

Magnetic resonance (MR) images of 70 joints were reviewed in 38 patients with avascular necrosis of the knee or hip joint, whose ages ranged from 19 to 62 years with an average of 41 years. According to causes, steroid induced avascular necrosis was the commonest, accounting for 87% of cases. The remainer of the cases were alcoholic avascular necrosis (8%) and idiopathic avascular necrosis (5%). Steroid induced avascular necrosis was greatly different from idiopathic avascular necrosis in view of clinical manifestations, common sites, and complications of femur head necrosis. Idiopathic avascular necrosis was common in the central part of internal condyle and was confined to one joint. Steroid induced avascular necrosis was common in the posterior part of external condyle and was frequently associated with multiple necroses of the diaphysis. Seventy five percent of the cases were associated with avascular necrosis of the knee. The diagnostic accuracy of the other imaging modalities in avascular necrosis was low (33% for plain roentgenography and 50% for RI examination). Thus, MR was the imaging procedure of choice for detecting avascular necrotic lesions. (N.K.).

MRI study of avascular necrosis of the knee

International Nuclear Information System (INIS)

Simizu, Koh; Suguro, Toru; Tsuchiya, Akihiro; Moriya, Hideshige; Nishikawa, Satoru; Arimizu, Noboru

1990-01-01

Magnetic resonance (MR) images of 70 joints were reviewed in 38 patients with avascular necrosis of the knee or hip joint, whose ages ranged from 19 to 62 years with an average of 41 years. According to causes, steroid induced avascular necrosis was the commonest, accounting for 87% of cases. The remainer of the cases were alcoholic avascular necrosis (8%) and idiopathic avascular necrosis (5%). Steroid induced avascular necrosis was greatly different from idiopathic avascular necrosis in view of clinical manifestations, common sites, and complications of femur head necrosis. Idiopathic avascular necrosis was common in the central part of internal condyle and was confined to one joint. Steroid induced avascular necrosis was common in the posterior part of external condyle and was frequently associated with multiple necroses of the diaphysis. Seventy five percent of the cases were associated with avascular necrosis of the knee. The diagnostic accuracy of the other imaging modalities in avascular necrosis was low (33% for plain roentgenography and 50% for RI examination). Thus, MR was the imaging procedure of choice for detecting avascular necrotic lesions. (N.K.)

Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging.

Science.gov (United States)

Murphy, B J

2001-06-01

To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee.

Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging

International Nuclear Information System (INIS)

Murphy, B.J.

2001-01-01

Objective. To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee.Design and patients. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed.Results. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%.Conclusion. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee. (orig.)

Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging

Energy Technology Data Exchange (ETDEWEB)

Murphy, B.J. [Dept. of Radiology, Univ. of Miami School of Medicine, FL (United States)

2001-06-01

Objective. To determine the accuracy of T2*-weighted three-dimensional (3D) gradient-echo articular cartilage imaging in the identification of grades 3 and 4 chondromalacia of the knee.Design and patients. A retrospective evaluation of 80 patients who underwent both arthroscopic and MRI evaluation was performed. The 3D images were interpreted by one observer without knowledge of the surgical results. The medial and lateral femoral condyles, the medial and lateral tibial plateau, the patellar cartilage and trochlear groove were evaluated. MR cartilage images were considered positive if focal reduction of cartilage thickness was present (grade 3 chondromalacia) or if complete loss of cartilage was present (grade 4 chondromalacia). Comparison of the 3D MR results with the arthroscopic findings was performed.Results. Eighty patients were included in the study group. A total of 480 articular cartilage sites were evaluated with MRI and arthroscopy. Results of MR identification of grades 3 and 4 chondromalacia, all sites combined, were: sensitivity 83%, specificity 97%, false negative rate 17%, false positive rate 3%, positive predictive value 87%, negative predictive value 95%, overall accuracy 93%.Conclusion. The results demonstrate that T2*-weighted 3D gradient-echo articular cartilage imaging can identify grades 3 and 4 chondromalacia of the knee. (orig.)

Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study

International Nuclear Information System (INIS)

Lutterbey, G.; Behrends, K.; Falkenhausen, M.V.; Wattjes, M.P.; Morakkabati, N.; Schild, H.; Gieseke, J.

2007-01-01

The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained. (orig.)

Is the body-coil at 3 Tesla feasible for the MRI evaluation of the painful knee? A comparative study.

Science.gov (United States)

Lutterbey, G; Behrends, K; Falkenhausen, M V; Wattjes, M P; Morakkabati, N; Gieseke, J; Schild, H

2007-02-01

The purpose of this study was to compare the in-built body coil of the 3.0-Tesla (T) scanner with a dedicated surface coil of a 1.5 T system regarding knee imaging. We performed an intraindividual prospective clinical trial on 17 patients with knee pain using magnetic resonance imaging (MRI) at 1.5 and 3.0 T systems equipped with identical gradient systems. Proton-density-weighted turbo spin echo sequences with the same spatial resolution and comparable contrast parameters were used. A quantitative measurement of signal to noise ratio (SNR), relative contrast (RC) and contrast to noise ratio (CNR) between muscle and bone marrow was performed, followed by a qualitative assessment of anatomic/pathologic structures and the extent of artefacts. At 3.0 T, 30 lesions (91%) compared to 33 lesions at 1.5 T were detected. The SNR/CNR/RC were moderately reduced at 3.0 T versus 1.5 T (muscle 42 vs 47 and bone 83 vs 112/46 vs 69/0.33 vs 0.43). Motion artefacts from the pulsating popliteal artery were significantly increased at 3.0 T. A visible and measurable signal loss occurred at 3.0 T using the built-in body coil compared with the dedicated 1.5 T knee coil, but nearly all clinically important information could be obtained.

Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges?

Energy Technology Data Exchange (ETDEWEB)

Gans, Itai; Ganley, Theodore J. [The Children' s Hospital of Philadelphia, Division of Orthopaedics, 34th and Civic Center Boulevard, Philadelphia, PA (United States); Bedoya, Maria A.; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

2014-08-31

Diagnosis of intra-articular lesions in children based on clinical examination and MRI is particularly challenging. To evaluate the diagnostic performance of MRI and pre-surgical evaluation of the knee in pediatric patients relative to arthroscopic evaluation as the gold standard. We report diagnoses frequently missed or inaccurately diagnosed pre-operatively. We conducted a retrospective review of MRI and pre-surgical evaluation in children and adolescents ages 1-17 years who were treated by knee arthroscopy during a 21/2-year period. All MRIs were reviewed by a pediatric radiologist blinded to clinical findings. Pediatric orthopedic clinic notes were reviewed for pre-surgical evaluation (based on physical exam, radiograph, MR images and radiologist's MRI report). Arthroscopic findings were used as the gold standard. We calculated the percentages of diagnoses at arthroscopy missed on both MRI and pre-surgical evaluation. Diagnostic accuracy between children and adolescents and in patients with one pathological lesion vs. those with >1 lesion was analyzed. We performed a second review of MR images of the missed or over-called MRI diagnoses with knowledge of arthroscopic findings. We included 178 children and adolescents. The most common diagnoses missed on MRI or pre-surgical evaluation but found at arthroscopy were: discoid meniscus (8/30, or 26.7% of cases); lateral meniscal tears (15/80, or 18.8% of cases); intra-articular loose bodies (5/36, or 13.9% of cases), and osteochondral injuries (9/73, or 12.3% of cases). Overall diagnostic accuracy of MRI and pre-surgical evaluation was 92.7% and 95.3%, respectively. No significant difference in diagnostic accuracy between children and adolescents was observed. When multiple intra-articular lesions were present, lateral meniscal tears were more likely to be inaccurately diagnosed (missed or over-called) on both MRI (P = 0.009) and pre-surgical evaluation (P < 0.001). Overall diagnostic accuracy of MRI and pre

Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges?

International Nuclear Information System (INIS)

Gans, Itai; Ganley, Theodore J.; Bedoya, Maria A.; Ho-Fung, Victor

2015-01-01

Diagnosis of intra-articular lesions in children based on clinical examination and MRI is particularly challenging. To evaluate the diagnostic performance of MRI and pre-surgical evaluation of the knee in pediatric patients relative to arthroscopic evaluation as the gold standard. We report diagnoses frequently missed or inaccurately diagnosed pre-operatively. We conducted a retrospective review of MRI and pre-surgical evaluation in children and adolescents ages 1-17 years who were treated by knee arthroscopy during a 21/2-year period. All MRIs were reviewed by a pediatric radiologist blinded to clinical findings. Pediatric orthopedic clinic notes were reviewed for pre-surgical evaluation (based on physical exam, radiograph, MR images and radiologist's MRI report). Arthroscopic findings were used as the gold standard. We calculated the percentages of diagnoses at arthroscopy missed on both MRI and pre-surgical evaluation. Diagnostic accuracy between children and adolescents and in patients with one pathological lesion vs. those with >1 lesion was analyzed. We performed a second review of MR images of the missed or over-called MRI diagnoses with knowledge of arthroscopic findings. We included 178 children and adolescents. The most common diagnoses missed on MRI or pre-surgical evaluation but found at arthroscopy were: discoid meniscus (8/30, or 26.7% of cases); lateral meniscal tears (15/80, or 18.8% of cases); intra-articular loose bodies (5/36, or 13.9% of cases), and osteochondral injuries (9/73, or 12.3% of cases). Overall diagnostic accuracy of MRI and pre-surgical evaluation was 92.7% and 95.3%, respectively. No significant difference in diagnostic accuracy between children and adolescents was observed. When multiple intra-articular lesions were present, lateral meniscal tears were more likely to be inaccurately diagnosed (missed or over-called) on both MRI (P = 0.009) and pre-surgical evaluation (P < 0.001). Overall diagnostic accuracy of MRI and pre

Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear

International Nuclear Information System (INIS)

Degnan, A.J.; Adam, R.J.; Maldjian, C.; Harner, Ch.D.

2014-01-01

The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. Measurements of tibial translation were made in the medial and lateral compartments of patients and controls (10 males, 12 females) without clinical or MRI evidence of ligament injury. Significant medial compartment posterior tibial translation was present in patients with PCL tear compared to controls (+2.93 mm versus +0.03 mm, Ρ=0.002) with excellent interobserver agreement (intraclass correlation coefficient (ICC) = 0.94). No significant difference in lateral compartment tibial translation was observed (+0.17 mm versus -0.57 mm, Ρ=0.366) despite excellent interobserver agreement (ICC = 0.96). Posterior tibial translation in the midmedial compartment may be a secondary sign of isolated PCL tear on routine knee MRI with passive extension without manipulation or weight bearing. Additional work in a larger cohort may better address the accuracy of this finding

MRI demonstration of hypertrophic articular cartilage repair in osteoarthritis

International Nuclear Information System (INIS)

Braunstein, E.M.; Brandt, K.D.; Albrecht, M.

1990-01-01

Transection of the anterior cruciate ligament in the dog produces changes in the unstable joint typical of osteoarthritis, although full-thickness catilage ulceration is rare. Information concerning the late fate of the cartilage after transection is meager. In the present study magnetic resonance imaging (MRI) was used to evaluate cartilage abnormalities 3 years after transection. Plain radiographs of the osteoarthritic and contralateral knees were obtained serially. MRI was performed 3 years after anterior cruciate ligament transection, at which time all three animals exhibited knee instability. Radiographs of the osteoarthritic knees showed osteophytes and subchondral sclerosis with progression between 2 and 3 years. On MRI, articular cartilage margins in the knee were indistinct, and the cartilage was thicker than that in the contralateral knee (maximum difference = 2.7 mm). This increase in thickness is consistent with biochemical data from dogs killed up to 64 weeks after creation of knee instability, which showed marked increases in cartilage bulk and in proteoglycan synthesis and concentration. The findings emphasize that increased matrix synthesis after anterior cruciate ligament transection leads to functional cartilage repair sustained even in the presence of persistent alteration of joint mechanics. (orig.)

Radiographs and low field MRI (0.2T) as predictors of efficacy in a weight loss trial in obese women with knee osteoarthritis

DEFF Research Database (Denmark)

Gudbergsen, Henrik; Boesen, Mikael; Christensen, Robin

2011-01-01

To study the predictive value of baseline radiographs and low-field (0.2T) MRI scans for the symptomatic outcome of clinically significant weight loss in obese patients with knee osteoarthritis.......To study the predictive value of baseline radiographs and low-field (0.2T) MRI scans for the symptomatic outcome of clinically significant weight loss in obese patients with knee osteoarthritis....

