MRI of synovitis and joint fluid

Burke, Christopher J.; Alizai, Hamza; Beltrán, Luis; Regatte, Ravinder R.

doi:10.1002/jmri.26618

Cited by 40 publications

(25 citation statements)

References 107 publications

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“…We speculate that catabolic and proinflammatory mediators triggered by synovitis lead to intra-articular debris due to cartilage breakdown. In turn, presence of articular debris causes further inflammation of the synovium [1,2,4,11]. Hypothetically, an increase in joint intra-capsular pressure could push synovitis into the subchondral bone through the cartilage defects causing the formation of BMLs.…”

Section: Discussionmentioning

confidence: 99%

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Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

Ahedi

Aitken

Blizzard

et al. 2020

BMC Musculoskelet Disord

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Background: Hip effusion-synovitis may be relevant to osteoarthritis (OA) but is of uncertain etiology. The aim of this study was to describe the cross-sectional and longitudinal associations of hip effusion-synovitis with clinical and structural risk factors of OA in older adults. Methods: One hundred ninety-six subjects from the Tasmanian Older Adult Cohort (TASOAC) study with a right hip STIR (Short T1 Inversion Recovery) Magnetic Resonance Imaging (MRI) on two occasions were included. Hip effusion-synovitis CSA (cm 2) was assessed quantitatively. Hip pain was determined by WOMAC (Western Ontario and McMaster Universities Osteoarthritis) while hip bone marrow lesions (BMLs), cartilage defects (femoral and/or acetabular) and high cartilage signal were assessed on MRI. Joint space narrowing (0-3) and osteophytes (0-3) were measured on x-ray using Altman's atlas. Results: Of 196 subjects, 32% (n = 63) had no or a small hip effusion-synovitis while 68% (n = 133) subjects had a moderate or large hip effusion-synovitis. Both groups were similar but those with moderate or large hip effusionsynovitis were older, had higher BMI and more hip pain. Cross-sectionally, hip effusion-synovitis at multiple sites was associated with presence of hip pain [Prevalence ratio (PR):1.42 95%CI:1.05,1.93], but not with severity of hip pain. Furthermore, hip effusion-synovitis size associated with femoral defect (βeta:0.32 95%CI:0.08,0.56). Longitudinally, and incident hip cartilage defect (PR: 2.23 95%CI:1.00, 4.97) were associated with an increase in hip effusion-synovitis CSA. Furthermore, independent of presence of effusion-synovitis, hip BMLs predicted incident (PR:

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Section: Discussionmentioning

confidence: 99%

“…Several studies have reported associations of knee effusion-synovitis proving that it is one of the causes of knee pain, has an adverse effect on cartilage and is linked with radiographic knee OA [3,[7][8][9][10]. Although effusion-synovitis is a significant clinical prognostic factor for OA [11], at the hip it remains under-investigated.…”

Section: Introductionmentioning

confidence: 99%

Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

Ahedi

Aitken

Blizzard

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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“…We have two explanations for the superiority of MRI over US for synovitis evaluation in the ankle and hindfoot region found in our study. First comes from the MRI ability to visualize the entire joint and the deep part of the synovium, irrespective of the body fat tissue amount [26], while the US can visualize only the superficial joint recesses, not necessarily involved in cases of mild joint synovitis (as were the cases with synovitis not-identified by US). Second comes from the difficulty of US to differentiate synovial hypertrophy from fluid, especially in old, long-standing effusions, when fluid becomes hypoechoic in US scan [27].…”

Section: Discussionmentioning

confidence: 99%

“…Only the use of contrast-enhanced MRI can make the distinction -the inflamed synovium enhances after contrast injection [26]. However, gadolinium administration raises the cost and duration of the MRI examination and adds considerable discomfort to the patients [29].…”

