MR imaging of transient synovitis: differentiation from septic arthritis

Yang, W. J.; Im, Soo Ah; Lim, Gio‐Bin; Chun, Ho Jong; Jung, Na Young; Sung, Mi Sook; Choi, Byung Gil

doi:10.1007/s00247-006-0289-9

Cited by 76 publications

(31 citation statements)

References 27 publications

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“…Several studies investigating MRI predictors of septic arthritis have shown considerable overlap of imaging features of pyogenic and non-pyogenic joint effusions [8,9]. In pediatric and adult patients, MR findings of synovial thickening, perisynovial and bone marrow edema and enhancement and the lack of contralateral joint effusions favor septic arthritis rather than transient synovitis, but there is overlap of findings in pyogenic and non-pyogenic causes of a joint effusion [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

et al. 2015

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Patients with joint effusions identified by MRI, in the setting of metaphyseal osteomyelitis, should be presumed to have septic arthritis until proven otherwise. Epiphyseal extension of edema, perisynovial edema and epiphyseal non-enhancement in the setting of metaphyseal osteomyelitis are not helpful predictors in differentiating reactive and pyogenic joint effusions. Osteomyelitis at a site with an intra-articular metaphyses, however, is more likely to have concurrent septic arthritis.

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Section: Introductionmentioning

confidence: 99%

“…In pediatric and adult patients, MR findings of synovial thickening, perisynovial and bone marrow edema and enhancement and the lack of contralateral joint effusions favor septic arthritis rather than transient synovitis, but there is overlap of findings in pyogenic and non-pyogenic causes of a joint effusion [8,9].…”

Section: Introductionmentioning

confidence: 99%

Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

et al. 2015

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“…In evaluation of bone scans, Williamson and Sistrom [23] found femoral and acetabular photopenia associated with septic arthritis of the hip. Yang et al [24] reported that decreased enhancement of the femoral head is frequently seen on images of patients with septic arthritis, but they did not find a statistical difference. In our study, eight patients with septic arthritis had decreased perfusion at the femoral head on fat-suppressed contrast-enhanced T1-weighted MRI.…”

Section: Discussionmentioning

confidence: 94%

Septic Arthritis Versus Transient Synovitis of the Hip: Gadolinium-Enhanced MRI Finding of Decreased Perfusion at the Femoral Epiphysis

Kwack

Cho

Lee

et al. 2007

American Journal of Roentgenology

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OBJECTIVE. The purpose of this study was to identify differences in the MRI findings of septic arthritis and transient synovitis in patients with nontraumatic acute hip pain and hip effusion.MATERIALS AND METHODS. The MRI findings in nine patients with septic arthritis and 11 with transient synovitis were reviewed retrospectively. This study was approved by our institutional review board. The diagnoses were based on findings at physical examination, laboratory studies, and joint aspiration and bacteriologic study. The MRI findings were analyzed with emphasis on the grade of joint effusion, alterations in signal intensity in the soft tissues and bone marrow, and the presence of decreased perfusion at the femoral head.RESULTS. Low signal intensity on fat-suppressed gadolinium-enhanced T1-weighted coronal MRI suggesting decreased perfusion at the femoral head of the affected hip joint was seen in eight of nine patients with septic arthritis and in two of 11 patients with transient synovitis. Statistically reliable differences (p = 0.005) were found between the two groups. Alterations in signal intensity in the bone marrow were seen in three patients with septic arthritis but in none of the patients with transient synovitis. Decreased perfusion on fat-suppressed gadolinium-enhanced coronal T1-weighted MRI was seen in the six patients with septic arthritis who did not have alterations in signal intensity involving the bone marrow.CONCLUSION. Decreased perfusion at the femoral epiphysis on fat-suppressed gadolinium-enhanced coronal T1-weighted MRI is useful for differentiating septic arthritis from transient synovitis.

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“…Yang et al (9) reported that the that the main diagnostic MRI findings seen in transient synovitis are joint effusion, presence of synovial thickening, alterations in signal intensity of soft tissue and bone marrow in the affected hip joint.…”

Section: Discussionmentioning

confidence: 99%

The Role of MRI in the Evaluation of Painful Hip Joint (MRI of Hip Joint)

Drar¹

2014

IJMI

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Abstract:This study aim to evaluate the diagnostic value of MRI in assessment of painful hip joint. Background: Radiographic evaluation is crucial in patients with painful hip joint. Hip pain has different etiologies in adults and children. MRI is the method of choice in characterizing the various disorders and assessing the full extent of osseous, chondral and soft tissue abnormality of the hip joint. Methods: This prospective study included 100 patients with painful hip joint. The following MR sequences were performed to all patients: Coronal T1, T2 & STIR WIs, axial T1&T2WIs, axial T1WI and sagittal T1WI after contrast injection. Patient's history, local examination of the diseased hip and laboratory investigations were performed. Results: Male to female was 45 to 55, their ages ranged from 10 to 60 years with a mean age of 35 years. The MRI sensitivity were as follows 88% in avascular necrosis, 80% in osteoarthritis,90% in migratory osteoporosis, 100% in transient synovitis, 72% in septic arthritis, 80% in Perthe's disease, 80 % in tumor, 100% in inflammatory lesions 75% in slipped femoral epiphysis and 100% in stress fractures . Conclusion: MRI of the hip joint is an informative, diagnostic, and accurate for the assessment of hip pain and sufficient imaging modality for delineation of different hip joint pathology.

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MR imaging of transient synovitis: differentiation from septic arthritis

Cited by 76 publications

References 27 publications

Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

Septic Arthritis Versus Transient Synovitis of the Hip: Gadolinium-Enhanced MRI Finding of Decreased Perfusion at the Femoral Epiphysis

The Role of MRI in the Evaluation of Painful Hip Joint (MRI of Hip Joint)

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