scholarly journals Intra-articular venous malformation of the knee in children: magnetic resonance imaging findings and significance of synovial involvement

2019 ◽  
Vol 50 (4) ◽  
pp. 509-515 ◽  
Author(s):  
Katariina A. Mattila ◽  
Johanna Aronniemi ◽  
Päivi Salminen ◽  
Risto J. Rintala ◽  
Kristiina Kyrklund

Abstract Background Intra-articular venous malformations of the knee are an uncommon cause of unilateral knee pain in children. Timely diagnosis is important because lesions with intrasynovial involvement can lead to joint space hemorrhage and secondary cartilage damage. Objective To describe our tertiary center’s experience of diagnostics and typical magnetic resonance imaging (MRI) findings. Materials and methods A retrospective review of all patients ≤16 years of age managed for intra-articular venous malformations of the knee at our institution between 2002 and 2018. Results Of 14 patients (8 male), the mean age at presentation was 6 years (range: 0–14 years). The most common clinical findings were unilateral knee pain (93%), joint swelling (79%), quadriceps atrophy (50%) and a limited range of motion (29%). Cutaneous manifestations were present in four patients (29%). Contrast-enhanced MRI was available in all cases. After initial MRI, a vascular anomaly etiology had been identified in 11 cases (79%), and correctly reported as a venous malformation in 6 (55%). Three patients received entirely different diagnoses (arthritis, tumor or pigmented villonodular synovitis). Three of seven patients with intrasynovial lesions had established chondropathy at diagnosis. Two patients with lesions of the suprapatellar fat pad had intrasynovial involvement that was not visualised on MRI. Conclusion Although MRI usually permits the diagnosis, clinical awareness of these lesions is important for optimal imaging, accurate interpretation and timely diagnosis. Involvement of the intrasynovial cavity carries a risk of hemarthrosis and progressive chondropathy that may be underestimated by MRI.

2015 ◽  
Vol 31 (6) ◽  
pp. 397-402 ◽  
Author(s):  
Si-Ming Yuan ◽  
Chang-Sheng Zhou ◽  
Lei Cui ◽  
Yao Guo ◽  
Zhi-Jian Hong ◽  
...  

Background Venous malformation (VM) is a common vascular malformation in soft tissue. Surgical management plays an important role in its treatment. The location, extent, and adjacent anatomy of the lesion are crucial information for the safety of operation. This study introduces the application of magnetic resonance imaging and percutaneous sinus angiography/three-dimensional computed tomography imaging in gathering above information. Methods A retrospective analysis was made in the patients with venous malformation from January 2012 to June 2014 in our clinic. All patients underwent magnetic resonance imaging and percutaneous sinus angiography/three-dimensional computed tomography imaging. The location, extent of the lesion, its draining veins, and the relationship with around tissues were showed. Surgical management was carried out in the lesions which were well defined, located in the superficial fascia without important vessels and nerves across it. The wound was repaired by skin flap or skin graft. Results A total of 13 patients underwent complete surgical removal of the lesions, including five type I venous malformations and eight type II venous malformations. Ten lesions were removed by undermining dissection, and the wound was repaired by the undermined flap. Three superficial lesions were removed together with the skin over it, and the wound was repaired by the skin graft. In the six months to two years of follow-up period, none of the recurrence of the lesion was observed. Conclusion Magnetic resonance imaging and percutaneous sinus angiography/three-dimensional computed tomography imaging can display abundant morphological details of venous malformation, which are helpful for the surgical management.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Harry Knights ◽  
Elizabeth Minas ◽  
Faraan Khan ◽  
Lindsay Shaw ◽  
Muthana Al Obaidi ◽  
...  

Abstract Background The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. Methods This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher’s exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. Results Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3–20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). Conclusions In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.


2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Abdishakur Mohamed ◽  
◽  
Vinay Gangadharan ◽  
Sukhdeep Jutla ◽  
◽  
...  

Brodie abscess is a relatively rare subacute form of osteomyelitis that is difficult to diagnose due to its insidious onset and limited initial systemic response. We present a case of Brodie abscess in a person with knee pain, swelling and antalgic gait. Diagnosis was made initially using plain radiography, this was supported by magnetic resonance imaging and confirmed on bacterial culture of the surgical samples.


