Common Mistakes and Pitfalls in Magnetic Resonance Imaging of the Knee

Vanhoenacker, Filip; Vos, Nicolas De; Dyck, Pieter Van

doi:10.5334/jbr-btr.1206

Cited by 9 publications

(5 citation statements)

References 39 publications

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“…Consistent with the fact that most secondary BCs are connected to the knee joint space, [1–5] some previous studies have suggested that BCs are associated with lesions within the knee joint. [6,13–16] Balik et al retrospectively examined 45 knee MRIs of symptomatic patients.…”

Section: Discussionsupporting

confidence: 67%

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Association of complicated Baker’s cysts with knee pathologies as compared to simple Baker’s cysts

Kim,

Kang,

Yoon

2024

Medicine

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Baker’s cysts (BCs) are known to be associated with intra-articular pathologies. BCs can be classified into 2 types: simple and complicated. Although some studies have focused on BC using magnetic resonance imaging (MRI), which is the gold standard examination, no study has compared knee MRI features in patients with simple and complicated BCs. To assess the relationship between the type of BC (simple vs complicated) and other knee pathologies using MRI. Seventy patients who underwent knee MRI examination due to symptomatic knee were retrospectively recruited from April 2011 to April 2021 at a single hospital. In the knee MRI images, the following were assessed: type (simple or complicated), morphology, volume of BCs, thickness of the suprapatellar recess, presence of synovial proliferation of the suprapatellar recess, grade of knee joint effusion, presence of meniscal tear, and extent of meniscal extrusion. The patients were classified into 2 groups according to the type of BC: simple BC and complicated BC. The differences between the 2 groups were evaluated for all variables. Finally, 52 patients were included in this study, 15 were classified as “simple BC” group and 37 as “complicated BC” group. The volume of complicated BC (median: 4.6, interquartile range – IQR: 1.6–12.4) was significantly greater than that of simple BC (median: 0.7, IQR: 0.3–3.7; P = .007). The presence of synovial proliferation in the suprapatellar recess was significantly higher in complicated BC (91.9%) than that in simple BC (46.7%; P = .001). The thickness of the suprapatellar recess was significantly greater in complicated BC (median: 7.5, IQR: 5.8–10.7) than that in simple BC (median: 4.3, IQR: 2.3–7.6; P = .020). The medial meniscus extrusion was greater in complicated BC (median: 4.1, IQR: 2.8–5.1) than that in simple BC (median: 2.5, IQR: 1.8–4.4; P = .037). After adjusting these P-values using the Holm method, only the presence of synovial proliferation in the suprapatellar recess remained significant (P = .010). Using knee MRI images, we demonstrated that complicated BCs are more associated with intra-articular pathologies than simple BCs; such as cyst volume, amount of the knee joint effusion, synovial proliferation and medial meniscal extrusion. Among them, the presence of synovial proliferation was the most significant factor associated with complicated BCs.

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Section: Discussionsupporting

confidence: 67%

“…[1,2] Most of the BCs are secondary BCs connected with knee joint space. [1][2][3][4][5][6] BCs sometimes cause clinical symptoms such as pain or swelling. When the size become large, BC can cause knee stiffness or decrease flexibility.…”

Section: Introductionmentioning

confidence: 99%

Association of complicated Baker’s cysts with knee pathologies as compared to simple Baker’s cysts

Kim,

Kang,

Yoon

2024

Medicine

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“…Carotti et al [46] proposed the identification of early osteoarthrosis which is not based on the cartilage status, but on visible bone marrow lesions and infrapatellar fat pad synovitis. Such an approach can be explained by the so-called satisfaction of the search [47] when the detection of abnormality can reduce the detectability of other intraarticular lesions.…”

