Purpose
MRI is considered to be the imaging technique of choice for the detection of joint infection because its
high spatial resolution and soft tissue contrast allow accurate depiction of joint effusion and synovial abnormalities.
Synovial bacterial infection induces synovitis,
in which the classic MRI findings are synovial thickening and joint effusion.
The presence of synovial inflammation is associated with a gadolinium-enhanced MR T1 signal increase that helps to distinguish synovial hyperplasia from tendons,
cartilage,
and effusion [1].
Infectious arthritis is a common,
often disabling disease...
Methods and Materials
Patients
MR imaging examinations performed from February 2010 to June 2010 of 30 patients (13 women and 17 men with a mean age of 48.8 years [range.
11-75 years]) .
Dynamic contrast-enhanced MRI (3.0T) was performed in 12 patients with infectious condition and 18 patients with non-infectious condition.
In infectious group,
cellulitis in 3 patients,
myonecrosis with myositis in 3 patients,
synovitis in 2 patients,
osteomyelitis in 2 patients and septic arthritis in 2 patients.
Examination Technique
Bone dynamic MR images of the joints were...
Results
For all 30 patients,
the study is comprised of 12 infectious lesions and 18 non-infectious lesions.
For 12 patients of infectious group,
three patients with cellulitis,
three patients with myositis,
two patients with synovitis,
two patients with osteomyelitis and two patients with septic arthritis.
In six patients,
the infectious process involved single knee joint,
four patients involved ankle joint and two patients involved the foot.
The final diagnoses,
proven surgically in 7 cases (Incision and drainage : 5 cases,
partial synovectomy : 1 case and...
Conclusion
Infectious arthritis can result in serious disability,
so pertinent treatment based on a specific diagnosis is imperative.
[5].
Traditionally,
MR imaging is widely used to diagnose a musculoskeletal infection,
because of its sensitivity in the detection of marrow abnormalities,
soft tissue extent of disease,
and the presence of fluid collections.
[2].
Especially,
bone erosions and marrow edema are highly suggestive of infectious arthritis,
and the added presence of synovial thickening,
synovial edema,
soft tissue edema,
or bone marrow enhancement is even more suggestive of infection[6]....
References
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Lefevre S,
Robert P,
Kremer S,
Dietemann JL.
MRI of macrophages in infectious knee synovitis.
AJR Am J Roentgenol. 2010 Jun;194(6):W521-6.
2.
Learch TJ,
Farooki S.
Magnetic resonance imaging of septic arthritis.
Clin Imaging 2000;24:236–242
3.
Fitzgerald RH Jr,
Kelly PJ.
Infections of the skeletal system.
In: Howard RJ,
Simmons RL,
eds.
Surgical infectious diseases,
3rd ed.
London,
England: Appleton & Lange,
1995:1207–1236
4.
Thomassin-Naggara I,
Bazot M,
Daraï E,
Callard P,
Thomassin J,
Cuenod CA.
Epithelial ovarian...