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MRI Features of Lyme Arthritis in Children

Kirsten Ecklund1, Sigella Vargas1, David Zurakowski2 and Robert P. Sundel3

1 Department of Radiology, Children's Hospital, 300 Longwood Ave., Boston, MA 02115.
2 Departments of Orthopaedics and Biostatistics, Children's Hospital, Harvard Medical School, Boston, MA 02115.
3 Rheumatology Program, Division of Immunology and the Department of Pediatrics, Children's Hospital, Harvard Medical School, Boston, MA 02115.



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  		Fig. 1. —16-year-old boy with bacterial arthritis of left knee. Sagittal intermediate-weighted fat-suppressed MR image shows large joint effusion with maximal distention of suprapatellar bursa.

 


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  		Fig. 2. —12-year-old boy with septic arthritis of right knee. Maximum synovial thickness measures 4.11 mm along anterior aspect of suprapatellar bursa on this sagittal T1-weighted postcontrast MR image with fat suppression.

 


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  		Fig. 3. —9-year-old boy with Lyme arthritis of knee. Sagittal T2-weighted fat-suppressed MR image shows joint effusion, synovial thickening, and high-signal-intensity fluid within popliteus muscle (arrow).

 


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  		Fig. 4. —16-year-old boy with Lyme arthritis of left knee. Sagittal T2-weighted fat-suppressed MR image shows suprapatellar effusion, synovial hypertrophy, and popliteal lymph nodes (arrows).

 


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  		Fig. 5. —4-year-old girl with septic arthritis of left knee. Sagittal intermediate-weighted fat-suppressed MR image reveals joint effusion, synovial thickening, and extensive high-signal-intensity edema within subcutaneous tissues (arrow).

 


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  		Fig. 6A. —12.5-year-old girl with Lyme arthritis of right knee. Sagittal T2-weighted fat-suppressed image shows joint effusion, synovial thickening, and high-signal-intensity masslike lesion posteriorly (arrow).

 


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  		Fig. 6B. —12.5-year-old girl with Lyme arthritis of right knee. Sagittal T1-weighted postcontrast fat-suppressed MR image at the same level as A confirms that posterior lesion is distended popliteal cyst with thickened, enhancing synovium peripherally (arrow).

 


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  		Fig. 6C. —12.5-year-old girl with Lyme arthritis of right knee. Sagittal T1-weighted postcontrast fat-suppressed MR image just medial to B shows associated lymphadenopathy (white arrows) and myositis (black arrow).

 

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