scholarly journals Magnetic resonance imaging scans are not a reliable tool for predicting symptomatic acromioclavicular arthritis

2017 ◽  
Vol 10 (4) ◽  
pp. 250-254 ◽  
Author(s):  
Bijayendra Singh ◽  
Abhinav Gulihar ◽  
Praveen Bilagi ◽  
Arpit Goyal ◽  
Pallavi Goyal ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Clinical Symptoms ◽  
Bone Marrow Oedema ◽  
Control Group ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Asymptomatic Group ◽  
Mri Scans

Background We investigated whether magnetic resonance imaging (MRI) scans can accurately diagnose arthritis of the acromioclavicular joint (ACJ) because it has recently been suggested that bone marrow oedema on MRI scans is a predictive sign of symptomatic ACJ arthritis. Methods The MRI scans of 43 patients (50 shoulders) who underwent ACJ excision for clinically symptomatic ACJ arthritis were compared to a control group of 43 age- and sex-matched patients (48 shoulders) who underwent an MRI scan for investigation of shoulder pain but did not have clinical symptoms or signs of ACJ arthritis. The scans were evaluated by an experienced musculoskeletal radiologist, who was blinded to the examination findings. Results Bone marrow oedema was present in only 15 (30%) shoulders in the ACJ excision group, although this was higher than the six shoulders in the asymptomatic group ( p = 0.03). Forty-one (82%) shoulders in the symptomatic group had grade III/IV ACJ arthritis compared to 31 (65%) in the asymptomatic group ( p = 0.05). However, 44 out of 48 (92%) shoulders in the asymptomatic group had signs of osteoarthritis on MRI scans. Conclusions In contrast to recent reports, the present study shows that MRI is not helpful in making the diagnosis of ACJ arthritis. A focused history and clinical examination should remain the mainstay for surgical decision making. Level of evidence Level 3

scholarly journals THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.4-483
Author(s):  
A. Jones ◽  
C. Ciurtin ◽  
H. Kazkaz ◽  
M. Hall-Craggs
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Bone Marrow Oedema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Fatty Change ◽  
Subchondral Sclerosis

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

Does diffusion-weighted magnetic resonance imaging have a place in the differential diagnosis of brucella sacroiliitis and seronegative spondyloarthropathy?

2020 ◽  
pp. 028418512093837
Author(s):  
Sunay Sibel Karayol ◽  
Kudret Cem Karayol
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Control Group ◽  
Resonance Imaging ◽  
Visual Evaluation ◽  
Mean Values ◽  
Diffusion Weighted ◽  
The Mean

Background The aim of this study is to investigate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of sacroiliitis. Purpose To compare the sacroiliac magnetic resonance imaging (MRI) examinations of patients with suspected active sacroiliitis with patients with acute SpA MR findings and the DWI examinations of patients with acute brucella sacroiliitis, and thereby determine whether DWI can contribute to the differential diagnosis. Material and Methods A total of 84 patients were included in the study and were separated into three groups: group 1 (13 women, 6 men) comprised cases with brucella positive for sacroiliitis; group 2 (17 women, 19 men) comprised cases negative for brucella but with sacroiliitis; and group 3 (16 women, 13 men) comprised cases negative for brucella and sacroiliitis. Results The mean bone marrow apparent diffusion coefficient (ADC) values independently of edema were determined as 0.71 × 10−3 in sacroiliitis and brucella-positive patients, as 0.53 × 10−3 in brucella-negative and sacroiliitis-positive patients, and as 0.43 × 10−3 in the control group of brucella-negative sacroiliitis-negative patients. In the ADC measurements taken from areas of evident edema in patients with sacroiliitis, the mean values were 0.13 × 10−3 in the brucella-positive group and 0.12 × 10−3 in the brucella-negative group. Conclusion By adding DWI, which is a rapid MR sequence, to sacroiliac joint MR examination, normal bone marrow and bone marrow with sacroiliitis can be objectively differentiated with ADC measurements in addition to visual evaluation.

scholarly journals New Modalities in Knee Osteoarthritis Treatment Using Autologous Bone Marrow-Derived Mononuclear Cells

2018 ◽  
Vol 72 (4) ◽  
pp. 207-215
Author(s):  
Valdis Gončars ◽  
Konstantīns Kalnbērzs ◽  
Ēriks Jākobsons ◽  
Ieva Briede ◽  
Kristaps Blūms ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Knee Osteoarthritis ◽  
Mononuclear Cell ◽  
Mononuclear Cells ◽  
Intraarticular Injection ◽  
Control Group ◽  
Resonance Imaging

