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European Radiology
Published in: European Radiology 3/2018

Open Access 01-03-2018 | Paediatric

Contrast-enhanced MRI findings of the knee in healthy children; establishing normal values

Authors: Robert Hemke, J. Merlijn van den Berg, Charlotte M. Nusman, E. Charlotte van Gulik, Anouk M. Barendregt, Dieneke Schonenberg-Meinema, Koert M. Dolman, Taco W. Kuijpers, Mario Maas

Published in: European Radiology | Issue 3/2018

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Abstract

Objectives

To define normative standards for the knee in healthy children using contrast-enhanced MRI, focusing on normal synovial membrane thickness. Secondly, presence of joint fluid and bone marrow oedema was evaluated.

Methods

For this study, children without disorders potentially resulting in (accompanying) arthritis were included. Patients underwent clinical assessments, followed by contrast-enhanced MRI. MRI features were evaluated in consensus using the Juvenile Arthritis MRI Scoring (JAMRIS) system. Additionally, the presence of joint fluid was evaluated. No cartilage lesions or bone abnormalities were observed.

Results

We included 57 healthy children. The overall mean thickness of the normal synovial membrane was 0.4 mm (min–max; 0.0–1.8mm). The synovium was thickest around the cruciate ligaments and retropatellar and suprapatellar regions. The mean overall diameter of the largest pocket of joint fluid was 2.8 mm (min–max; 0.9–8.0mm). Bone marrow changes were observed in three children (all in the apex patellae).

Conclusions

The normal synovial membrane was maximally 1.8 mm thick, indicating that the JAMRIS cut-off value of 2 mm can be considered a valid measure for evaluating synovial hypertrophy. Some joint fluid and bone marrow changes suggestive of bone marrow oedema in the apex patellae can be seen in healthy children.

Key Points

• Knowledge on the normal synovial appearance using contrast-enhanced MR is lacking.
• In healthy children, normal synovial membrane is maximally 1.8 mm thick.
• Normal synovium is thickest around the cruciate ligaments, retropatellar and suprapatellar.
• Bone marrow oedema in the apex patellae is seen in healthy children.
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Metadata
Title
Contrast-enhanced MRI findings of the knee in healthy children; establishing normal values
Authors
Robert Hemke
J. Merlijn van den Berg
Charlotte M. Nusman
E. Charlotte van Gulik
Anouk M. Barendregt
Dieneke Schonenberg-Meinema
Koert M. Dolman
Taco W. Kuijpers
Mario Maas
Publication date
01-03-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5067-6

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