Section: Discussionmentioning

confidence: 99%

Knee MRI Underestimates the Grade of Cartilage Lesions

et al. 2021

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Purpose: This study was conducted in order to evaluate the clinical utility of MRI in detecting cartilage lesions and its dependence on anatomical location and lesion grade. Methods: A retrospective analysis of MRI reports and arthroscopic findings was performed on 190 consecutive patients treated in one orthopaedic department. MRI protocols were prepared by 18 radiologists from 10 different MRI centers with the use of 1.5 T magnets. The image protocols were selected by reading radiologists. Four hundred and fifty-three chondral lesions in five anatomic locations were identified during this study and graded according to the ICRS classification. Sensitivity, specificity, receiver operating characteristic (ROC), and Bangdiwala’s observer agreement charts were utilized to evaluate the diagnostic performance. Results: Only approximately 30% of MRI showed an adequate cartilage status in all anatomical locations. The sensitivity ranged from 92% in healthy cartilage to 5% in grade I lesions. The specificity differed also grossly depending on the lesion grade, reaching 96.5% in grade four lesions and 38% in healthy cartilage. The medial compartment Bangdiwala’s observer agreement charts show a gross underestimation of cartilage lesions, and the area under the curve (AUC) of ROC surpasses 0.7 only in the medial femoral condyle and patella-femoral joint. Overall, the medial compartment accuracy was significantly higher than the lateral compartment. The MRI showed correspondence of its diagnostic performance with cartilage lesion severity. Conclusion: MRI underestimates the extent of cartilage injury and evaluation of cartilage defects based on MRI should be taken with caution by orthopaedic surgeons in planning surgery. Surgical planning on MRI should take cartilage lesions under consideration, even if no cartilage lesions are reported on the MRI.

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“…Complex tears in the anterior horn of the lateral meniscus were seen at arthroscopy as degeneration (Figures 1a and 1b). On sagittal images, a linear band of lateral meniscus and anterior transverse ligament, occasionally simulate an oblique meniscal tear (Figure 1b) [21][22][23]. We may have exaggerated the degeneration of meniscus as a tear due to the transverse ligament.…”

Section: Discussionmentioning

confidence: 99%

The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study

Bilge¹,

Tokgöz²,

Dur³

et al. 2019

Journal of Surgery and Medicine

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Aim: Diagnostic arthroscopy is an invasive and an expensive method using for the diagnosis of meniscal tears. The aim of this study was to determine the value of knee magnetic resonance imaging in the diagnosis of meniscal tears and its role in the prevention of unnecessary diagnostic arthroscopy. Methods: A total of 105 patients who underwent knee magnetic resonance imaging and arthroscopy due to meniscus injury were included in the study. Fifty-nine patients were examined using a 1.5 Tesla magnetic resonance scanner and 46 were examined using a 3.0 Tesla magnetic resonance scanner. Magnetic resonance imaging findings were evaluated retrospectively in workstations by two radiologists experienced in musculoskeletal magnetic resonance imaging. Meniscal tears were reported as anterior horn tear, corpus tear or posterior horn tear. Meniscal tears were classified by using surgical classification. Each patient's magnetic resonance images were evaluated with a consensus and compared with the arthroscopic diagnosis. Results: Meniscal tears were detected in 96 out of 106 knees on arthroscopy. By using arthroscopy as the gold standard for diagnosis of meniscal tears, the sensitivity, specificity, and accuracy values of the magnetic resonance imaging evaluation were found as 85.71% (95% CI: 77.84-91.61), 93% (95% CI: 86.11-97.14) and 89.15% (95% CI: 84.17-93), respectively. These values of magnetic resonance imaging were found high in the diagnosis of meniscal tears. Conclusions: Magnetic resonance imaging is an effective imaging method in the diagnosis of meniscal tears. Although the resolution of 3.0 Tesla magnetic resonance imaging is higher, 1.5 Tesla magnetic resonance imaging is sufficient in routine meniscus tear diagnosis.

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Common Mistakes and Pitfalls in Magnetic Resonance Imaging of the Knee

Abstract: This pictorial review presents an overview of common interpretation errors and pitfalls in magnetic resonance imaging (MRI) of the knee. Instead of being exhaustive, we will emphasize those pitfalls that are most commonly encountered by young residents or less experienced radiologists.

Cited by 9 publications

References 39 publications

Association of complicated Baker’s cysts with knee pathologies as compared to simple Baker’s cysts

Association of complicated Baker’s cysts with knee pathologies as compared to simple Baker’s cysts

Knee MRI Underestimates the Grade of Cartilage Lesions

The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study

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