Section: Discussionmentioning

confidence: 99%

Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

et al. 2019

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Aim: To compare the ultrasonography (US) performance with magnetic resonance imaging (MRI) in identifying pathology in ankles, hindfeet and heels of rheumatoid arthritis (RA) patients and to evaluate the reasons for discordances between the two imaging methods.Material and methods: RA patients were enrolled and evaluated using the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28 with C-reactive Protein (DAS28-CRP). The ankle (tibiotalar joint, tendons), hindfoot (talonavicular, subtalar joints) and heel of the most symptomatic or dominant foot (for the asymptomatic patient)were evaluated by two pairs of examiners using US and contrast-enhanced MRI.Results: Totally, 105 joints, 245 tendons and 35 heels in 35 patients [mean age 59.2±11.25 years old, median disease duration 36 (16.5-114), mean CDAI 19.87±12.7] were evaluated. The interobserver agreements between the two sonographers, and the two radiologists were good and very good (k=0.624-0.940). The overall agreement between US and MRI was very good for subcalcaneal panniculitis (k=0.928, p<0.001), moderate for synovitis (k=0.463, p<0.001) and tenosynovitis (k=0.514, p<0.001), fair for osteophytes (k=0.260, p=0.004), and poor for erosions (k=0.063, p=0.308) and heel’s structures. MRI found more erosions, synovitis, osteophytes,tenosynovitis and retrocalcaneal bursitis, but US found more enthesophytes and plantar fasciitis. Many of the discordancesbetween the two imaging techniques have explanations related to the technique itself or definition of the pathologic findings.Conclusions: US is comparable to MRI for the evaluation of ankle, hindfoot and heel in RA patients and discordances in theinterpretation of the pathological findings/normal structures must be carefully analyzed.

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“…MRI is a one of advanced imaging techniques that play an important role in evaluating the wrist and is a useful examination modality because of its multiplanar, multisequence capability and its excellent resolution of soft tissue structures. MRI is the most sensitive imaging modality for the assessment of structures critical in the evolution of inflammatory disease, with studies confirming the superiority of MRI when compared with plain film radiography [8] The purpose of study carred out by Burke [9] was to summarize and review the role of MRI in the assessment of synovitis and joint effusion which are common manifestations of rheumatic disease and play an important role in the disease pathophysiology. MRI enables not only detection of synovitis and effusion, but also allows quantification, detailed characterization, and noninvasive monitoring of synovial processes.…”

Section: Discussionmentioning

confidence: 99%

Assessment of wrist joint pain by Magnetic Resonance Imaging

Shibiny

Rahim

Jbory

2019

Sohag Medical Journal

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Introduction: Wrist pain is a common clinical complaint. The most common causes of wrist pain are traumatic and non traumatic abnormalities involving ganglia, avascular necrosis, and triangular fibrocartilage lesions. MRI serves as a problemsolving technique to assess the cause of wrist pain. It also plays an important prognostic role. Aim of the Work: The aim of this study is to highlight the value of MRI in assessment of patients suffering from wrist joint pain. Patients and Methods: A descriptive study, conducted on fifty patients underwent MRI examination (patients with painful wrist joint) during this period. Every patient with normal MRI examination had been excluded from this study. All patients were performed MRI in radiology department, Ain Shams University Hospital. The examination carried out after signing the informed consent by the patient himself or his guardian if the patient is incapacitated by any means. Results: The study included 50 patients (21 females and 29 males) rangedin age between 19-70 years with mean age 20-40 [30.90±11.38], 56.0% of the patient were between the age of 20-30 years Conclusion: MRI is modality of choice in evaluating the painful wrist joint diseases due to its high soft tissue contrast resolution, and multi-planar capabilities. It provides a non-invasive tool for the diagnosis of wrist joint disease, which are often difficult to diagnose with alternative modalities. MRI is particularly advantageous for assessing soft tissue structures around the wrist such as tendons, ligaments, nerves, and fascia and for detecting occult bone injuries.

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MRI of synovitis and joint fluid

Cited by 40 publications

References 107 publications

Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

Quantification of hip effusion-synovitis and its cross-sectional and longitudinal associations with hip pain, MRI findings and early radiographic hip OA

Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

Assessment of wrist joint pain by Magnetic Resonance Imaging

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