Abstract The clinical effects on knee osteoarthritis (OA) symptoms and tissue structure were evaluated after bone marrow-derived mononuclear cell intraarticular injection. A group of 32 patients with 34 knee joints in stage II–III osteoarthritis were treated by intraarticular injection of mononuclear cell suspension. Clinical results were obtained by KOOS (Knee Osteoarthritis Outcome Score) and KSS (Knee Society Score) scores during a 12 months follow-up period. Radiological evaluation was performed using magnetic resonance imaging. A comparison with a control group of 28 patients treated with routinely used three hyaluronic acid intra-articular injections was made. No adverse effects were observed after the bone marrow derived mononuclear cells (BM-MNC) injection. At the end point of the follow up all score results had improved, compared to those at to the starting point. 65% of patients maintained minimal perceptible clinical improvement of the score results. The Whole Organ Magnetic Resonance Imaging Score showed improvement from 44.31 to 42.93 points (p < 0.05) during a 6–7 month period. Comparing score results to the control group, a statistically significant (p < 0.05) improvement in the KOOS pain subscale score at the 6 and 12 months was observed in the mononuclear cell group. BM-MNC injection leads to a decrease of knee OA symptoms and slows changes in structure of the degenerative joint tissue.

scholarly journals Dynamic Evaluation of Notch Signaling-Mediated Angiogenesis in Ischemic Rats Using Magnetic Resonance Imaging

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Jia-qi Tian ◽  
Jia-jun Zheng ◽  
Xiao-zhu Hao ◽  
Le-kang Yin ◽  
Xiao-xue Zhang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Notch Signaling ◽  
Butyl Ester ◽  
Notch Signaling Pathway ◽  
Control Group ◽  
Vascular Density ◽  
Resonance Imaging ◽  
Sprague Dawley ◽  
Mri Scans

Objective. The Notch signaling pathway is involved in angiogenesis induced by brain ischemia and can be efficiently inhibited by the γ-secretase inhibitor N-[N-(3,5-difluorophenacetyl)-1-alanyl]-S-phenylglycine t-butyl ester (DAPT). The aim of the present study was to noninvasively investigate the effect of DAPT treatment on angiogenesis in brain repair after stroke using magnetic resonance imaging (MRI). Methods. Sprague-Dawley rats (n=40) were subjected to 90 minutes of transient middle cerebral artery (MCA) occlusion and treated with PBS (n=20) or DAPT (n=20) at 72 hours after the onset of ischemia. MRI measurements including T2-weighted imaging (T2WI), susceptibility-weighted imaging (SWI), and cerebral blood flow (CBF) were performed at 24 hours after reperfusion and weekly up to 4 weeks using a 3-Tesla system. Histological measurements were obtained at each time point after MRI scans. Results. SWI showed that DAPT treatment significantly enhanced angiogenesis in the ischemic boundary zone (IBZ) with respect to the control group, with local CBF in the angiogenic area elevated, along with increases in vascular density confirmed by histology. Conclusion. Treatment of ischemic stroke with DAPT significantly augments angiogenesis, which promotes poststroke brain remodeling by elevating CBF level, and these processes can be dynamically monitored and evaluated by MRI.

Relationship Between the Size of Bone Marrow Edema of the Talus and Ankle Pain

2011 ◽  
Vol 101 (5) ◽  
pp. 430-436 ◽  
Author(s):  
Murat Tonbul ◽  
Aliye Yildirim Guzelant ◽  
Aysun Gonen ◽  
Emre Baca ◽  
Mehmet U. Ozbaydar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Bone Marrow Edema ◽  
Rating Scale ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Mri Scans ◽  
American Orthopaedic ◽  
Marrow Edema