Anterolateral ligament injuries in knees with an anterior cruciate ligament tear. Contribution of ultrasonography and MRI

International Nuclear Information System (INIS)

Faruch Bilfeld, Marie; Constans, Olivia; Lapegue, Franck; Chiavassa Gandois, Helene; Sans, Nicolas; Cavaignac, Etienne; Wytrykowski, Karine; Larbi, Ahmed

2018-01-01

To describe the pathological appearance of the anterolateral ligament (ALL) on US and MRI in knees with an anterior cruciate ligament (ACL) tear. This prospective study included 30 patients who had a suspected acute ACL tear. Their injured and contralateral knees were evaluated with radiography, US and MRI. Two radiologists evaluated the ALL on the MRI and US examinations. Agreement between these examiners' findings was evaluated with Cohen's kappa. On US examination, the ALL was found to be injured in 63% of cases (19/30; k = 0.93). The enthesis was found to be torn in 50% of cases (15/30; k = 1), with the tear located at the tibial attachment in all instances. On the MRI exam, the ALL was found to be injured in 53% of cases (16/30; k = 0.93). The enthesis was found to be torn in 13% of cases (4/30; k = 0.76), with the tear located at the tibial attachment in all instances (k = 0.93). ALL injuries that occur with ACL tears are located at the tibial enthesis. They are often associated with bone avulsion at the enthesis and are better viewed on US. (orig.)

Anterolateral ligament injuries in knees with an anterior cruciate ligament tear. Contribution of ultrasonography and MRI

Energy Technology Data Exchange (ETDEWEB)

Faruch Bilfeld, Marie; Constans, Olivia; Lapegue, Franck; Chiavassa Gandois, Helene; Sans, Nicolas [CHU Toulouse-Purpan, Service de Radiologie, Toulouse (France); Cavaignac, Etienne; Wytrykowski, Karine [CHU Toulouse-Purpan, Service d' Orthopedie, Toulouse (France); Larbi, Ahmed [Hopital Universitaire Caremeau, Service de Radiologie, Nimes (France)

2018-01-15

To describe the pathological appearance of the anterolateral ligament (ALL) on US and MRI in knees with an anterior cruciate ligament (ACL) tear. This prospective study included 30 patients who had a suspected acute ACL tear. Their injured and contralateral knees were evaluated with radiography, US and MRI. Two radiologists evaluated the ALL on the MRI and US examinations. Agreement between these examiners' findings was evaluated with Cohen's kappa. On US examination, the ALL was found to be injured in 63% of cases (19/30; k = 0.93). The enthesis was found to be torn in 50% of cases (15/30; k = 1), with the tear located at the tibial attachment in all instances. On the MRI exam, the ALL was found to be injured in 53% of cases (16/30; k = 0.93). The enthesis was found to be torn in 13% of cases (4/30; k = 0.76), with the tear located at the tibial attachment in all instances (k = 0.93). ALL injuries that occur with ACL tears are located at the tibial enthesis. They are often associated with bone avulsion at the enthesis and are better viewed on US. (orig.)

Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour; Zikria, Bashir; Carrino, John A.

2015-01-01

To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

Energy Technology Data Exchange (ETDEWEB)

Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour [Johns Hopkins University School of Medicine, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Zikria, Bashir [Johns Hopkins University, Department of Orthopedic Surgery, Baltimore, MD (United States); Carrino, John A. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States)

2015-11-15

To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

The magnetic resonance imaging appearance of the anterolateral ligament of the knee in association with anterior cruciate rupture

Energy Technology Data Exchange (ETDEWEB)

Kosy, Jonathan D.; Schranz, Peter J.; Patel, Anish; Anaspure, Rahul; Mandalia, Vipul I. [Royal Devon and Exeter Hospital, Princess Elizabeth Orthopaedic Centre, Exeter (United Kingdom)

2017-09-15

The magnetic resonance imaging (MRI) appearance of the anterolateral ligament (ALL) has been described. However, the appearance of this structure and injury, in the presence of anterior cruciate ligament (ACL) injury, is less well defined. We studied the incidence of injury to the ALL and the pattern of this injury on MRI. Following Institutional Review Board approval, a retrospective study of 375 consecutive MRI studies was performed. Cases were identified from a prospective database of ACL reconstruction patients. Following exclusions, 280 MRIs (277 patients; 197 males: 80 females; mean age 30.2 years, range, 16-54) were evaluated. Injury was defined as full thickness, partial thickness, or an avulsion fracture. Each study was independently assessed by two consultant musculoskeletal radiologists. Injury to the ALL was identified (by at least one observer) in only 10.7% of cases (2.50% full thickness, 7.50% partial thickness, and 0.71% avulsion fracture). There was an almost perfect level of interobserver agreement for both the identification of an injury (κ = 0.854) and grading of injury (κ = 0.858). The MRI incidence of ALL injury was significantly greater within 6 weeks of the knee injury (18.5 vs. 8.37%; p < 0.05). ALL injury was identified in only one-tenth of cases of ACL rupture. MRI changes can be reliably identified with strong agreement between observers. ALL injury is found more frequently on MRI within 6 weeks of the knee injury (compared to scans performed after this time period) suggesting that some injuries may resolve or become less visible. (orig.)

Chondromalacia of the knee: evaluation with a fat-suppression three-dimensional SPGR imaging after intravenous contrast injection.

Science.gov (United States)

Suh, J S; Cho, J H; Shin, K H; Kim, S J

1996-01-01

Twenty-one MRI studies with a fat-suppression three-dimensional spoiled gradient-recalled echo in a steady state (3D SPGR) pulse sequence after intravenous contrast injection were evaluated to assess the accuracy in depicting chondromalacia of the knee. On the basis of MR images, chondromalacia and its grade were determined in each of five articular cartilage regions (total, 105 regions) and then the results were compared to arthroscopic findings. The sensitivity, specificity, and accuracy of MRI were 70%, 99%, and 93%, respectively. MR images depicted 7 of 11 lesions of arthroscopic grade 1 or 2 chondromalacia, and seven of nine lesions of arthroscopic grade 3 or 4 chondromalacia. The cartilage abnormalities in all cases appeared as focal lesions with high signal intensity. Intravenous contrast-injection, fat-suppression 3D SPGR imaging showed high specificity in excluding cartilage abnormalities and may be considered as an alternative to intra-articular MR arthrography when chondromalacia is suspected.

Cross-sectional and Longitudinal Associations between Knee Joint Effusion Synovitis and Knee Pain in Older Adults.

Science.gov (United States)

Wang, Xia; Jin, Xingzhong; Han, Weiyu; Cao, Yuelong; Halliday, Andrew; Blizzard, Leigh; Pan, Faming; Antony, Benny; Cicuttini, Flavia; Jones, Graeme; Ding, Changhai

2016-01-01

To describe the cross-sectional and longitudinal associations between knee regional effusion synovitis and knee pain in older adults. Data from a population-based random sample (n = 880, mean age 62 yrs, 50% women) were used. Baseline knee joint effusion synovitis was graded (0-3) using T2-weighted magnetic resonance imaging (MRI) in the suprapatellar pouch, central portion, posterior femoral recess, and subpopliteal recess. Effusion synovitis of the whole joint was defined as a score of ≥ 2 in any subregion. Other knee structural (including cartilage, bone marrow, and menisci) lesions were assessed by MRI at baseline. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire at baseline and 2.6 years later. Multivariable analyses were performed after adjustment for age, sex, body mass index, and other structural lesions. The prevalence of effusion synovitis was 67%. Suprapatellar pouch effusion synovitis was significantly and independently associated with increased total and nonweight-bearing knee pain in both cross-sectional and longitudinal analyses (for an increase in total knee pain of ≥ 5, RR 1.26 per grade, 95% CI 1.04-1.52), and increased weight-bearing knee pain in longitudinal analysis only. Effusion synovitis in posterior femoral recess and central portion were independently associated with increases in nonweight-bearing pain (RR 1.63 per grade, 95% CI 1.32-2.01 and RR 1.29 per grade, 95% CI 1.01-1.65, respectively) in longitudinal analyses only. Knee joint effusion synovitis has independent associations with knee pain in older adults. Suprapatellar pouch effusion synovitis is associated with nonweight-bearing and weight-bearing knee pain, while posterior femoral recess and central portion effusion synovitis are only associated with nonweight-bearing pain.

Associations of anatomical measures from MRI with radiographically defined knee osteoarthritis score, pain, and physical functioning.

Science.gov (United States)

Sowers, Maryfran; Karvonen-Gutierrez, Carrie A; Jacobson, Jon A; Jiang, Yebin; Yosef, Matheos

2011-02-02

The prevalence of knee osteoarthritis is traditionally based on radiographic findings, but magnetic resonance imaging is now being used to provide better visualization of bone, cartilage, and soft tissues as well as the patellar compartment. The goal of this study was to estimate the prevalences of knee features defined on magnetic resonance imaging in a population and to relate these abnormalities to knee osteoarthritis severity scores based on radiographic findings, physical functioning, and reported knee pain in middle-aged women. Magnetic resonance images of the knee were evaluated for the location and severity of cartilage defects, bone marrow lesions, osteophytes, subchondral cysts, meniscal and/or ligamentous tears, effusion, and synovitis among 363 middle-aged women (724 knees) from the Michigan Study of Women's Health Across the Nation. These findings were related to Kellgren-Lawrence osteoarthritis severity scores from radiographs, self-reported knee pain, self-reported knee injury, perception of physical functioning, and physical performance measures to assess mobility. Radiographs, physical performance assessment, and interviews were undertaken at the 1996 study baseline and again (with the addition of magnetic resonance imaging assessment) at the follow-up visit during 2007 to 2008. The prevalence of moderate-to-severe knee osteoarthritis changed from 3.7% at the baseline assessment to 26.7% at the follow-up visit eleven years later. Full-thickness cartilage defects of the medial, lateral, and patellofemoral compartments were present in 14.5% (105 knees), 4.6% (thirty-three knees), and 26.2% (190 knees), respectively. Synovitis was identified in 24.7% (179) of the knees, and joint effusions were observed in 70% (507 knees); 21.7% (157) of the knees had complex or macerated meniscal tears. Large osteophytes, marked synovitis, macerated meniscal tears, and full-thickness tibial cartilage defects were associated with increased odds of knee pain and with

Osteoarthritis in the Knee Joints of Göttingen Minipigs after Resection of the Anterior Cruciate Ligament? Missing Correlation of MRI, Gene and Protein Expression with Histological Scoring.

Directory of Open Access Journals (Sweden)

Gregor Reisig

Full Text Available The Göttingen Minipig (GM is used as large animal model in articular cartilage research. The aim of the study was to introduce osteoarthritis (OA in the GM by resecting the anterior cruciate ligament (ACLR according to Pond and Nuki, verified by histological and magnetic resonance imaging (MRI scoring as well as analysis of gene and protein expression.The eight included skeletally mature female GM were assessed after ACLR in the left and a sham operation in the right knee, which served as control. 26 weeks after surgery the knee joints were scanned using a 3-Tesla high-field MR tomography unit with a 3 T CP Large Flex Coil. Standard proton-density weighted fat saturated sequences in coronal and sagittal direction with a slice thickness of 3 mm were used. The MRI scans were assessed by two radiologists according to a modified WORMS-score, the X-rays of the knee joints by two evaluators. Osteochondral plugs with a diameter of 4mm were taken for histological examination from either the main loading zone or the macroscopic most degenerated parts of the tibia plateau or condyle respectively. The histological sections were blinded and scored by three experts according to Little et al. Gene expression analysis was performed from surrounding cartilage. Expression of adamts4, adamts5, acan, col1A1, col2, il-1ß, mmp1, mmp3, mmp13, vegf was determined by qRT-PCR. Immunohistochemical staining (IH of Col I and II was performed. IH was scored using a 4 point grading (0-no staining; 3-intense staining.Similar signs of OA were evident both in ACLR and sham operated knee joints with the histological scoring result of the ACLR joints with 6.48 ± 5.67 points and the sham joints with 6.86 ± 5.84 points (p = 0.7953 The MRI scoring yielded 0.34 ± 0.89 points for the ACLR and 0.03 ± 0.17 for the sham knee joints. There was no correlation between the histological and MRI scores (r = 0.10021. The gene expression profiles as well as the immunohistochemical findings

Knee osteoarthritis image registration: data from the Osteoarthritis Initiative

Science.gov (United States)

Galván-Tejada, Jorge I.; Celaya-Padilla, José M.; Treviño, Victor; Tamez-Peña, José G.

2015-03-01

Knee osteoarthritis is a very common disease, in early stages, changes in joint structures are shown, some of the most common symptoms are; formation of osteophytes, cartilage degradation and joint space reduction, among others. Based on a joint space reduction measurement, Kellgren-Lawrence grading scale, is a very extensive used tool to asses radiological OA knee x-ray images, based on information obtained from these assessments, the objective of this work is to correlate the Kellgren-Lawrence score to the bilateral asymmetry between knees. Using public data from the Osteoarthritis initiative (OAI), a set of images with different Kellgren-Lawrencescores were used to determine a relationship of Kellgren-Lawrence score and the bilateral asymmetry, in order to measure the asymmetry between the knees, the right knee was registered to match the left knee, then a series of similarity metrics, mutual information, correlation, and mean squared error where computed to correlate the deformation (mismatch) of the knees to the Kellgren-Lawrence score. Radiological information was evaluated and scored by OAI radiologist groups. The results of the study suggest an association between Radiological Kellgren-Lawrence score and image registration metrics, mutual information and correlation is higher in the early stages, and mean squared error is higher in advanced stages. This association can be helpful to develop a computer aided grading tool.

