Diagnostic Value of <scp>MRI</scp> Lamellated Hyperintense Synovitis in Periprosthetic Infection of Hip

Gao, Zongyan; Jin, Yi; Chen, Xiao; Dai, Zhipeng; Qiang, Shuo; Guan, Shuyuan; Li, Qiang; Huang, Jincheng; Zheng, Jia

doi:10.1111/os.12789

Cited by 14 publications

(11 citation statements)

References 14 publications

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“…Some papers reported high sensitivity and specificity of lamellated hyperintense synovitis as an MRI characteristic of PJI in patients with knee [87,88] and hip [89] prosthesis. Lamellated hyperintense synovitis in an MRI image refers to the thickened synovial tissue nearby the joint in MRI, and "high signal" refers to the high signal in the T2WI sequence image.…”

Section: Prosthetic Infectionsmentioning

confidence: 99%

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Sambri

Spinnato

Tedeschi

et al. 2021

JPM

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Imaging is needed for the diagnosis of bone and joint infections, determining the severity and extent of disease, planning biopsy, and monitoring the response to treatment. Some radiological features are pathognomonic of bone and joint infections for each modality used. However, imaging diagnosis of these infections is challenging because of several overlaps with non-infectious etiologies. Interventional radiology is generally needed to verify the diagnosis and to identify the microorganism involved in the infectious process through imaging-guided biopsy. This narrative review aims to summarize the radiological features of the commonest orthopedic infections, the indications and the limits of different modalities in the diagnostic strategy as well as to outline recent findings that may facilitate diagnosis.

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Section: Prosthetic Infectionsmentioning

confidence: 99%

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Sambri

Spinnato

Tedeschi

et al. 2021

JPM

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“…However, in this study, the sole predictive value of MRI findings was not investigated. Gao et al found that the sensitivity of lamellated hyperintense synovitis for infection was 0.80 to 0.88 and the specificity was 0.84 to 0.92 [ 33 ]. Another study showed that the sensitivity of lamellated hyperintense synovitis for infection was 0.86 to 0.92 and the specificity was 0.85 to 0.87, with almost perfect interobserver agreement and intraobserver agreement [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…In another study, the AUC of CRP levels was 0.9 [ 37 ]. Gao found that the sensitivity and specificity of MRI in the prediction of infection were only 0.80 and 0.84, respectively [ 33 ]. In the present study, the AUC of this new scoring system was 0.965, which was the highest among the scoring systems and demonstrated the strength of this comprehensive predictive system.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study from a Single Center to Identify Risk Factors Associated with Reinfection in Patients Undergoing 2-Stage Revision Surgery for Periprosthetic Joint Infection

Zhang

Liu

et al. 2022

Med Sci Monit

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Background This study identified risk factors associated with reinfection and created a scoring system designed for patients with periprosthetic joint infection (PJI) who have undergone prosthetic resection and spacer implantation. Material/Methods Patients who underwent 2-stage revision for PJI from January 2010 to December 2017 were retrospectively analyzed in this study. Patients were divided into 2 groups: infection recurrence and infection cure. Demographic and clinical information, laboratory test results, and radiological images that were potentially associated with infection were obtained and analyzed. Results Seven independent risk (protective) factors for infection recurrence in patients with PJI who underwent 2-stage hip revision surgery were identified: C-reactive protein level, type of bacterial infection, age, immunosuppression, albumin/globulin ratio, glucose level, and magnetic resonance imaging findings. Finally, a weighted scoring system of 100-mark system was established and the area under the curve was 0.965 (95% confidential interval=0.947–0.983). The predictive scores for low risk (≤30%), moderate risk (31–69%), and high risk (≥70%) of infection recurrence were ≤45, 46–77, and ≥78, respectively. Conclusions For patients with PJI who had already undergone joint resection and spacer implantation, this newly established scoring system might help determine the accurate risk of infection recurrence after a definitive new prosthesis implantation. Patients with scores greater than 78 points would be considered very likely to have an infection recurrence. Therefore, the second-stage revision surgery should be changed to an additional anti-infection treatment or a debridement surgery instead of a definitive prosthesis implantation surgery.

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“…Since the development of advanced metal artifact reducing techniques, magnetic resonance imaging scans provided an optimal sensitivity and specificity for the diagnosis of PJI after hip arthroplasty with improved diagnostic value. [ 27 ] Also, nuclear scan such as leukocyte–bone marrow scintigraphy or fluorodeoxyglucose PET have been shown to be sensitive for diagnosis of PJI. [ 28 ] However, imaging modality is currently not part of the musculoskeletal infection society criteria for diagnosing PJI.…”

Section: Discussionmentioning

confidence: 99%

The natural trends of C-reactive protein after hip arthroplasty for femoral neck fracture without infection

Cho¹,

Choi²,

Jun³

et al. 2021

Medicine

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The aim of this study was to estimate the degree of normalization of C-reactive protein (CRP) at 2-weeks and 4-weeks after hip arthroplasty after femoral neck fracture. We also wished to determine whether the degree of CRP normalization differs after total hip arthroplasty (THA) compared to bipolar hemiarthroplasty (BH). We also wanted to analyze the patient factors that may influence CRP normalization. We conducted a retrospective study of 135 patients who had undergone THA (32 cases) or BH (103 cases) for femoral neck fracture by single surgeon from January 2015 to December 2019. We analyzed CRP levels during the preoperative period, the early postoperative period, the 2-week postoperative period, and the 4-week postoperative period. In THA, CRP was normalized in 4 patients (12.5%) and in 15 patients (46.9%) within 2-weeks and 4-weeks after surgery, respectively. In BH, CRP was normalized in 16 patients (15.5%) and in 52 patients (50.5%) within 2-weeks and 4-weeks after surgery, respectively. There were no statistical differences between THA and BH. Compared to women, men were 3.78 (95% confidence interval, 1.05–13.63) times less likely to have normalized CRP at 2-weeks after surgery ( P = .042). Compared to women, men were 3.01 (95% confidence interval, 1.44–6.27) times less likely to have normalized CRP at 4-weeks after surgery ( P = .003). Only 50% of patient's CRP level was normalized during 4-week postoperative period. In men, CRP levels were significantly higher than women in whole period. In the case of THA, the CRP level was higher only in early postoperative period compared to BH, and there was no difference since then.

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Diagnostic Value of MRI Lamellated Hyperintense Synovitis in Periprosthetic Infection of Hip

Cited by 14 publications

References 14 publications

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Bone and Joint Infections: The Role of Imaging in Tailoring Diagnosis to Improve Patients’ Care

Retrospective Study from a Single Center to Identify Risk Factors Associated with Reinfection in Patients Undergoing 2-Stage Revision Surgery for Periprosthetic Joint Infection

The natural trends of C-reactive protein after hip arthroplasty for femoral neck fracture without infection

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