Background: We sought to determine the changes in the size of the edema observed on MRI scans and its relation to the patient’s pain during activity and pain during rest in bone marrow edema. Methods: A total of 26 patients were followed up at 3-month intervals for a period of 1 year. During the follow-ups, magnetic resonance imaging scans of the patients’ ankles were obtained; the scores obtained on the American Orthopaedic Foot and Ankle Society functional rating scale and visual analog scale were determined. The changes in these parameters and the correlation between them were examined. Results: The size of the edema as observed on magnetic resonance imaging scans decreased, and the pain during activity and rest decreased. Although there is a correlation between the decrease in the edema size observed on magnetic resonance imaging scans and decrease in the pain during activity, there is no correlation between the decrease in the edema size observed on magnetic resonance imaging scans and the decrease in pain during rest. Conclusions: Patients can be informed more precisely, that the pain during rest and activity may not decrease after the third and sixth month, respectively. Magnetic resonance imaging may not alter after the ninth month, so it may not be necessary to be performed again. (J Am Podiatr Med Assoc 101(5): 430–436, 2011)

scholarly journals Novel Semiquantitative Bone Marrow Oedema Score and Fracture Score for the Magnetic Resonance Imaging Assessment of the Active Charcot Foot in Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
L. Meacock ◽  
N. L. Petrova ◽  
Ana Donaldson ◽  
A. Isaac ◽  
A. Briody ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Interobserver Agreement ◽  
Bone Volume ◽  
Foot And Ankle ◽  
Intraobserver Agreement ◽  
Charcot Foot ◽  
Resonance Imaging ◽  
Mri Scans

There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0—no oedema, 1—oedema < 50% of bone volume, and 2—oedema > 50% of bone volume) and fracture (0—no fracture, 1—fracture, and 2—collapse/fragmentation). Interobserver agreement and intraobserver agreement were measured using multilevel modelling and intraclass correlation (ICC). The interobserver agreement for the total BMO and fracture scores was very good (ICC = 0.83, 95% confidence intervals (CI) 0.76, 0.91) and good (ICC = 0.62; 95% CI 0.48, 0.76), respectively. The intraobserver agreement for the total BMO and fracture scores was good (ICC = 0.78, 95% CI 0.6, 0.95) and fair to moderate (ICC = 0.44; 95% CI 0.14, 0.74), respectively. The proposed BMO and fracture scores are reliable and can be used to grade the extent of bone damage in the active Charcot foot.

scholarly journals Sacroiliac Joint Magnetic Resonance Imaging in Asymptomatic Patients with Recurrent Acute Anterior Uveitis: A Proof-of-concept Study

2017 ◽  
Vol 44 (12) ◽  
pp. 1833-1840 ◽  
Author(s):  
Thauana L. Oliveira ◽  
Walter P. Maksymowych ◽  
Robert G.W. Lambert ◽  
Cristina Muccioli ◽  
Artur R.C. Fernandes ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Anterior Uveitis ◽  
Resonance Imaging ◽  
Acute Anterior Uveitis ◽  
Asymptomatic Group ◽  
Asymptomatic Patients ◽  
Mri Scans ◽  
Group 3

Objective.Our aim was to quantify bone marrow edema (BME) and/or structural lesions in the sacroiliac joints (SIJ) of patients with recurrent acute anterior uveitis (rAAU) with or without back pain, to evaluate the frequency of axial (axSpA) and peripheral spondyloarthritis (pSpA) and to establish which criterion for magnetic resonance imaging (MRI) positivity best reflected the global assessment of SIJ MRI.Methods.A total of 50 patients with rAAU without prior rheumatologic diagnosis were included in our cross-sectional study, and these patients were compared to 21 healthy volunteers. SIJ MRI scans were read by 2 rheumatologists according to the Spondyloarthritis Research Consortium of Canada (SPARCC/MORPHO) protocol. Discrepant cases were adjudicated by a radiologist.Results.Patients with rAAU were diagnosed with axSpA (Group 1, n = 20, 40%) and nonspecific back pain (Group 2, n = 6, 12%), or as being asymptomatic (Group 3, n = 24, 48%). Group 3 results showed 9 patients (37.5%) had SIJ MRI and/or were radiography-positive for axSpA (5 MRI and radiograph, 1 MRI, 3 radiograph). SIJ MRI scans that were compatible with SpA in groups 1 (n = 12) and 3 (n = 6) were similar in acute and structural lesions that were analyzed according to SPARCC/MORPHO. The best sensitivity/specificity criterion for defining a positive global MRI assessment was a BME score ≥ 3 (88%/94%).Conclusion.This is the first study evaluating SIJ MRI in patients with rAAU without back symptoms, showing positive findings for sacroiliitis. Moreover, a BME score ≥ 3 had better performance to define an SIJ MRI as positive for axSpA.

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