Large Intra-Articular Anterior Cruciate Ligament Ganglion Cyst, Presenting with Inability to Flex the Knee

Directory of Open Access Journals (Sweden)

Jake Sloane

2010-01-01

Full Text Available A 41-year-old female presented with a 3-month history of gradually worsening anterior knee pain, swelling and inability to flex the knee. Magnetic resonance imaging (MRI revealed a large intra-articular cystic swelling anterior to the anterior cruciate ligament (ACL, extending into the Hoffa's infrapatellar fat pad. Following manipulation under anaesthesia and arthroscopic debridement of the cyst, the patient's symptoms were relieved with restoration of normal knee motion. ACL ganglion cysts are uncommon intra-articular pathological entities, which are usually asymptomatic and diagnosed incidentally by MRI. This is the first reported case of an ACL cyst being so large as to cause a mechanical block to knee flexion.

Knee osteoarthritis in traumatic knee symptoms in general practice: 6-year cohort study

NARCIS (Netherlands)

M. Kastelein (Marlous); P.A.J. Luijsterburg (Pim); I.M. Koster (Ingrid); J.A.N. Verhaar (Jan); D. Vroegindeweij (Dammis); S.M. Bierma-Zeinstra (Sita); E.H.G. Oei (Edwin)

2016-01-01

textabstractAim: To identify degenerative knee abnormalities using MRI and radiography 6 years after knee trauma, their relation with persistent knee symptoms and baseline prognostic factors. Methods: Adults (18–65 years) with incident traumatic knee symptoms visiting their

High-resolution MR imaging of the knee at 3 T

Energy Technology Data Exchange (ETDEWEB)

Niitsu, M.; Nakai, T.; Ikeda, K.; Tang, G.Y.; Yoshioka, H.; Itai, Y. [Tsukuba Univ., Ibaraki (Japan). Dept. of Radiology

2000-07-01

In order to examine the practical feasibility of using a 3.0-T MR unit to obtain high-quality, high-resolution images of the knee joint, one human cadaveric and 5 porcine knees were imaged with the 3.0-T unit. Sets of T1-weighted spin echo images were obtained with in-plane resolution of 0.195x0.39 mm and an acquisition time of approximately 5 min. Two porcine knees were also imaged with the 1.0-T unit with an identical imaging protocol and the signal-to-noise (S/N) ratios were measured on images at 3 T and 1 T. The 3-T MR system provided detailed delineation of the knees. Deep layers of the medial collateral ligament and associated fine fibers beneath the medial and lateral collateral ligament were demarcated. We observed precise demonstration of the tibial attachment of the anterior cruciate ligament, irregularity of the meniscal free edge, and conjoint tendon formation together with the lateral collateral ligament and the biceps femoris tendon. Compared to the 1-T unit, the S/N ratio with the 3-T unit was increased by a factor of 1.39 to 1.72. Due to the potential advantage of obtaining detailed images, the 3-T MR system suggests a practical utility for fine demonstration of the knee morphology.

High-resolution MR imaging of the knee at 3 T

International Nuclear Information System (INIS)

Niitsu, M.; Nakai, T.; Ikeda, K.; Tang, G.Y.; Yoshioka, H.; Itai, Y.

2000-01-01

In order to examine the practical feasibility of using a 3.0-T MR unit to obtain high-quality, high-resolution images of the knee joint, one human cadaveric and 5 porcine knees were imaged with the 3.0-T unit. Sets of T1-weighted spin echo images were obtained with in-plane resolution of 0.195x0.39 mm and an acquisition time of approximately 5 min. Two porcine knees were also imaged with the 1.0-T unit with an identical imaging protocol and the signal-to-noise (S/N) ratios were measured on images at 3 T and 1 T. The 3-T MR system provided detailed delineation of the knees. Deep layers of the medial collateral ligament and associated fine fibers beneath the medial and lateral collateral ligament were demarcated. We observed precise demonstration of the tibial attachment of the anterior cruciate ligament, irregularity of the meniscal free edge, and conjoint tendon formation together with the lateral collateral ligament and the biceps femoris tendon. Compared to the 1-T unit, the S/N ratio with the 3-T unit was increased by a factor of 1.39 to 1.72. Due to the potential advantage of obtaining detailed images, the 3-T MR system suggests a practical utility for fine demonstration of the knee morphology

Radiographical diagnosis of posttraumatic knee joints hemarthrosis and lipohemarthrosis

International Nuclear Information System (INIS)

Li Shuling; Liu Xulin; Ma Heng; Zhang Guanghui; Zhou Chengtao; Tang Xiaofeng; Li Wenle; Liu Zhongguang; Zhang Baozheng; Sun Qingju

2008-01-01

Objective: To explore the imaging findings and diagnostic values of X-ray, CT, MR, and ultrasonography in traumatic knee joints hemarthrosis and lipohemarthrosis. Methods: Traumatic knee joints hemarthrosis (12 knees) and lipohemarthrosis (18 knees) proved by operation (27 knees) or puncturation (3 knees) were included in the study. Horizontal-beam plain radiographs (16 knees), CT (30 knees), MRI (30 knees) and ultrasonography (24 knees) in supine position were investigated. Results (1)supine position horizontal-beam plain radiographs: Fat-liquid layer was found in 8 cases of lipohemarthrosis. Dense supragenual bursa was found in 1 case of lipohemarthrosis and 7 cases of hemarthrosis. Fracture (13 knees) was diagnosed correctly. (2) CT findings: double fluid-fluid layer was found in 11 of all 18 cases, and single fluid-fluid layer was found in 7 of 11 cases of lipohemarthrosis. Single fluid-fluid layer was found in 3 of 12 cases of hemarthrosis. Isodensity was detected in 9 cases, and high- density blood clot was found in 4 cases. Fracture (30 knees) was diagnosed correctly. (3) MRI findings: in 12 of 18 cases of lipohemarthrosis, double fluid-fluid layer was shown including supernatant layer as short T 1 , long T 2 signal and low signal after fat-suppression, middle layer as long T 1 , long T 2 signal and high signal after fat-suppression, and dependent layer as iso-T 1 , iso-T 2 and slight high signal after fat- suppression. Single fluid-fluid layer was seen in 6 cases, only had aforementioned upper and under layer. Only aforementioned supernatant layer and dependent layer were seen in 12 cases of hemarthrosis. 4 cases showed entire blood clot in fluid, T 1 WI showed middle signal or center iso-signal accompanied with peripheral high signal ring, and fat-suppression imaging showed high signal. T 2 WI and fat-suppression imaging showed middling or high signal accompanied with peripheral low signal ring. Fracture (30 knees) was diagnosed correctly. (4) Ultrasound

Lower limb fractures associated with multiligament knee injury

OpenAIRE

Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

2017-01-01

Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of l...

Lower limb fractures associated with multiligament knee injury

Science.gov (United States)

Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

2017-01-01

Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries. Methods: A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed. Results: Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months. Conclusion: Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.

Accuracy of clinical diagnosis in knee arthroscopy.

OpenAIRE

Brooks, Stuart; Morgan, Mamdouh

2002-01-01

A prospective study of 238 patients was performed in a district general hospital to assess current diagnostic accuracy rates and to ascertain the use and the effectiveness of magnetic resonance imaging (MRI) scanning in reducing the number of negative arthroscopies. The pre-operative diagnosis of patients listed for knee arthroscopy was medial meniscus tear 94 (40%) and osteoarthritis 59 (25%). MRI scans were requested in 57 patients (24%) with medial meniscus tear representing 65% (37 patien...

MRI after patellofemoral replacement: The preserved compartments

International Nuclear Information System (INIS)

Heyse, Thomas J.; Figiel, Jens; Hähnlein, Ulrike; Timmesfeld, Nina; Lakemeier, Stefan; Schofer, Markus D.; Fuchs-Winkelmann, Susanne; Efe, Turgay

2012-01-01

Introduction: The aim of this study was to assess the reproducibility of magnet resonance imaging (MRI) analysis of preserved anatomic structures of the knee after patellofemoral replacement (PFR). It was hypothesized that evaluation of cartilage, ligaments, meniscus and tendons would result in high inter-observer reliability after PFR. Material and methods: MRI, tailored to reduce metallic artefacts of the knee, after PFR was performed in seven patients. Two independent investigators evaluated cartilage, menisci, collateral and cruciate ligaments, the quadriceps and patellar tendons and the presence of joint effusion. The reviewers used a five-point scale to give a degree of confidence to their evaluation of each parameter. Inter-observer reliability was determined by calculation of Cohen's Kappas. Results: Artefact provoked by the implants was not observed. For all assessed structures, there was excellent inter-observer reliability, with high Cohen's Kappas. There were also high levels of inter-observer agreement and observer confidence in the evaluation of cartilage, meniscus, tendons, ligaments and joint effusion. Conclusion: Tailored MRI allows reproducible analysis of the preserved knee joint structures after PFR. It might prove helpful in assessment of painful knee joints after PFR

MRI after patellofemoral replacement: The preserved compartments

Energy Technology Data Exchange (ETDEWEB)

Heyse, Thomas J., E-mail: heyse@med.uni-marburg.de [Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg (Germany); Figiel, Jens [Department of Radiology, University Hospital Marburg, Marburg (Germany); Hähnlein, Ulrike [Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg (Germany); Timmesfeld, Nina [Institute for Medical Biometry and Epidemiology, Marburg (Germany); Lakemeier, Stefan; Schofer, Markus D.; Fuchs-Winkelmann, Susanne; Efe, Turgay [Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043 Marburg (Germany)

2012-09-15

Introduction: The aim of this study was to assess the reproducibility of magnet resonance imaging (MRI) analysis of preserved anatomic structures of the knee after patellofemoral replacement (PFR). It was hypothesized that evaluation of cartilage, ligaments, meniscus and tendons would result in high inter-observer reliability after PFR. Material and methods: MRI, tailored to reduce metallic artefacts of the knee, after PFR was performed in seven patients. Two independent investigators evaluated cartilage, menisci, collateral and cruciate ligaments, the quadriceps and patellar tendons and the presence of joint effusion. The reviewers used a five-point scale to give a degree of confidence to their evaluation of each parameter. Inter-observer reliability was determined by calculation of Cohen's Kappas. Results: Artefact provoked by the implants was not observed. For all assessed structures, there was excellent inter-observer reliability, with high Cohen's Kappas. There were also high levels of inter-observer agreement and observer confidence in the evaluation of cartilage, meniscus, tendons, ligaments and joint effusion. Conclusion: Tailored MRI allows reproducible analysis of the preserved knee joint structures after PFR. It might prove helpful in assessment of painful knee joints after PFR.

Distribution pattern of MRI abnormalities within the knee and wrist of juvenile idiopathic arthritis patients: signature of disease activity

NARCIS (Netherlands)

Nusman, Charlotte M.; Hemke, Robert; Schonenberg, Dieneke; Dolman, Koert M.; van Rossum, Marion A. J.; van den Berg, J. Merlijn; Kuijpers, Taco W.; Maas, Mario

2014-01-01

The aim of this study in clinically active juvenile idiopathic arthritis (JIA) was to assess the frequency and distribution pattern of synovitis as hallmark of disease and additional soft-tissue and bony abnormalities on MRI in the knee and wrist as two target joints. MRI datasets of 153 clinically

Magnetic Resonance Imaging (MRI) -- Head

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Full Text Available ... to a CD or uploaded to a digital cloud server. Currently, MRI is the most sensitive imaging ... over time. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... claustrophobia. Newer open MRI units provide very high quality images for many types of exams. Older open MRI units may not provide this same image quality. Certain types of exams cannot be performed using ...

MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint

Energy Technology Data Exchange (ETDEWEB)

Nakanishi, Katsuyuki; Inoue, Masahiro; Murakami, Takamichi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

1992-12-01

To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26,70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90deg). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM. (author).

MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint

International Nuclear Information System (INIS)

Nakanishi, Katsuyuki; Inoue, Masahiro; Murakami, Takamichi

1992-01-01

To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26,70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90deg). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM. (author)

MRI profiles of menisci of the knee

International Nuclear Information System (INIS)

Kitano, Kimizo; Akahori, Osamu; Suwa, Shinichi

1992-01-01

The rate of correct diagnosis of disorders of menisci is considered to exceed 95% by arthrography and arthroscopy, but these examinations are both invasive and effective only for evaluation of changes on the surface of meniscus. Diagnosis of injury of the posterior horn of the lateral meniscus is difficult by athrography, and that of injury of the posterior horn of the medial meniscus is difficult by arthroscopy. MRI is a non-invasive examination that allows the diagnosis of changes of the surface and the inside of the meniscus. This study reviewed 44 cases in which MRI findings could be confirmed by arthroscopy or at operating among 114 patients who underwent MRI to rule out the possibility of meniscus injury during the period between August 1988 and June 1991. The total number of patients who underwent MRI during this period was 6,983. The apparatus used was a 1.5-Tesla superconductive MR system, and evaluation was based mainly on the control T1-weighted image obtained by the spin-echo mode and sagittal image double-echo sequence. Characteristics of MRI were described as follows. Four cases of injury of the medial meniscus are (1) typical bucket-handle injury; (2) horizontal tear visible by arthroscopy; (3) horizontal tear difficult to observe by arthroscopy; (4) horizontal tear after partial meniscectomy under arthroscopy. Four cases of injury of the lateral meniscus are (1) multiple tear and artifact of foreign body of needle-fragment; (2) longitudinal tear; (3) multiple injury of discoid meniscus; (4) locking of discoid meniscus. MRI was considered to be advantageous over arthrography or arthroscopy in injury of medial meniscus (especially horizonal tear extending to the lower surface on the tibial side), meniscus ganglion, injury of the posterior horn of the lateral meniscus, and discoid menisci of children. From the findings in these 44 cases, MRI is considered to provide important information for the diagnosis of injury of menisci. (author)

MR imaging of the knee: findings in asymptomatic collegiate basketball players.

Science.gov (United States)

Major, Nancy M; Helms, Clyde A

2002-09-01

The purpose of our study was to evaluate the knees of asymptomatic high-level collegiate basketball players before the beginning of the basketball season to gain an understanding of nonclinical findings in this patient population. Bilateral knee MR imaging examinations of 17 varsity basketball players (12 men and five women) were performed before basketball season began. All of the subjects were imaged on a 1.5-T magnet. The MR imaging studies were reviewed by two musculoskeletal radiologists. Structures analyzed were the menisci, ligaments, cartilage, plicae, and bone marrow. The presence of a joint effusion was also noted. Fourteen (41%) of the 34 knees had bone marrow edema, eight (24%) showed signal in the patellar tendon, and 14 (41%) had abnormal cartilage signal or a focal abnormality. Twelve (35%) of the 34 knees showed a joint effusion. Two knees (6%) showed abnormal signal along the infrapatellar plica. Four knees (12%) were noted to have a discoid meniscus. An MR examination of the knees of high-level collegiate basketball players may show changes unique to this population. The changes seen on MR imaging in these athletes may be asymptomatic abnormalities. For instance, changes suggestive of patellar tendinopathy were identified in these asymptomatic subjects.

MRI of discoid lateral meniscus

International Nuclear Information System (INIS)

Araki, Yutaka; Ootani, Masatoshi; Furukawa, Tomoaki; Yamamoto, Tadatsuka; Tomoda, Kaname; Tsukaguchi, Isao; Mitomo, Masanori.

1991-01-01

We retrospectively reviewed the MR examinations of 10 patients (17 knees) with surgically documented discoid lateral meniscus of the knee joint. As MRI of the knee is being used more often, the criteria for diagnosis of this entity with MRI need to be established. We tried to define MRI criteria for the detection of discoid menisci by performing numerical measurements of MR images on a display screen. The transverse diameter of the midbody of a discoid lateral meniscus averaged 21.9 mm (normal control: 8.6 mm), and its proportion to the transverse width of the tibia averaged 29.4% (normal control: 12.0%). The measurable difference in height between the discoid and the medial meniscus was negligible. The number of sagittal sections on which the anterior and posterior horns connected varied from two to five in cases of discoid lateral meniscus, and from zero to two in normal controls. Among these parameters, the transverse diameter and its proportion of the transverse width of the tibia proved to be the most reliable. We concluded that a discoid meniscus is indicated if a transverse diameter of a lateral meniscus exceeds 15 mm (proportion to the tibia: 20%). (author)

Predictive value of MRI features for development of radiographic osteoarthritis in a cohort of participants with pre-radiographic knee osteoarthritis-the CHECK study

NARCIS (Netherlands)

van Oudenaarde, Kim; Jobke, Björn; Oostveen, Ans C M; Marijnissen, Annekarien C A; Wolterbeek, Ron; Wesseling, Janet; Bierma-Zeinstra, Sita M A; Bloem, Hans L; Reijnierse, Monique; Kloppenburg, Margreet

OBJECTIVE: To determine whether MRI features are associated with development of radiographic knee OA and can be used as a predictive tool in early knee OA. METHODS: In 148 participants of the Cohort Hip and Cohort Knee study (mean age 56 years, 78% women), with a Kellgren Lawrence (KL) score ⩽1, we

Kinematic MR imaging of the knee for evaluating patellar tracking

International Nuclear Information System (INIS)

Shellock, F.G.; Mink, J.H.; Fox, J.

1988-01-01

A new technique to evaluate patellar tracking uses MR imaging and a specially designed positioning device (MEDRAD). T1-weighted, axial plane imaging was performed on both knees at the following joint angles: 0 0 , 5 0 , 10 0 , 15 0 , 20 0 , 25 0 , and 30 0 . The total examination time was approximately 12 minutes. Images were viewed in a cine loop to produce a kinematic study that depicted the relationship of the patella to the trochlear groove during the different angles of knee flexion. To date, 102 subjects (204 knees) have been examined. Dislocation, subluxatino, lateral tilt, lateral and medial displacement of the patella, and normal patellar tracking could all be identified with this technique. Abnormal configurations of the patella and/or trochlear groove were also clearly demonstrated. In conclusion, kinematic MR imaging of the knee provided important clinical information concerning patellar tracking and other related abnormalities of the patellofemoral joint

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician ... Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose medical conditions. MRI ...

Magnetic resonance image segmentation using semi-automated software for quantification of knee articular cartilage - initial evaluation of a technique for paired scans

International Nuclear Information System (INIS)

Brem, M.H.; Lang, P.K.; Neumann, G.; Schlechtweg, P.M.; Yoshioka, H.; Pappas, G.; Duryea, J.; Schneider, E.; Jackson, R.; Yu, J.; Eaton, C.B.; Hennig, F.F.

2009-01-01

Software-based image analysis is important for studies of cartilage changes in knee osteoarthritis (OA). This study describes an evaluation of a semi-automated cartilage segmentation software tool capable of quantifying paired images for potential use in longitudinal studies of knee OA. We describe the methodology behind the analysis and demonstrate its use by determination of test-retest analysis precision of duplicate knee magnetic resonance imaging (MRI) data sets. Test-retest knee MR images of 12 subjects with a range of knee health were evaluated from the Osteoarthritis Initiative (OAI) pilot MR study. Each subject was removed from the magnet between the two scans. The 3D DESS (sagittal, 0.456 mm x 0.365 mm, 0.7 mm slice thickness, TR 16.5 ms, TE 4.7 ms) images were obtained on a 3-T Siemens Trio MR system with a USA Instruments quadrature transmit-receive extremity coil. Segmentation of one 3D-image series was first performed and then the corresponding retest series was segmented by viewing both image series concurrently in two adjacent windows. After manual registration of the series, the first segmentation cartilage outline served as an initial estimate for the second segmentation. We evaluated morphometric measures of the bone and cartilage surface area (tAB and AC), cartilage volume (VC), and mean thickness (ThC.me) for medial/lateral tibia (MT/LT), total femur (F) and patella (P). Test-retest reproducibility was assessed using the root-mean square coefficient of variation (RMS CV%). For the paired analyses, RMS CV % ranged from 0.9% to 1.2% for VC, from 0.3% to 0.7% for AC, from 0.6% to 2.7% for tAB and 0.8% to 1.5% for ThC.me. Paired image analysis improved the measurement precision of cartilage segmentation. Our results are in agreement with other publications supporting the use of paired analysis for longitudinal studies of knee OA. (orig.)

Magnetic resonance image segmentation using semi-automated software for quantification of knee articular cartilage - initial evaluation of a technique for paired scans

Energy Technology Data Exchange (ETDEWEB)

Brem, M.H. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Friedrich-Alexander-University Erlangen Nurenberg, Division of Orthopaedic and Trauma Surgery, Department of Surgery, Erlangen (Germany); Lang, P.K.; Neumann, G.; Schlechtweg, P.M.; Yoshioka, H.; Pappas, G.; Duryea, J. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Schneider, E. [LLC, SciTrials, Rocky River, OH (United States); Cleveland Clinic, Imaging Institute, Cleveland, OH (United States); Jackson, R.; Yu, J. [Ohio State University, Diabetes and Metabolism and Radiology, Department of Endocrinology, Columbus, OH (United States); Eaton, C.B. [Center for Primary Care and Prevention and the Warren Alpert Medical School of Brown University, Memorial Hospital of Rhode Island, Providence, RI (United States); Hennig, F.F. [Friedrich-Alexander-University Erlangen Nurenberg, Division of Orthopaedic and Trauma Surgery, Department of Surgery, Erlangen (Germany)

2009-05-15

Software-based image analysis is important for studies of cartilage changes in knee osteoarthritis (OA). This study describes an evaluation of a semi-automated cartilage segmentation software tool capable of quantifying paired images for potential use in longitudinal studies of knee OA. We describe the methodology behind the analysis and demonstrate its use by determination of test-retest analysis precision of duplicate knee magnetic resonance imaging (MRI) data sets. Test-retest knee MR images of 12 subjects with a range of knee health were evaluated from the Osteoarthritis Initiative (OAI) pilot MR study. Each subject was removed from the magnet between the two scans. The 3D DESS (sagittal, 0.456 mm x 0.365 mm, 0.7 mm slice thickness, TR 16.5 ms, TE 4.7 ms) images were obtained on a 3-T Siemens Trio MR system with a USA Instruments quadrature transmit-receive extremity coil. Segmentation of one 3D-image series was first performed and then the corresponding retest series was segmented by viewing both image series concurrently in two adjacent windows. After manual registration of the series, the first segmentation cartilage outline served as an initial estimate for the second segmentation. We evaluated morphometric measures of the bone and cartilage surface area (tAB and AC), cartilage volume (VC), and mean thickness (ThC.me) for medial/lateral tibia (MT/LT), total femur (F) and patella (P). Test-retest reproducibility was assessed using the root-mean square coefficient of variation (RMS CV%). For the paired analyses, RMS CV % ranged from 0.9% to 1.2% for VC, from 0.3% to 0.7% for AC, from 0.6% to 2.7% for tAB and 0.8% to 1.5% for ThC.me. Paired image analysis improved the measurement precision of cartilage segmentation. Our results are in agreement with other publications supporting the use of paired analysis for longitudinal studies of knee OA. (orig.)

MR imaging before arthroscopy in knee joint disorders?

International Nuclear Information System (INIS)

Rappeport, E.D.; Mehta, S.; Wieslander, S.B.; Schwarz Lausten, G.; Thomsen, H.S.

1996-01-01

Purpose: To review the current literature examining the relative merits of arthroscopy and MR imaging of the knee. Material and Methods: All papers comparing MR imaging with arthroscopy published within the last 10 years according to Medline were collected and read. Results: Technology has improved considerably during recent years allowing detailed non-invasive visualization of the knee. In particular, the development of cheaper whole-body and dedicated low-field MR units has opened up for non-invasive inspection of the knee at reasonable cost. Meniscal tears can be detected with accuracy rates of around 90% and rupture of the anterior cruciate ligament with accuracy rates of around 93% compared to arthroscopy. However, arthroscopy is not the ideal gold standard, since it has weak points, e.g. peripheral meniscal tears or osteochondritis without apparent damage to the cartilage. Conclusion: Based on the overwhelming literature it seems safe to conclude that MR examinations of the knee should be performed before arthroscopy is undertaken. (orig.)

Regional migratory osteoporosis in the knee: MRI findings in 22 patients and review of the literature

International Nuclear Information System (INIS)

Karantanas, Apostolos H.; Nikolakopoulos, Ioannis; Korompilias, Anastasios V.; Apostolaki, Eleni; Skoulikaris, Nicolaos; Eracleous, Eleni

2008-01-01

Objective: Acute non-traumatic bone marrow edema (BME) in the knee is a common clinical problem. The aim of the present study is to present the MR imaging findings of the uncommon transient migratory pattern of this syndrome. Materials and methods: Twenty-two patients (21 men, 1 woman, age range 35-73 years, mean 49.4 ± 7.6) who presented with pain in the knee joint (ranging from 2 weeks to 6 months) and BME in the MR imaging examination, were included in the study. In all cases, the knee joint BME was either preceded or followed by another site of BME in the same or another joint. All patients were studied with plain X-rays and MR imaging at presentation and with MR imaging after resolution of symptoms. Results: The eight patients with initial involvement in the knee showed migration either intra-articularly (5), or/and in the contralateral knee (2) and only 1 case showed migration to the ipsilateral hip joint. In two patients the BME shifted from the hip first to the foot and then to the knee. The median migration period was 4 months for the second involvement in all patients and 3 months for the third involvement (10 patients). Conclusions: The present study reports the largest series of patients with regional migratory osteoporosis involving the knee. In most of the cases, shifting of BME remains in the joint or moves to the contralateral knee. In only one case the BME shifted from the knee elsewhere. All lesions were transient

Longitudinal sensitivity to change of MRI-based muscle cross-sectional area versus isometric strength analysis in osteoarthritic knees with and without structural progression: pilot data from the Osteoarthritis Initiative.

