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Skeletal Radiology

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01-03-2009 | Scientific Article

MRI features of tuberculosis of the knee

Authors: Darshana A. Sanghvi, Veena R. Iyer, Tejaswini Deshmukh, Sumedh S. Hoskote

Published in: Skeletal Radiology | Issue 3/2009

Abstract

Objective

The objective of this study was to describe the magnetic resonance imaging (MRI) features of tuberculosis (TB) of the knee joint.

Materials and methods

The MRI features in 15 patients with TB of the knee, as confirmed by histology of the biopsied joint synovium, were reviewed retrospectively. The images were assessed for intra-articular and peri-articular abnormalities.

Results

All patients had florid synovial proliferation. The proliferating synovium showed intermediate to low T2 signal intensity. In the patients who were administered intravenous contrast, the hypertrophic synovium was intensely enhancing. Marrow edema (n = 9), osteomyelitis (n = 4), cortical erosions (n = 5), myositis (n = 6), cellulitis (n = 2), abscesses (n = 3), and skin ulceration/sinus formation (n = 2) were seen in the adjacent bone and soft tissue.

Conclusion

Synovial proliferation associated with tuberculous arthritis is typically hypointense on T2-weighted images. This appearance, in conjunction with other peri-articular MRI features described, can help in distinguishing TB arthritis from other proliferating synovial arthropathies.

Zimmerman MR. Pulmonary and osseous TB in an Egyptian mummy. Bull NY Acad Med 1979; 55: 604–608.

WHO Factsheet on TB 2007. Available from: http://www.who.int/mediacentre/factsheets/fs104/en/index.html. Accessed on February 21, 2008.

Engin G, Acunas B, Acunas G, Tunaci M. Imaging of extrapulmonary tuberculosis. Radiographics 2000; 20: 471–488.CrossRef

Moon MS. Tuberculosis of the spine: controversies and a new challenge. Spine 1997; 22: 1791–1797.CrossRef

Davidson PT, Horowitz I. Skeletal TB: a review with patient presentations and discussions. Am J Med 1970; 48(1): 77–84.CrossRef

Yao DC, Sartoris DJ. Musculoskeletal tuberculosis. Radio Clin North Am 1995; 33(4): 679–689.

Tuli SM. General principles of osteoarticular tuberculosis. Clin Orthop Relat Res 2002; 398: 111–119.CrossRef

Iagnocco A, Coari G, Buzzi G, Guerrisi R, Valesini G. Magnetic resonance imaging of peripheral osteoarticular tuberculosis compared with sonography and standard radiographs. Rheumatol Int 2003; 23(4): 195–197.CrossRef

Aloui N, Nessib N, Jalel C, et al. Tuberculosis of the knee: MRI findings in two pediatric cases. J Radiol 2003; 84(7–8 Pt 1): 861–864.PubMed

10.

Kulshrestha A, Misra RN, Agarwal P, Gupta D. Magnetic resonance appearance of tuberculosis of the knee joint with ruptured Baker’s cyst. Australas Radiol 1995; 39(1): 80–83.CrossRef

11.

Oueslati S, Douira W, Dhieb R, et al. MRI of knee tuberculous arthritis. Med Mal Infect 2007; 37(9): 549–553.CrossRef

12.

Araki Y, Tsukaguchi I, Shino K, Nakamura H. Tuberculous arthritis of the knee: MR findings. AJR Am J Roentgenol 1993; 160(3): 664.PubMed

13.

Tuli SM. Tuberculosis of the Knee Joint. In: Tuberculosis of the skeletal system. New Delhi: Jaypee Brothers Medical Publishers (P) LTD, 2nd edition, 1997: 97-114.CrossRef

14.

Suh JS, Lee JD, Cho JH, Kim MJ, Han DY, Cho NH. MR imaging of tuberculous arthritis: clinical and experimental studies. J Magn Reson Imaging 1996; 6(1): 185–189.CrossRef

15.

Hsu CY, Lu HC, Shih TT. Tuberculous infection of the wrist: MRI features. AJR Am J Roentgenol 2004; 183(3): 623–628.CrossRef

16.

Hong SH, Kim SM, Ahn JM, Chung HW, Shin MJ, Kang HS. Tuberculous versus pyogenic arthritis: MR Imaging evaluation. Radiology 2001; 218: 848–853.CrossRef

17.

Narvaez JA, Narvaez J, Ortega R, De Lama E, Roca Y, Vidal N. Hypointense synovial lesions on T2-weighted images: differential diagnosis with pathologic correlation. AJR Am J Roentgenol 2003; 181: 761–769.CrossRef

18.

Boles CA, Ward WG Sr. Loose fragments and other debris; miscellaneous synovial and marrow disorders. Magn Reson Imaging Clin N Am 2000; 8: 371.PubMed

19.

Stoller DW, Tirman PFJ, Bredella MA. Section 9. In: Diagnostic Imaging Orthopedics Canada: Amirsys, 2004: 18–21.

20.

Parmar H, Shah J, Patkar D, Singrakhia M, Patankar T, Hutchinson C. Tuberculous arthritis of the appendicular skeleton: MR imaging appearances. Eur J Radiol 2004; 52(3): 300–309.CrossRef

21.

Sawlani V, Chandra T, Mishra RN, Aggarwal A, Jain UK, Gujral RB. MRI features of tuberculosis of peripheral joints. Clin Radiol 2003; 58(10): 755–762.CrossRef

22.

Zacharia TT, Shah JR, Patkar D, Kale H, Sindhwani V. MRI in ankle tuberculosis: review of 14 cases. Australas Radiol 2003; 47(1): 11–16.CrossRef

23.

Shah J, Patkar D, Parikh B, et al. Tuberculosis of the sternum and clavicle: imaging findings in 15 patients. Skeletal Radiol 2000; 29(8): 447–453.CrossRef

Title: MRI features of tuberculosis of the knee
Authors: Darshana A. Sanghvi
Veena R. Iyer
Tejaswini Deshmukh
Sumedh S. Hoskote
Publication date: 01-03-2009
Publisher: Springer Berlin Heidelberg
Published in: Skeletal Radiology / Issue 3/2009
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-008-0617-2

At a glance: The STEP trials

Springer Medicine

MRI features of tuberculosis of the knee

Abstract

Objective

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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