2011 ◽  
Vol 3 (2) ◽  
pp. 11 ◽  
Author(s):  
Bernd Bittersohl

With the increasing advances in hip joint preservation surgery, accurate diagnosis and assessment of femoral head and acetabular cartilage status is becoming increasingly important. Magnetic resonance imaging (MRI) of the hip does present technical difficulties. The fairly thin cartilage lining necessitates high image resolution and high contrast-to-noise ratio (CNR). With MR arthrography (MRA) using intraarticular injected gadolinium, labral tears and cartilage clefts may be better identified through the contrast medium filling into the clefts. However, the ability of MRA to detect varying grades of cartilage damage is fairly limited and early histological and biochemical changes in the beginning of osteoarthritis (OA) cannot be accurately delineated. Traditional MRI thus lacks the ability to analyze the biological status of cartilage degeneration. The technique of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is sensitive to the charge density of cartilage contributed by glycosaminoglycans (GAGs), which are lost early in the process of OA. Therefore, the dGEMRIC technique has a potential to detect early cartilage damage that is obviously critical for decision-making regarding time and extent of intervention for joint-preservation. In the last decade, cartilage imaging with dGEMRIC has been established as an accurate and reliable tool for assessment of cartilage status in the knee and hip joint. This review outlines the current status of dGEMRIC for assessment of hip joint cartilage. Practical modifications of the standard technique including three-dimensional (3D) dGEMRIC and dGEMRIC after intra-articular gadolinium instead of iv-dGEMRIC will also be addressed.


2018 ◽  
Vol 30 (7) ◽  
pp. 565-570 ◽  
Author(s):  
J M Gómez-García ◽  
F J Gómez-Romero ◽  
M Arencibia-Jiménez ◽  
J F Navarro-Gracia ◽  
M Sánchez-Mollá

2020 ◽  
Vol 35 (9) ◽  
pp. 663-671
Author(s):  
Tenghui Zhan ◽  
Fanggang Cai ◽  
Pingfan Guo ◽  
Yujie Lian ◽  
Hui Zhuang ◽  
...  

Objectives To examine three different methods for evaluating the effect of percutaneous sclerotherapy on limb venous malformations in a series of patients with a relatively long follow-up. Method The study was a retrospective study. Results Thirty-eight patients treated with percutaneous sclerotherapy underwent sclerotherapy, with a median number of sessions of 4 (range, 1–10). They were followed up for 1–60 months (average 12.5 months). The kappa between clinical manifestations and Doppler ultrasound was 0.684 ( P < 0.001). The kappa between clinical manifestations and magnetic resonance imaging was 0.217 ( P = 0.006). The kappa between Doppler ultrasound and magnetic resonance imaging was 0.323 ( P < 0.001). The rate of grade IV patients evaluated by clinical manifestations was significantly higher than that by Doppler ultrasound and magnetic resonance imaging. Conclusions Magnetic resonance imaging is the gold standard for VM imaging. Its consistency with clinical examination and Doppler ultrasound is poor, and Doppler ultrasound and clinical examination could be more appropriate for follow-up imaging after sclerotherapy.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Şükran Bekdemir ◽  
Ahmet Kaan Gündüz ◽  
Ömür Ataoğlu

A 22-year-old woman presented with progressive swelling of the nasal conjunctiva in the left eye. Anterior segment examination revealed a diffuse cystic appearance to the inferonasal bulbar conjunctiva and plica semilunaris. Anterior segment swept-source optical coherence tomography (OCT) revealed clear hyporeflective spaces demarcated by hyperreflective septae in the affected conjunctiva, consistent with the diagnosis of lymphatic malformation (LM). Magnetic resonance imaging revealed a well circumscribed intraconal mass located inferonasally in the left orbit. Systemic examination revealed a lesion similar to LM on the left hard palate. The left conjunctival mass was excised subtotally. Subsequently, a transconjunctival anterior orbitotomy was performed and the left orbital mass was completely removed intact. Histopathologically, the conjunctival mass was diagnosed as LM and the orbital mass as venous malformation (VM). This case represents a rare coexistence of histopathologically proven conjunctival LM and orbital VM as well as a presumed LM of the hard palate, all 3 lesions occurring in the ipsilateral midface area.


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