Science.gov (United States)

Dannhauer, Torben; Sattler, Martina; Wirth, Wolfgang; Hunter, David J; Kwoh, C Kent; Eckstein, Felix

2014-08-01

Biomechanical measurement of muscle strength represents established technology in evaluating limb function. Yet, analysis of longitudinal change suffers from relatively large between-measurement variability. Here, we determine the sensitivity to change of magnetic resonance imaging (MRI)-based measurement of thigh muscle anatomical cross sectional areas (ACSAs) versus isometric strength in limbs with and without structural progressive knee osteoarthritis (KOA), with focus on the quadriceps. Of 625 "Osteoarthritis Initiative" participants with radiographic KOA, 20 had MRI cartilage and radiographic joint space width loss in the right knee isometric muscle strength measurement and axial T1-weighted spin-echo acquisitions of the thigh. Muscle ACSAs were determined from manual segmentation at 33% femoral length (distal to proximal). In progressor knees, the reduction in quadriceps ACSA between baseline and 2-year follow-up was -2.8 ± 7.9 % (standardized response mean [SRM] = -0.35), and it was -1.8 ± 6.8% (SRM = -0.26) in matched, non-progressive KOA controls. The decline in extensor strength was more variable than that in ACSAs, both in progressors (-3.9 ± 20%; SRM = -0.20) and in non-progressive controls (-4.5 ± 28%; SRM = -0.16). MRI-based analysis of quadriceps muscles ACSAs appears to be more sensitive to longitudinal change than isometric extensor strength and is suggestive of greater loss in limbs with structurally progressive KOA than in non-progressive controls.

Imaging of postoperative knee extensor mechanism

Energy Technology Data Exchange (ETDEWEB)

Motamedi, Kambiz [David Geffen School of Medicine at UCLA, Musculoskeletal Imaging-Department of Radiology, 200 Medical Plaza, Suite 165-59, Los Angeles, CA 90095 (United States); Seeger, Leanne L. [David Geffen School of Medicine at UCLA, Musculoskeletal Imaging-Department of Radiology, 200 Medical Plaza, Suite 165-57, Los Angeles, CA 90095 (United States); Hame, Sharon L. [David Geffen School of Medicine at UCLA, Department of Orthopedic Surgery, Box 956902, 76-143 CHS, Los Angeles, CA 90095 (United States)

2005-05-01

Disorders of the anterior knee are common and include patellofemoral syndrome, patella instability, patella fracture, and patellar and quadriceps tendon ruptures. Depending on the operative procedure performed, the post-operative imaging appearance of these knees may be confusing. It is crucial for the radiologist to be familiar with the procedures performed in order to recognize the postoperative findings. Radiologists must be able to interpret hardware (anchors, screw and wires) and disruptions in soft tissue planes that may persist with these types of procedures.

Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

Energy Technology Data Exchange (ETDEWEB)

Peltola, Erno K. [Helsinki University Hospital, Toeoeloe Trauma Center, Department of Radiology, Helsinki Medical Imaging Center, Helsinki (Finland); Koskinen, Seppo K. [Karolinska Universitetssjukhuset, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden)

2015-09-15

To examine dual-energy computed tomography (DECT) in evaluating cruciate ligament injuries. More specifically, the purpose was to assess the optimal keV level in DECT gemstone spectral imaging (GSI) images and to examine the usefulness of collagen-specific color mapping and dual-energy bone removal in the evaluation of cruciate ligaments and the popliteus tendon. At a level 1 trauma center, a 29-month period of emergency department DECT examinations for acute knee trauma was reviewed by two radiologists for presence of cruciate ligament injuries, visualization of the popliteus tendon and the optimal keV level in GSI images. Three different evaluating protocols (GSI, bone removal and collagen-specific color mapping) were rated. Subsequent MRI served as a reference standard for intraarticular injuries. A total of 18 patients who had an acute knee trauma, DECT and MRI were found. On MRI, six patients had an ACL rupture. DECT's sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively. The DECT vs. MRI intra- and interobserver proportions of agreement for ACL rupture were excellent or good (kappa values 0.72-0.87). Only one patient had a PCL rupture. In GSI images, the optimal keV level was 63 keV. GSI of 40-140 keV was considered to be the best evaluation protocol in the majority of cases. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon. (orig.)

Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects-a 3.0 T magnetic resonance imaging study.

Science.gov (United States)

Stahl, Robert; Luke, Anthony; Ma, C Benjamin; Krug, Roland; Steinbach, Lynne; Majumdar, Sharmila; Link, Thomas M

2008-07-01

To determine the prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects. To compare the diagnostic performance of cartilage-dedicated magnetic resonance imaging (MRI) sequences at 3.0 T. Ten marathon runners underwent 3.0 T MRI 2-3 days before and after competition. Twelve physically active asymptomatic subjects not performing long-distance running were examined as controls. Pathologic condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were quantified. Visualization of cartilage pathology was assessed with intermediate-weighted fast spin-echo (IM-w FSE), fast imaging employing steady-state acquisition (FIESTA) and T1-weighted three-dimensional (3D) high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) MRI sequences. Eight of ten marathon runners and 7/12 controls showed knee abnormality. Slightly more and larger cartilage abnormalities, and BMEP, in marathon runners yielded higher but not significantly different WORMS (P > 0.05) than in controls. Running a single marathon did not alter MR findings substantially. Cartilage abnormalities were best visualized with IM-w FSE images (P marathon runners and also in active subjects participating in other recreational sports. IM-w FSE sequences delineated more cartilage MR imaging abnormalities than did FIESTA and SPGR sequences.

Local contrast-enhanced MR images via high dynamic range processing.

Science.gov (United States)

Chandra, Shekhar S; Engstrom, Craig; Fripp, Jurgen; Neubert, Ales; Jin, Jin; Walker, Duncan; Salvado, Olivier; Ho, Charles; Crozier, Stuart

2018-09-01

To develop a local contrast-enhancing and feature-preserving high dynamic range (HDR) image processing algorithm for multichannel and multisequence MR images of multiple body regions and tissues, and to evaluate its performance for structure visualization, bias field (correction) mitigation, and automated tissue segmentation. A multiscale-shape and detail-enhancement HDR-MRI algorithm is applied to data sets of multichannel and multisequence MR images of the brain, knee, breast, and hip. In multisequence 3T hip images, agreement between automatic cartilage segmentations and corresponding synthesized HDR-MRI series were computed for mean voxel overlap established from manual segmentations for a series of cases. Qualitative comparisons between the developed HDR-MRI and standard synthesis methods were performed on multichannel 7T brain and knee data, and multisequence 3T breast and knee data. The synthesized HDR-MRI series provided excellent enhancement of fine-scale structure from multiple scales and contrasts, while substantially reducing bias field effects in 7T brain gradient echo, T 1 and T 2 breast images and 7T knee multichannel images. Evaluation of the HDR-MRI approach on 3T hip multisequence images showed superior outcomes for automatic cartilage segmentations with respect to manual segmentation, particularly around regions with hyperintense synovial fluid, across a set of 3D sequences. The successful combination of multichannel/sequence MR images into a single-fused HDR-MR image format provided consolidated visualization of tissues within 1 omnibus image, enhanced definition of thin, complex anatomical structures in the presence of variable or hyperintense signals, and improved tissue (cartilage) segmentation outcomes. © 2018 International Society for Magnetic Resonance in Medicine.

Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease

International Nuclear Information System (INIS)

Hirano, Atsushi; Ishii, Tomoo; Ochiai, Naoyuki

2002-01-01

Objective. The purpose of this study was to clarify the nature of Osgood-Schlatter disease (OSD) using MR images.Design. Thirty boys (40 knees) with OSD diagnosed by clinical symptoms and signs were investigated with MRI. Longitudinal evaluation was undertaken in 22 patients and the mean follow-up was 1.5±0.9 years. MR examinations were performed at least every 6 months in most cases. When a patient's symptoms changed, MRI was repeated and in cases where the initial MR examination showed an early or progressive stage of OSD, MRI was undertaken every month where possible. All MR examinations were performed in the sagittal plane with a 0.2 T imager.Results. MR images were classified into five stages as follows: normal, early, progressive, terminal and healing. The stage of 11 knees (28%) did not change during the course of the study and 21 knees (53%) showed a change of at least one stage. Eight knees (20%) did not have follow-up MR studies. The initial MR examination was normal in nine knees. Eight knees were at the early stage at presentation. MR images showed edema-like changes around the tibial tuberosity. Ten knees were classified as in the progressive stage at the initial presentation and six knees were classified in this group during progression on follow-up MRI. MR images showed partial avulsion of the secondary ossification center, which was seen to be being pulled proximally. Eleven knees were at the terminal stage on presentation, where the avulsed parts of the secondary ossification center had become completely separated. Two knees were classified as in the healing stage at presentation and 19 knees progressed to the healing stage from the normal, early and progressive stages. The MR images showed the separated part that did not create the ossicle had recovered by osseous healing. On the other hand, radiographs of the early stage appeared almost normal, and in the progressive stage could not show the avulsed parts.Conclusions. We clarified the progress

Age Predicts Disruption of the Articular Surface of the Femoral Condyles in Knee OCD: Can We Reduce Usage of Arthroscopy and MRI?

Science.gov (United States)

Siegall, Evan; Faust, John R; Herzog, Mackenzie M; Marshall, Kelley W; Willimon, S Clifton; Busch, Michael T

2018-03-01

The purpose of this study was to determine if patient age could accurately identify disrupted articular cartilage overlying an osteochondritis dissecans (OCD) lesion of the femoral condyle in adolescents. This could have important implications for imaging and treatment decisions. All patients from 2001 to 2014 who were arthroscopically treated for a femoral condyle OCD were included in this Institutional Review Board-approved study. Exclusion criteria were trochlear and patellar OCD lesions, idiopathic arthritis, and traumatic osteochondral injuries. Arthroscopy was performed to visualize and probe the articular surface. Arthroscopic and magnetic resonance imaging (MRI) findings were recorded as "intact" or "disrupted" cartilage. Extra-articular drilling was performed when the articular cartilage was intact. There were 119 patients (81 male, 68%) with 139 OCD lesions in 136 knees. The mean age at time of surgery was 13.0 years (range, 7.2 to 19.3 y). At arthroscopy, 115 knees had intact cartilage and 24 had disrupted cartilage. There was a significant difference in age between patients with intact versus disrupted cartilage at arthroscopy (12.5 vs. 15.3 y; POCD lesions had MRIs preoperatively, showing 69 as intact and 19 (24%) disrupted. MRI reading for cartilage status had 94% sensitivity and 97% specificity. Multivariable regression analysis revealed that age (P<0.01) and MRI status (P<0.0001) were strong predictors of cartilage status. Sixteen years was the critical age in which both sensitivity was maximized and false positive probability was minimized. Over the age of 17 years, 7 of 7 (100%) had disrupted cartilage. Age alone was 100% sensitive for children below the age of 10, and 96% sensitive below the age of 13. Age was a good predictor of cartilage status in both younger (<13 y) and older (≥17 y) patients in this study. For patients in the mid-range group (13 through 16 y), age alone is not an adequate predictor of cartilage status, but adding MRI

Magnetic Resonance Imaging (MRI) -- Head

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Full Text Available ... can also provide functional information (fMRI) in selected cases. MR images of the brain and other cranial structures are clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in early diagnosis and evaluation of many conditions, ...

Magnetic resonance imaging of anterior cruciate ligament of the knee: a comparison of four sequences

International Nuclear Information System (INIS)

Casillas, C.; Marti-Bonmati, L.; Molla, E.; Ferrer, P.; Dosda, R.

1999-01-01

To compare the diagnostic efficacy of the four magnetic resonance imaging (MRI) sequences that compose the standard protocol for the study of the knee in our center when employed in the examination of anterior cruciate ligament (ACL). A prospective study was carried out based on MRI findings in the knees of 326 consecutive patients. Sagittal [proton density (PD w eighted turbo-spin-echo and T2*-weighted gradient echo], coronal (PD-weighted turbo-spin-echo with fat suppression) and transverse (T2*-weighted gradient echo with magnetization transfer) images were evaluated. Each sequence was analyzed independently by two radiologists, while another two assessed all the sequences together with the clinical findings. Four categories were established: normal ACL, partially torn, completely torn and synovialized. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with respect to the definitive diagnosis were calculated for each sequence. The statistical analysis of the findings for each category was done using the chi-squared test and the Kappa test was employed to assess the degree of agreement. According to the final diagnosis, 263 ACL were normal, 29 were partially torn, 33 were completely torn and there was 1 case of synovialization associated with a completely torn ACL. The relationship between the analysis of the ACL according to each sequence and the definitive diagnosis was very significant (p<0.001) and the agreement was excellent. All the sequences presented similar levels of diagnostic precision. The coronal sequence had least number of diagnostic errors (2.1%). The combinations of imaging techniques that resulted in the lowest error rate with respect to the definitive diagnosis were coronal PD-weighted turbo-spin-echo with fat suppression and sagittal PD-weighted turbo-spin-echo. Coronal images are highly precise in the evaluation of ACL. Sagittal sequences are the most valid for diagnosis of torn ACL. Transverse

The relationship between three-dimensional knee MRI bone shape and total knee replacement—a case control study: data from the Osteoarthritis Initiative

Science.gov (United States)

Barr, Andrew J.; Dube, Bright; Hensor, Elizabeth M. A.; Kingsbury, Sarah R.; Peat, George; Bowes, Mike A.; Sharples, Linda D.

