Septic Arthritis Versus Transient Synovitis of the Hip: Gadolinium-Enhanced MRI Finding of Decreased Perfusion at the Femoral Epiphysis
Kyu-Sung Kwack1,
Jae Hyun Cho1,
Jei Hee Lee1,
Jae Ho Cho2,
Ki Keun Oh3 and
Sun Yong Kim1
1 Department of Radiology, Ajou University Medical Center, Wonchun Dong,
Yongtong Gu, Suwon 442-721, Republic of Korea.
2 Department of Orthopaedic Surgery, Ajou University Medical Center, Suwon,
South Korea.
3 Department of Radiology, Yonsei University College of Medicine, Seoul,
Korea.
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Fig. 1C —9-year-old girl with septic arthritis of right hip. Coronal
fat-suppressed gadolinium-enhanced T1-weighted spin-echo MR image (550/14)
shows low signal intensity (arrow) of right femoral head compared
with contralateral femoral head and enhancement of synovial membrane
(arrowheads) around right hip joint.
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Fig. 2A —11-year-old boy with septic arthritis of right hip. Coronal
T1-weighted spin-echo MR image (TR/TE, 450/14) shows no abnormal signal
intensity in bone marrow of proximal portion of right femur or in pelvis.
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Fig. 2C —11-year-old boy with septic arthritis of right hip. Coronal
fat-suppressed gadolinium-enhanced T1-weighted spin-echo MR image (417/14)
shows low signal intensity (arrow) of right femoral head compared
with left femoral head and no abnormal enhancement of proximal portion of
femur or of pelvic bone.
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Fig. 3A —27-year-old woman with septic arthritis of left hip. Coronal
T1-weighted spin-echo MR image (TR/TE, 550/14) shows no abnormal low signal
intensity in bone marrow of proximal portion of left femur or of pelvis.
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Fig. 3B —27-year-old woman with septic arthritis of left hip. Coronal
fat-suppressed T2-weighted fast spin-echo MR image (4,000/67) shows grade 2
effusion (arrows) in left hip joint. Abnormal high signal intensity
of either proximal portion of left femur or of pelvis is not evident.
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Fig. 3C —27-year-old woman with septic arthritis of left hip. Coronal
fat-suppressed gadolinium-enhanced T1-weighted spin-echo MR image (467/14)
showed relatively low signal intensity (arrow) of left femoral head
compared with right femoral head. Abnormal enhancement of bone marrow is not
evident.
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Fig. 4B —2-year-old girl with transient synovitis of left hip. Coronal
fat-suppressed T2-weighted fast spin-echo MR image (4,100/75) shows grade 3
effusion (arrow) in left hip joint. Abnormal high signal intensity of
soft tissue around left hip joint is evident.
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Fig. 4C —2-year-old girl with transient synovitis of left hip. Axial
fat-suppressed T2-weighted fast spin-echo MR image (4,100/75) shows high
signal intensity of soft tissue around proximal portion of left femur
(arrows).
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Fig. 4D —2-year-old girl with transient synovitis of left hip. Coronal
fat-suppressed gadolinium-enhanced T1-weighted spin-echo MR image (500/14)
shows lower signal intensity of left femoral head than of right femoral head
(arrow). Synovial thickening appears as thicker enhancing rim of
synovium (arrowheads).
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Fig. 5A —6-year-old girl with transient synovitis of left hip. Coronal
T1-weighted spin-echo MR image (TR/TE, 550/14) shows no abnormal alteration of
signal intensity in bone marrow in proximal portion of left femur or in
pelvis.
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Fig. 5B —6-year-old girl with transient synovitis of left hip. Fat-suppressed
T2-weighted fast spin-echo MR image (4,000/75) shows grade 2 effusion
(arrowheads) in left hip joint. Abnormal high signal intensity is not
evident in proximal portion of left femur or in pelvis.
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Fig. 5C —6-year-old girl with transient synovitis of left hip. Fat-suppressed
gadolinium-enhanced T1-weighted spin-echo MR image (450/14) shows no
difference in signal intensity between right femoral head and left femoral
head (arrows). Abnormal enhancement of bone marrow is not
evident.
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