HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Karchevsky, M. Articles by Parellada, J. A. Search for Related Content PubMed PubMed Citation Articles by Karchevsky, M. Articles by Parellada, J. A. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

MRI Findings of Septic Arthritis and Associated Osteomyelitis in Adults

¹ Department of Radiology, Thomas Jefferson University Hospital, 111 S 11th St., Ste. 3390, Philadelphia, PA 19107.
² Department of Radiology, Hospital for Joint Diseases, Bernard Aronson Plaza, 301 E 17th St., New York, NY 10003.

OBJECTIVE. The purpose of this study was to describe the soft-tissue, synovial, and osseous MRI findings of septic arthritis.

MATERIALS AND METHODS. At 1.5 T (T1-weighted, T2-weighted or STIR, and contrast-enhanced images), 50 consecutive cases of septic arthritis were evaluated by two observers for synovial enhancement, perisynovial edema, joint effusion, fluid outpouching, fluid enhancement, and synovial thickening. The marrow was assessed for abnormal signal on T1- and T2-weighted images or after contrast enhancement. We noted whether the marrow signal was diffuse or abnormal in bare areas. MRI findings were compared with microbiologic, clinical, and surgical data and diagnoses.

RESULTS. The frequency of MRI findings in septic joints was as follows: synovial enhancement (98%), perisynovial edema (84%), joint effusions (70%), fluid outpouching (53%), fluid enhancement (30%), and synovial thickening (22%). The marrow showed bare area changes (86%), abnormal T2 signal (84%), abnormal gadolinium enhancement (81%), and abnormal T1 signal (66%). Associated osteomyelitis more often showed T1 signal abnormalities and was diffuse.

CONCLUSION. Synovial enhancement, perisynovial edema, and joint effusion had the highest correlation with the clinical diagnosis of a septic joint. However, almost a third of patients with septic arthritis lacked an effusion. Abnormal marrow signal—particularly if it was diffuse and seen on T1-weighted images—had the highest association with concomitant osteomyelitis.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				L. W. Averill, A. Hernandez, L. Gonzalez, A. H. Pena, and D. Jaramillo Diagnosis of Osteomyelitis in Children: Utility of Fat-Suppressed Contrast-Enhanced MRI Am. J. Roentgenol., May 1, 2009; 192(5): 1232 - 1238. [Abstract] [Full Text] [PDF]

				C J Mathews, G Kingsley, M Field, A Jones, V C Weston, M Phillips, D Walker, and G Coakley Management of septic arthritis: a systematic review Postgrad. Med. J., May 1, 2008; 84(991): 265 - 270. [Abstract] [Full Text] [PDF]

				V. C. Ejindu, A. L. Hine, M. Mashayekhi, P. J. Shorvon, and R. R. Misra Musculoskeletal Manifestations of Sickle Cell Disease RadioGraphics, July 1, 2007; 27(4): 1005 - 1021. [Abstract] [Full Text] [PDF]

				C J Mathews, G Kingsley, M Field, A Jones, V C Weston, M Phillips, D Walker, and G Coakley Management of septic arthritis: a systematic review Ann Rheum Dis, April 1, 2007; 66(4): 440 - 445. [Abstract] [Full Text] [PDF]

				A. Kapoor, S. Page, M. LaValley, D. R. Gale, and D. T. Felson Magnetic Resonance Imaging for Diagnosing Foot Osteomyelitis: A Meta-analysis Arch Intern Med, January 22, 2007; 167(2): 125 - 132. [Abstract] [Full Text] [PDF]