2016-01-01

Objective. There is growing understanding of the importance of bone in OA. Our aim was to determine the relationship between 3D MRI bone shape and total knee replacement (TKR). Methods. A nested case-control study within the Osteoarthritis Initiative cohort identified case knees with confirmed TKR for OA and controls that were matched using propensity scores. Active appearance modelling quantification of the bone shape of all knee bones identified vectors between knees having or not having OA. Vectors were scaled such that −1 and +1 represented the mean non-OA and mean OA shapes. Results. Compared to controls (n = 310), TKR cases (n = 310) had a more positive mean baseline 3D bone shape vector, indicating more advanced structural OA, for the femur [mean 0.98 vs −0.11; difference (95% CI) 1.10 (0.88, 1.31)], tibia [mean 0.86 vs −0.07; difference (95% CI) 0.94 (0.72, 1.16)] and patella [mean 0.95 vs 0.03; difference (95% CI) 0.92 (0.65, 1.20)]. Odds ratios (95% CI) for TKR per normalized unit of 3D bone shape vector for the femur, tibia and patella were: 1.85 (1.59, 2.16), 1.64 (1.42, 1.89) and 1.36 (1.22, 1.50), respectively, all P < 0.001. After including Kellgren–Lawrence grade in a multivariable analysis, only the femur 3D shape vector remained significantly associated with TKR [odds ratio 1.24 (1.02, 1.51)]. Conclusion. 3D bone shape was associated with the endpoint of this study, TKR, with femoral shape being most associated. This study contributes to the validation of quantitative MRI bone biomarkers for OA structure-modification trials. PMID:27185958

Knee pain (image)

Science.gov (United States)

The location of knee pain can help identify the problem. Pain on the front of the knee can be due to bursitis, arthritis, or ... synovial fluid) that forms behind the knee. Overall knee pain can be due to bursitis, arthritis, tears in ...

Unusual Cause of Knee Locking

Directory of Open Access Journals (Sweden)

Gazi Huri

2013-01-01

Full Text Available We report a case of partial intrasubstance tear of popliteus tendon as an unusual cause of pseudolocking of the knee. A 13-year-old semiprofessional soccer player applied to our clinic with a locked right knee in spite of the therapy applied (cold pack, NSAID, and immobilization in another institution 20 days after the injury. Significant extension loss was observed in his right knee with 30∘–90∘ ROM. Magnetic resonance imaging (MRI and arthroscopy confirmed the intrasubstance tear of popliteus tendon and synovitis. The ruptured part of the tendon was debrided, and the inflammatory tissue around the tendon, which may lead to pseudolocking, was gently removed with a shaver in order to regain the normal ROM. The patient was discharged with full ROM and weight bearing first day after the surgery. To our knowledge, this is the first case demonstrating intrasubstance tear of popliteus tendon causing pseudolocking of the knee.

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... or patients with claustrophobia. Other MRI machines are open on the sides (open MRI). Open units are especially helpful for examining larger patients or those with claustrophobia. Newer open MRI units provide very high quality images for ...

MR imaging in patients with knee injury: an observational study in general practice

NARCIS (Netherlands)

S.S. Boks (Simone)

2007-01-01

textabstractKnee trauma is often seen in general practice. The availability of magnetic resonance (MR) imaging has improved the diagnostic possibilities after knee trauma. Nevertheless, little is known about the findings on MR imaging after knee trauma in general practice. Especially, there is

Magnetization transfer contrast MR imaging of the knee at 0.3 T

International Nuclear Information System (INIS)

Yoshioka, Hiroshi; Onaya, Hiroaki; Niitsu, Mamoru; Anno, Izumi; Itai, Yuji; Nishimura, Hiroshi; Kajiyama, Koji; Masuda, Tomonori; Nakajima, Kotaro.

1994-01-01

It has been reported that magnetization transfer contrast (MTC) images were effective in evaluating the articular cartilage. However, only one in vivo study of the articular cartilage in the knee has been demonstrated at 1.5T. The purpose of this study was to evaluate the optimal off-resonance MTC pulse at 0.3T MR imager and assess its clinical usefulness. Five normal volunteers and eleven patients with suspected knee injuries were investigated using off-resonance sinc, gaussian, constant shaped irradiation pulses. All MTC images revealed higher contrast and contrast-to-noise (C/N) ratio between articular cartilage and external reference (saline) in the normal volunteers' knee than conventional gradient recalled echo images. MTC images with the gaussian or sinc shaped pulse were judged superior to those with constant wave pulse because the former images showed a fewer artifact with lower specific absorption rate than the latter images. The sinc MTC images were performed with the lowest SAR. The gaussian MTC images revealed better contrast and C/N between articular cartilage and joint fluid than the sinc MTC images in patients. 3D MTC images using Guassian pulse were also performed within a clinically tolerable imaging time (13 min 39 sec). Thus, MTC images in the knee at 0.3T using off-resonance pulse may be effective to assess knee injury due to better contrast between articular cartilage and joint fluid. (author)

Optimization of contrast of MR images in imaging of knee joint

International Nuclear Information System (INIS)

Szyblinski, K.; Bacic, G.

1994-01-01

The work describes the method of contrast optimization in magnetic resonance imaging. Computer program presented in the report allows analysis of contrast in selected tissues as a function of experiment parameters. Application to imaging of knee joint is presented

Role of magnetic resonance imaging in the clinical management of the acutely locked knee

International Nuclear Information System (INIS)

McNally, Eugene G.; Nasser, Khalid N.; Dawson, Stewart; Goh, Leslie A.

2002-01-01

To explore prospectively the hypothesis that MRI of the acutely locked knee can alter surgical decision-making.Design and patients. The study group comprised patients with a clinical diagnosis of knee locking requiring arthroscopy. The decision to carry out arthroscopy was made by an experienced consultant orthopaedic surgeon specialising in trauma and recorded in the patient's notes prior to MRI. Preoperative MRI was carried out using a 1.5 T system. The management was altered from surgical to conservative treatment in 20 (48%) patients on the basis of the MR findings. Arthroscopy was limited to patients with an MR diagnosis of a mechanical block, usually a displaced meniscal tear or loose body. Both patient groups were followed clinically until symptoms resolved.Results. Forty-two patients were entered into the study. MRI identified a mechanical cause for locking in 22 patients (21 avulsion meniscal tears and 1 loose body). All were confirmed at arthroscopy. Twenty patients were changed from operative to non-operative treatment on the basis of the MRI findings. One patient in this group required a delayed arthroscopy for an impinging anterior cruciate ligament stump. The sensitivity/specificity/accuracy of MRI in identifying patients who require arthroscopy was therefore 96%/100%/98% respectively.Conclusion. MRI can successfully segregate patients with a clinical diagnosis of mechanical locking into those who have a true mechanical block and those who can be treated conservatively. MRI should precede arthroscopy in this clinical setting. (orig.)

Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl.

Science.gov (United States)

Wen, D W; Tan, T J; Rasheed, S

2016-06-01

We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint.

Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl

Energy Technology Data Exchange (ETDEWEB)

Wen, D.W.; Rasheed, S. [KK Women' s and Children' s Hospital, Department of Diagnostic and Interventional Imaging, Singapore (Singapore); Tan, T.J. [Changi General Hospital, Department of Radiology, Singapore (Singapore)

2016-06-15

We report a histologically proven case of synovial haemangioma of the knee in a 14-month old girl who presented to the emergency department with an acute 1-day history of refusing to weight-bear on the right leg and a preceding 3-week history of a right knee lump. Physical examination revealed a non-tender, soft lump over the lateral infrapatellar region. Radiographs revealed a poorly defined soft tissue density over the infrapatellar fat pad and a suprapatellar joint effusion. Ultrasound was used to confirm the presence of a vascular soft tissue mass compatible with a synovial haemangioma within the infrapatellar fat pad which showed both intra-articular and extra-articular extension. There was good correlation of the ultrasound findings with magnetic resonance imaging (MRI), highlighting the potential clinical utility of ultrasound as an alternative imaging modality in establishing the pre-operative diagnosis and extent of a synovial haemangioma about the knee joint. (orig.)

Radial MR images of the knee

International Nuclear Information System (INIS)

Hewes, R.C.; Miller, T.R.

1988-01-01

To profile optimally each portion of the meniscus, the authors use the multiangle, multisection feature of a General Electric SIGNA 1.5-T imager to produce radial images centered on each meniscus. A total of 12-15 sections are imaged at 10 0 -15 0 intervals of each meniscus, yielding perpendicular images of the entire meniscus, comparable with the arthrographic tangential views. The authors review their technique and demonstrate correlation cases between the radial gradient recalled acquisition in a steady state sequences, sagittal and coronal MR images, and arthrograms. Radial images should be a routine part of knee MR imaging

Valid MR imaging predictors of prior knee arthroscopy

International Nuclear Information System (INIS)

Discepola, Federico; Le, Huy B.Q.; Park, John S.; Clopton, Paul; Knoll, Andrew N.; Austin, Matthew J.; Resnick, Donald L.

2012-01-01

To determine whether fibrosis of the medial patellar reticulum (MPR), lateral patellar reticulum (LPR), deep medial aspect of Hoffa's fat pad (MDH), or deep lateral aspect of Hoffa's fat pad (LDH) is a valid predictor of prior knee arthroscopy. Institutional review board approval and waiver of informed consent were obtained for this HIPPA-compliant study. Initially, fibrosis of the MPR, LPR, MDH, or LDH in MR imaging studies of 50 patients with prior knee arthroscopy and 100 patients without was recorded. Subsequently, two additional radiologists, blinded to clinical data, retrospectively and independently recorded the presence of fibrosis of the MPR in 50 patients with prior knee arthroscopy and 50 without. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detecting the presence of fibrosis in the MPR were calculated. κ statistics were used to analyze inter-observer agreement. Fibrosis of each of the regions examined during the first portion of the study showed a significant association with prior knee arthroscopy (p < 0.005 for each). A patient with fibrosis of the MPR, LDH, or LPR was 45.5, 9, or 3.7 times more likely, respectively, to have had a prior knee arthroscopy. Logistic regression analysis indicated that fibrosis of the MPR supplanted the diagnostic utility of identifying fibrosis of the LPR, LDH, or MDH, or combinations of these (p ≥ 0.09 for all combinations). In the second portion of the study, fibrosis of the MPR demonstrated a mean sensitivity of 82%, specificity of 72%, PPV of 75%, NPV of 81%, and accuracy of 77% for predicting prior knee arthroscopy. Analysis of MR images can be used to determine if a patient has had prior knee arthroscopy by identifying fibrosis of the MPR, LPR, MDH, or LDH. Fibrosis of the MPR was the strongest predictor of prior knee arthroscopy. (orig.)

Valid MR imaging predictors of prior knee arthroscopy

Energy Technology Data Exchange (ETDEWEB)

Discepola, Federico; Le, Huy B.Q. [McGill University Health Center, Jewsih General Hospital, Division of Musculoskeletal Radiology, Montreal, Quebec (Canada); Park, John S. [Annapolis Radiology Associates, Division of Musculoskeletal Radiology, Annapolis, MD (United States); Clopton, Paul; Knoll, Andrew N.; Austin, Matthew J.; Resnick, Donald L. [University of California San Diego (UCSD), Division of Musculoskeletal Radiology, San Diego, CA (United States)

2012-01-15

To determine whether fibrosis of the medial patellar reticulum (MPR), lateral patellar reticulum (LPR), deep medial aspect of Hoffa's fat pad (MDH), or deep lateral aspect of Hoffa's fat pad (LDH) is a valid predictor of prior knee arthroscopy. Institutional review board approval and waiver of informed consent were obtained for this HIPPA-compliant study. Initially, fibrosis of the MPR, LPR, MDH, or LDH in MR imaging studies of 50 patients with prior knee arthroscopy and 100 patients without was recorded. Subsequently, two additional radiologists, blinded to clinical data, retrospectively and independently recorded the presence of fibrosis of the MPR in 50 patients with prior knee arthroscopy and 50 without. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detecting the presence of fibrosis in the MPR were calculated. {kappa} statistics were used to analyze inter-observer agreement. Fibrosis of each of the regions examined during the first portion of the study showed a significant association with prior knee arthroscopy (p < 0.005 for each). A patient with fibrosis of the MPR, LDH, or LPR was 45.5, 9, or 3.7 times more likely, respectively, to have had a prior knee arthroscopy. Logistic regression analysis indicated that fibrosis of the MPR supplanted the diagnostic utility of identifying fibrosis of the LPR, LDH, or MDH, or combinations of these (p {>=} 0.09 for all combinations). In the second portion of the study, fibrosis of the MPR demonstrated a mean sensitivity of 82%, specificity of 72%, PPV of 75%, NPV of 81%, and accuracy of 77% for predicting prior knee arthroscopy. Analysis of MR images can be used to determine if a patient has had prior knee arthroscopy by identifying fibrosis of the MPR, LPR, MDH, or LDH. Fibrosis of the MPR was the strongest predictor of prior knee arthroscopy. (orig.)

Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later?

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Madan-Sharma, Ruby; Kornaat, Peter R.; Bloem, Johannes L.; Watt, Iain [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Kloppenburg, Margreet; Botha-Scheepers, Stella A. [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Graverand, Marie-Pierre Hellio le [Pfizer Groton, Groton, CT (United States)

2008-09-15

The purpose of the study was to relate magnetic resonance imaging (MRI) features at baseline with radiographically determined joint space narrowing (JSN) in the medial compartment of the knee after 2 years in a group of patients with symptomatic osteoarthritis at multiple joint sites. MRI of the knee and standardized radiographs were obtained at baseline and after 2 years in 186 patients (81% female; aged 43-76 years; mean 60 years). MRI was analyzed for bone marrow lesions, cysts, osteophytes, hyaline cartilage defects, joint effusion, and meniscal pathology in the medial compartment. Radiographs were scored semiquantitatively for JSN in the medial tibiofemoral joint using the Osteoarthritis Research Society International (OARSI) atlas. Radiological progression was defined as {>=}1 grade increase. Associations between baseline magnetic resonance (MR) parameters and subsequent radiographic JSN changes were assessed using logistic regression. Relative risk (RR) was then calculated. Radiographic progression of JSN was observed in 17 (9.1%) of 186 patients. Eleven patients had a Kellgren and Lawrence (KL) score of {>=}2. A significant association was observed between all patients and meniscal tears (RR 3.57; confidence interval (CI) 1.08-10.0) and meniscal subluxation (RR 2.73; CI 1.20-5.41), between KL<2 and meniscal subluxation (RR 11.3; CI 2.49-29.49) and KL {>=} 2 and meniscus tears (RR 8.91; CI 1.13-22.84) and radiographic JSN 2 years later. Follow-up MR in 15 of 17 patients with progressive JSN showed only new meniscal abnormalities and no progression of cartilage loss. Meniscal pathology (tears and/or meniscal subluxation) was the only MRI parameter to be associated with subsequent radiographic progression of JSN in the medial tibiofemoral compartment on a radiograph 2 years later, as assessed by the OARSI score. (orig.)

Imaging findings of Hoffa's fat pad herniation

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Chauvin, Nancy A.; Khwaja, Asef [The Children' s Hospital of Philadelphia, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA (United States); Epelman, Monica [Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Callahan, Michael J. [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States)

2016-04-15

We report the radiologic findings of herniation of Hoffa's fat pad through a defect in the lateral patellar retinaculum in young children who presented with painless masses visible by ultrasound (US) only with flexion of the knee. Six children, between the ages of 1-8 years, presented with an anterolateral knee mass that was not tender and was only seen and palpable with knee flexion. An US was performed in all patients, magnetic resonance imaging (MRI) in 2 patients and knee radiographs in 1 patient. US imaging displayed focal herniation of Hoffa's fat pad within the infrapatellar region through a defect of the lateral retinaculum, visible only during dynamic imaging when the knee was in flexion. MRI performed in knee extension did not demonstrate a mass; however, it revealed a focal defect in the lateral retinaculum in the region of the abnormality. Radiographs were normal. Focal herniation of Hoffa's fat pad is an uncommon cause of an anterolateral knee mass in young children. When a knee mass is only identified in flexion, focal fat herniation through a defect in the retinaculum should be suspected and a dynamic US should be performed. (orig.)

Imaging findings of Hoffa's fat pad herniation

International Nuclear Information System (INIS)

Chauvin, Nancy A.; Khwaja, Asef; Epelman, Monica; Callahan, Michael J.

2016-01-01

We report the radiologic findings of herniation of Hoffa's fat pad through a defect in the lateral patellar retinaculum in young children who presented with painless masses visible by ultrasound (US) only with flexion of the knee. Six children, between the ages of 1-8 years, presented with an anterolateral knee mass that was not tender and was only seen and palpable with knee flexion. An US was performed in all patients, magnetic resonance imaging (MRI) in 2 patients and knee radiographs in 1 patient. US imaging displayed focal herniation of Hoffa's fat pad within the infrapatellar region through a defect of the lateral retinaculum, visible only during dynamic imaging when the knee was in flexion. MRI performed in knee extension did not demonstrate a mass; however, it revealed a focal defect in the lateral retinaculum in the region of the abnormality. Radiographs were normal. Focal herniation of Hoffa's fat pad is an uncommon cause of an anterolateral knee mass in young children. When a knee mass is only identified in flexion, focal fat herniation through a defect in the retinaculum should be suspected and a dynamic US should be performed. (orig.)

Magnetic resonance imaging in hemophilic arthropathy of the knee

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Pettersson, H.; Gillespy, T.; Kitchens, C.; Kentro, T.; Scott, K.N.

The MR findings at the examination of 16 knees in 9 hemophilic patients were reviewed. The hemophilic arthropathy was demonstrated in great detail. The state of the joint cartilage, menisci, posterior cruciate ligaments and synovial tissue could be assessed. The presence of intraarticular hemorrhage aned cyst fluid in bone cavities was recorded. MRI may become a valuable tool for assessment of early treatment of hemophilic arthropathy.

The effects of geometric uncertainties on computational modelling of knee biomechanics

Science.gov (United States)

Meng, Qingen; Fisher, John; Wilcox, Ruth

2017-08-01

The geometry of the articular components of the knee is an important factor in predicting joint mechanics in computational models. There are a number of uncertainties in the definition of the geometry of cartilage and meniscus, and evaluating the effects of these uncertainties is fundamental to understanding the level of reliability of the models. In this study, the sensitivity of knee mechanics to geometric uncertainties was investigated by comparing polynomial-based and image-based knee models and varying the size of meniscus. The results suggested that the geometric uncertainties in cartilage and meniscus resulting from the resolution of MRI and the accuracy of segmentation caused considerable effects on the predicted knee mechanics. Moreover, even if the mathematical geometric descriptors can be very close to the imaged-based articular surfaces, the detailed contact pressure distribution produced by the mathematical geometric descriptors was not the same as that of the image-based model. However, the trends predicted by the models based on mathematical geometric descriptors were similar to those of the imaged-based models.

Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M.; Nevitt, M.C.; Lynch, J.; McCulloch, C.E.

2012-01-01

To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI 2 , n = 38), overweight (BMI 25-29.9 kg/m 2 , n = 37), and obese (BMI ≥ 30 kg/m 2 , n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

Obesity increases the prevalence and severity of focal knee abnormalities diagnosed using 3T MRI in middle-aged subjects - data from the osteoarthritis initiative

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Laberge, Marc A.; Baum, Thomas; Virayavanich, Warapat; Nardo, Lorenzo; Link, Thomas M. [University of California San Francisco, Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Nevitt, M.C.; Lynch, J.; McCulloch, C.E. [University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

2012-06-15

To study the effect of BMI on the prevalence, severity, and 36-month progression of early degenerative changes in the knee by using 3T MRI in middle-aged subjects without radiographic osteoarthritis (OA). We examined baseline and 36-month follow-up MR studies from 137 middle-aged individuals (45-55 years old) with risk factors for knee OA but no radiographic OA from the Osteoarthritis Initiative. Subjects were grouped into three categories: normal BMI (BMI < 25 kg/m{sup 2}, n = 38), overweight (BMI 25-29.9 kg/m{sup 2}, n = 37), and obese (BMI {>=} 30 kg/m{sup 2}, n = 62). Using 3T MRI, cartilage, meniscus, and bone marrow abnormalities were graded using the OA Whole-organ MR Imaging Score (WORMS). The statistical analysis was corrected as necessary for differences in age, sex, and OA risk factors other than BMI. The overall prevalence of lesions was 64% for meniscus and 79% for cartilage (including low grade lesions). At baseline, the prevalence and severity of knee lesions was positively associated with BMI, with a nearly fourfold increase in meniscal tears and more than twofold increase in high-grade cartilage defects in obese individuals relative to normal-weight subjects. Over the 36-month follow-up period, the number of new or worsening cartilage lesions of any grade was significantly higher in obese subjects (p = 0.039), while there was no significant difference in meniscal lesion progression. Obesity was associated with both higher prevalence and severity of early degenerative changes in the knee in middle-aged individuals without radiographic OA and with significantly increased cartilage lesion progression (of any grade) over 36 months. (orig.)

Quantitative magnetic resonance imaging (MRI) evaluation of cartilage repair after microfracture treatment for full-thickness cartilage defect models in rabbit knee joints: correlations with histological findings

International Nuclear Information System (INIS)

Tao, Hongyue; Feng, Xiaoyuan; Chen, Shuang; Li, Hong; Hua, Yinghui; Chen, Zhongqing

2015-01-01

To evaluate repair tissue (RT) after microfracture treatment for full-thickness cartilage defect models using quantitative MRI and investigate the correlations between MRI and histological findings. The animal experiment was approved by the Animal Care and Use Committee of our college. Thirty-six full-thickness cartilage defect models in rabbit knee joints were assigned to the microfracture or joint debridement group (as control). Each group consisted of 3-week, 5-week, and 7-week subgroups. MR imaging, including a three-dimensional double-echo steady-state sequence (3D-DESS), and T2 mapping were performed at 3, 5, and 7 weeks postoperatively. The thickness and T2 indices of RT were calculated. After MRI scans at each time point, operation sites were removed to make hematoxylin-eosin (H and E)-stained sections. Histological results were evaluated using the modified O'Driscoll score system. Comparisons were made between the two groups with respect to the MRI and histological findings, and correlation analysis was performed within each group. The thickness index and histological O'Driscoll score of RT in the two groups increased over time, while the T2 index decreased. The thickness index and histological O'Driscoll score of the microfracture group were higher than in the joint debridement group at each time point. The T2 index of the microfracture group was lower than in the joint debridement group at 3 weeks (P = 0.006), while it was higher than in the joint debridement group at 5 and 7 weeks (P = 0.025 and 0.025). The thickness index was positively correlated with the histological O'Driscoll score in both groups (microfracture: r s = 0.745, P s = 0.680, P = 0.002). The T2 index was negatively correlated with the histological O'Driscoll score in both groups (microfracture: r s = -0.715, P = 0.002; joint debridement: r s = -0.826, P < 0.001). Significant improvement over time after microfracture can be expected on the basis of the quantitative MRI finding and

Occult Intra-articular Knee Injuries in Children With Hemarthrosis.

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Askenberger, Marie; Ekström, Wilhelmina; Finnbogason, Thröstur; Janarv, Per-Mats

2014-07-01

Hemarthrosis after acute knee trauma is a sign of a potentially serious knee injury. Few studies have described the epidemiology and detailed injury spectrum of acute knee injuries in a general pediatric population. To document the current injury spectrum of acute knee injuries with hemarthrosis in children aged 9 to 14 years and to describe the distribution of sex, age at injury, type of activity, and activity frequency in this population. Descriptive epidemiology study. All patients in the Stockholm County area aged 9 to 14 years who suffered acute knee trauma with hemarthrosis were referred to Astrid Lindgren Children's Hospital, Karolinska University Hospital, from September 2011 to April 2012. The patients underwent clinical examination, radiography, and magnetic resonance imaging (MRI). The type of activity when injured, regular sports activity/frequency, and patient sex and age were registered. The diagnoses were classified into minor and serious injuries. The study included 117 patients (47 girls and 70 boys; mean age, 13.2 years). Seventy percent had a serious knee injury. Lateral patellar dislocations, anterior cruciate ligament ruptures, and anterior tibial spine fractures were the most common injuries, with an incidence of 0.6, 0.2, and 0.1 per 1000 children, respectively. The sex distribution was equal up to age 13 years; twice as many boys were seen at the age of 14 years. The majority of injuries occurred during sports. Forty-six patients (39%) had radiographs without a bony injury but with a serious injury confirmed on MRI. Seventy percent of the patients aged 9 to 14 years with traumatic knee hemarthrosis had a serious intra-articular injury that needed specific medical attention. Fifty-six percent of these patients had no visible injury on plain radiographs. Physicians who treat this group of patients should consider MRI to establish the diagnosis when there is no or minimal radiographic findings. The most common serious knee injury was a lateral

MRI Reporter Genes for Noninvasive Molecular Imaging

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Caixia Yang

2016-05-01

Full Text Available Magnetic resonance imaging (MRI is one of the most important imaging technologies used in clinical diagnosis. Reporter genes for MRI can be applied to accurately track the delivery of cell in cell therapy, evaluate the therapy effect of gene delivery, and monitor tissue/cell-specific microenvironments. Commonly used reporter genes for MRI usually include genes encoding the enzyme (e.g., tyrosinase and β-galactosidase, the receptor on the cells (e.g., transferrin receptor, and endogenous reporter genes (e.g., ferritin reporter gene. However, low sensitivity limits the application of MRI and reporter gene-based multimodal imaging strategies are common including optical imaging and radionuclide imaging. These can significantly improve diagnostic efficiency and accelerate the development of new therapies.

