Ressonância magnética da osteonecrose do joelho: estudo de 19 casos

Cunha, Daniel Leme da; Carvalho, Antônio Carlos Pires; Ribeiro, Elísio José Salgado; Domingues, Romeu Côrtes

doi:10.1590/s0100-39842010000200005

Cited by 2 publications

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References 11 publications

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“…In the investigation of knee pain, it is equally important to correlate patients' clinical data and age with possible diseases which are more prevalent in that subgroup. Spontaneous knee osteonecrosis, for example, develops with sudden onset of localized pain, with prevalence in female individuals, notably from the seventh decade of life on, with no association with systemic disorders, alcohol abuse, previous corticosteroid therapy, meniscal surgery or local trauma (14) . In younger women, the occurrence of osteonecrosis corroborates the suspicion of any rheumathological disease, particularly systemic lupus erythematosus.…”

Section: Introductionmentioning

confidence: 99%

Fadiga óssea: causa de dor em joelhos na osteoartrite

et al. 2012

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Knee pain is the most frequent symptom in osteoarthritis, a condition that is the leading cause of chronic disability in the elderly and one of the main sources of morbidity attributable to osteoarthritis in general. The causes of knee pain in individuals with osteoarthritis cannot be easily understood, and the knowledge of such causes is critical for determining future specific interventions. Bone attrition represents remodelling of the subchondral bone envelope in osteoarthritis, leading to a consequential change in bone shape and/or bone loss. However, bone attrition is not a feature that can be easily read, since it is hardly detected in the absence of clear defects of cortical bone integrity and because of overlap of bone structures at radiography. Bone attrition is associated not only with knee pain, but also with stiffness and disability. If attrition occurs prior to advanced osteoarthritis, this would suggest that changes in subchondral bone occur concurrently with cartilage loss and that treatments targeting cartilage loss alone are unlikely to be effective. Association with edemalike bone marrow lesions may be observed and constitute predictive factors for subchondral bone attrition. The present study was aimed at reviewing the literature, demonstrating the relevance of bone attrition and explaining how to diagnose this entity on imaging studies. Keywords: Magnetic resonance imaging; Osteoarthritis; Knee pain; Bone attrition; Subchondral bone; Diagnosis.A dor no joelho é o sintoma mais comum na osteoartrite, sendo a principal causa de incapacidade crônica em idosos e uma das principais fontes de morbidade atribuível à osteoartrite em geral. As causas de dor no joelho em pessoas com osteoartrite não são facilmente entendidas e o conhecimento sobre as causas da dor é fundamental para que futuramente sejam realizadas intervenções específicas. A fadiga óssea representa o remodelamento do osso subcondral na osteoartrite, levando a uma consequente alteração na forma do osso e/ou perda óssea. No entanto, a fadiga óssea não é algo facilmente interpretado, pois é de difícil detecção na ausência de defeitos claros da cortical e pela sobreposição de estruturas ósseas nas radiografias convencionais. A fadiga óssea está associada não apenas a dor no joelho, mas também a rigidez e incapacidade. Se a fadiga ocorre antes da osteoartrite avançada, isso sugere que alterações no osso subcondral podem ocorrer simultaneamente a alterações da cartilagem e que tratamentos visando sua preservação podem não ser eficazes. Lesões com padrão de edema ósseo estão associadas e são fatores preditivos para fadiga óssea. Este trabalho tem por objetivo rever a literatura mostrando a importância da fadiga óssea e de como diagnosticar esta alteração nos exames de imagem. Unitermos: Ressonância magnética; Osteoartrite; Dor nos joelhos; Fadiga óssea; Osso subcondral; Diagnóstico. AbstractResumo

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Section: Introductionmentioning

confidence: 99%

Fadiga óssea: causa de dor em joelhos na osteoartrite

et al. 2012

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Agreement in Diagnosis of Knee Injuries by Orthopedists With Clinical Experience in Knee Treatment

et al. 2018

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Objective:To analyze the level of agreement in diagnosing knee injury among orthopedists with clinical experience in knee treatment. Method:An online questionnaire was used to analyze the ability of orthopedic knee surgeons to diagnose intra-articular knee injuries using MRI, the importance given to this test in their clinical practice, and the agreement between these diagnoses and the radiology report. Results:The study participants considered MRI an important tool for clarifying inconclusive diagnoses and surgical planning. The level of agreement between the surgeons and the radiologist was considered to be very slight for posterior cruciate ligament injuries, collateral ligament injuries, and chondral injuries, and was considered slight for anterior cruciate ligament and meniscus injuries. Conclusion:A diagnosis of intra-articular knee injury must be based on the patient history, physical examination, and radiological imaging (MRI) in order to provide a complete approach to the patient. Level of Evidence III; Clinical study.

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Ressonância magnética da osteonecrose do joelho: estudo de 19 casos

Cited by 2 publications

References 11 publications

Fadiga óssea: causa de dor em joelhos na osteoartrite

Fadiga óssea: causa de dor em joelhos na osteoartrite

Agreement in Diagnosis of Knee Injuries by Orthopedists With Clinical Experience in Knee Treatment

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