Thirty Minutes of Running Exercise Decreases T2 Signal Intensity but Not Thickness of the Knee Joint Cartilage: A 3.0-T Magnetic Resonance Imaging Study.

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Karanfil, Yiğitcan; Babayeva, Naila; Dönmez, Gürhan; Diren, H Barış; Eryılmaz, Muzaffer; Doral, Mahmut Nedim; Korkusuz, Feza

2018-04-01

Objective Recent studies showed a potential of magnetic resonance imaging (MRI), which can be used as an additional tool for diagnosing cartilage degeneration in the early stage. We designed a cross-sectional study in order to evaluate knee joint cartilage adaptation to running, using 3.0-T MRI equipped with the 3-dimensional turbo spin echo (VISTA = Volume ISotropic Turbo spin echo Acquisition) software. By this thickness (mm) and signal intensity (mean pixel value) can be quantified, which could be closely related to the fluid content of the knee joint cartilage, before and after running. Methods A total of 22 males, aged 18 to 35 years, dominant (right) and nondominant (left) knees were assessed before and after 30 minutes of running. Cartilage thickness and signal intensity of surfaces of the patella, medial and lateral femoral and tibial condyles were measured. Results Cartilage thickness of the lateral condyle decreased at the dominant knee, while it increased at the medial tibial plateau. Signal intensity decreased at all locations, except the lateral patella in both knees. The most obvious decrease in signal intensity (10.6%) was at the medial tibial plateau from 949.8 to 849.0 of the dominant knee. Conclusion There was an increase in thickness measurements and decrease in signal intensity in medial tibial plateau of the dominant knee after 30 minutes of running. This outcome could be related to fluid outflow from the tissue. Greater reductions in the medial tibial plateau cartilage indicate greater load sharing by these areas of the joint during a 30-minute running.

Longitudinal study of sodium MRI of articular cartilage in patients with knee osteoarthritis: initial experience with 16-month follow-up

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Madelin, Guillaume; Xia, Ding; Brown, Ryan; Babb, James; Chang, Gregory; Regatte, Ravinder R. [New York University School of Medicine, Department of Radiology, Center for Biomedical Imaging, New York, NY (United States); Krasnokutsky, Svetlana [New York University School of Medicine, Department of Medicine, Rheumatology Division, New York, NY (United States)

2018-01-15

To evaluate the potential of sodium MRI to detect changes over time of apparent sodium concentration (ASC) in articular cartilage in patients with knee osteoarthritis (OA). The cartilage of 12 patients with knee OA were scanned twice over a period of approximately 16 months with two sodium MRI sequences at 7 T: without fluid suppression (radial 3D) and with fluid suppression by adiabatic inversion recovery (IR). Changes between baseline and follow-up of mean and standard deviation of ASC (in mM), and their rate of change (in mM/day), were measured in the patellar, femorotibial medial and lateral cartilage regions for each subject. A matched-pair Wilcoxon signed rank test was used to assess significance of the changes. Changes in mean and in standard deviation of ASC, and in their respective rate of change over time, were only statistically different when data was acquired with the fluid-suppressed sequence. A significant decrease (p = 0.001) of approximately 70 mM in mean ASC was measured between the two IR scans. Quantitative sodium MRI with fluid suppression by adiabatic IR at 7 T has the potential to detect a decrease of ASC over time in articular cartilage of patients with knee osteoarthritis. (orig.)

Longitudinal study of sodium MRI of articular cartilage in patients with knee osteoarthritis: initial experience with 16-month follow-up

International Nuclear Information System (INIS)

Madelin, Guillaume; Xia, Ding; Brown, Ryan; Babb, James; Chang, Gregory; Regatte, Ravinder R.; Krasnokutsky, Svetlana

2018-01-01

To evaluate the potential of sodium MRI to detect changes over time of apparent sodium concentration (ASC) in articular cartilage in patients with knee osteoarthritis (OA). The cartilage of 12 patients with knee OA were scanned twice over a period of approximately 16 months with two sodium MRI sequences at 7 T: without fluid suppression (radial 3D) and with fluid suppression by adiabatic inversion recovery (IR). Changes between baseline and follow-up of mean and standard deviation of ASC (in mM), and their rate of change (in mM/day), were measured in the patellar, femorotibial medial and lateral cartilage regions for each subject. A matched-pair Wilcoxon signed rank test was used to assess significance of the changes. Changes in mean and in standard deviation of ASC, and in their respective rate of change over time, were only statistically different when data was acquired with the fluid-suppressed sequence. A significant decrease (p = 0.001) of approximately 70 mM in mean ASC was measured between the two IR scans. Quantitative sodium MRI with fluid suppression by adiabatic IR at 7 T has the potential to detect a decrease of ASC over time in articular cartilage of patients with knee osteoarthritis. (orig.)

Minimum joint space width (mJSW) of patellofemoral joint on standing ''skyline'' radiographs: test-retest reproducibility and comparison with quantitative magnetic resonance imaging (qMRI)

International Nuclear Information System (INIS)

Simoni, Paolo; Jamali, Sanaa; Alvarez Miezentseva, Victoria; Albert, Adelin; Totterman, Saara; Schreyer, Edward; Tamez-Pena, Jose G.; Zobel, Bruno Beomonte; Gillet, Philippe

2013-01-01

To assess the intraobserver, interobserver, and test-retest reproducibility of minimum joint space width (mJSW) measurement of medial and lateral patellofemoral joints on standing ''skyline'' radiographs and to compare the mJSW of the patellofemoral joint to the mean cartilage thickness calculated by quantitative magnetic resonance imaging (qMRI). A couple of standing ''skyline'' radiographs of the patellofemoral joints and MRI of 55 knees of 28 volunteers (18 females, ten males, mean age, 48.5 ± 16.2 years) were obtained on the same day. The mJSW of the patellofemoral joint was manually measured and Kellgren and Lawrence grade (KLG) was independently assessed by two observers. The mJSW was compared to the mean cartilage thickness of patellofemoral joint calculated by qMRI. mJSW of the medial and lateral patellofemoral joint showed an excellent intraobserver agreement (interclass correlation (ICC) = 0.94 and 0.96), interobserver agreement (ICC = 0.90 and 0.95) and test-retest agreement (ICC = 0.92 and 0.96). The mJSW measured on radiographs was correlated to mean cartilage thickness calculated by qMRI (r = 0.71, p < 0.0001 for the medial PFJ and r = 0.81, p < 0.0001 for the lateral PFJ). However, there was a lack of concordance between radiographs and qMRI for extreme values of joint width and KLG. Radiographs yielded higher joint space measures than qMRI in knees with a normal joint space, while qMRI yielded higher joint space measures than radiographs in knees with joint space narrowing and higher KLG. Standing ''skyline'' radiographs are a reproducible tool for measuring the mJSW of the patellofemoral joint. The mJSW of the patellofemoral joint on radiographs are correlated with, but not concordant with, qMRI measurements. (orig.)

PET-MRI and multimodal cancer imaging

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Wang Taisong; Zhao Jinhua; Song Jianhua

2011-01-01

Multimodality imaging, specifically PET-CT, brought a new perspective into the fields of clinical imaging. Clinical cases have shown that PET-CT has great value in clinical diagnosis and experimental research. But PET-CT still bears some limitations. A major drawback is that CT provides only limited soft tissue contrast and exposes the patient to a significant radiation dose. MRI overcome these limitations, it has excellent soft tissue contrast, high temporal and spatial resolution and no radiation damage. Additionally, since MRI provides also functional information, PET-MRI will show a new direction of multimodality imaging in the future. (authors)

Hemophilic arthropathy of the knee joint: static and dynamic Gd-DTPA - enhanced MRI

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Naegele, M. [Dept. of Radiology, Univ. Bonn (Germany); Bruening, R. [Dept. of Radiology, Univ. Muenchen (Germany); Kunze, V. [Dept. of Radiology, Univ. Bonn (Germany); Eickhoff, H. [Dept. of Orthopedic Surgery, Troisdorf (Germany); Koch, W. [Dept. of Orthopedic Surgery, Troisdorf (Germany); Reiser, M. [Dept. of Radiology, Univ. Muenchen (Germany)

1995-12-31

A total of 17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRI before and after an IV bolus injection of Gadolinium-DTPA (Gd-DTPA; 0.1 mmol/kg body weight). The T1-weighted spin-echo (SE) and gradient-echo (fast-field echo [FFE]) sequences were applied. The FFE sequences of eight consecutive scans carried out over a time interval of 160 s were used in order to determine the time to signal intensity (SI) curves of the synovial proliferations surrounding soft tissue, bone marrow, and joint effusion. After the administration of a contrast agent, synovial proliferations exhibited an increase on FFE and SE images of 47.7% (SD {+-} 14.3%) and 37.4% (SD {+-} 11.2%), respectively, whereas muscle and fatty tissue, tendons, bone marrow, and joint effusion revealed only a minor increase in SI. The gradient of SI (ratio SI/time) of pannus was 39.6%/min (SD {+-} 7.7%/min) and differed significantly (P < 0.001) from that of bone marrow, fatty tissue, muscle tissue, tendons, and joint effusion (P < 0.05). In contrast to synovial proliferations in rheumatoid arthritis, no differentiation between various pannus vascularities based on the degree of enhancement was possible. The Gd-DTPA-enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.)

Hemophilic arthropathy of the knee joint: static and dynamic Gd-DTPA -enhanced MRI

International Nuclear Information System (INIS)

Naegele, M.; Bruening, R.; Kunze, V.; Eickhoff, H.; Koch, W.; Reiser, M.

1995-01-01

A total of 17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRI before and after an IV bolus injection of Gadolinium-DTPA (Gd-DTPA; 0.1 mmol/kg body weight). The T1-weighted spin-echo (SE) and gradient-echo (fast-field echo [FFE]) sequences were applied. The FFE sequences of eight consecutive scans carried out over a time interval of 160 s were used in order to determine the time to signal intensity (SI) curves of the synovial proliferations surrounding soft tissue, bone marrow, and joint effusion. After the administration of a contrast agent, synovial proliferations exhibited an increase on FFE and SE images of 47.7% (SD ± 14.3%) and 37.4% (SD ± 11.2%), respectively, whereas muscle and fatty tissue, tendons, bone marrow, and joint effusion revealed only a minor increase in SI. The gradient of SI (ratio SI/time) of pannus was 39.6%/min (SD ± 7.7%/min) and differed significantly (P < 0.001) from that of bone marrow, fatty tissue, muscle tissue, tendons, and joint effusion (P < 0.05). In contrast to synovial proliferations in rheumatoid arthritis, no differentiation between various pannus vascularities based on the degree of enhancement was possible. The Gd-DTPA-enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.)

Application of a semi-automatic cartilage segmentation method for biomechanical modeling of the knee joint.

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Liukkonen, Mimmi K; Mononen, Mika E; Tanska, Petri; Saarakkala, Simo; Nieminen, Miika T; Korhonen, Rami K

2017-10-01

Manual segmentation of articular cartilage from knee joint 3D magnetic resonance images (MRI) is a time consuming and laborious task. Thus, automatic methods are needed for faster and reproducible segmentations. In the present study, we developed a semi-automatic segmentation method based on radial intensity profiles to generate 3D geometries of knee joint cartilage which were then used in computational biomechanical models of the knee joint. Six healthy volunteers were imaged with a 3T MRI device and their knee cartilages were segmented both manually and semi-automatically. The values of cartilage thicknesses and volumes produced by these two methods were compared. Furthermore, the influences of possible geometrical differences on cartilage stresses and strains in the knee were evaluated with finite element modeling. The semi-automatic segmentation and 3D geometry construction of one knee joint (menisci, femoral and tibial cartilages) was approximately two times faster than with manual segmentation. Differences in cartilage thicknesses, volumes, contact pressures, stresses, and strains between segmentation methods in femoral and tibial cartilage were mostly insignificant (p > 0.05) and random, i.e. there were no systematic differences between the methods. In conclusion, the devised semi-automatic segmentation method is a quick and accurate way to determine cartilage geometries; it may become a valuable tool for biomechanical modeling applications with large patient groups.

Knee Kinematics During Noncontact Anterior Cruciate Ligament Injury as Determined From Bone Bruise Location.