MRI Determination of Knee Effusion Volume: A Cadaveric Study

Wittstein, Jocelyn; Spritzer, Charles E.; Garrett, William E.

doi:10.5005/jp-journals-10017-1032

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…In comparison, MRI has been shown to be sensitive Supplemental material online at jultrasoundmed.org enough to detect 1 mL of fluid injected into cadaveric specimens and has potential to estimate the amount of fluid in a knee joint to within 1 mL. 13,14 Despite the data showing the differences in sensitivity of ultrasound and MRI in detecting knee effusion, there is limited research to guide clinicians on when these modalities should be used or if a thorough physical examination of the knee is sufficient. Previous systematic reviews on physical examination and ultrasound accuracy have relied on using ultrasound as a gold standard or found very few studies when using MRI as a gold standard.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Utility of Ultrasound Versus Physical Examination in Assessing Knee Effusions

Meyer

Lin

Yenokyan

et al. 2021

J of Ultrasound Medicine

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Knee effusion can be detected by physical examination, ultrasound and MRI, but the utility of each test is unclear. This study aimed to analyze the diagnostic value of physical examination and ultrasound for knee effusion. A systematic literature search of electronic databases was completed. Bivariate mixed-effects regression modelling was used to estimate sensitivity, specificity and diagnostic odds ratio of physical examination and ultrasound diagnosis of knee effusion. Sensitivity of ultrasound diagnosis of knee effusion was higher than the bulge sign and patellar tap, leading to improved positive and negative predictive values.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Utility of Ultrasound Versus Physical Examination in Assessing Knee Effusions

Meyer

Lin

Yenokyan

et al. 2021

J of Ultrasound Medicine

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“…MRI using axial T2 weighted turbo spin echo (T2WTSE) and sagittal SPACE (Sampling Perfection with application optimized contrast using different angle evolutions) were reported to be highly correlated with the known volumes of saline injection into cadavers (r = 0.993 and 0.996, p < 0.001). 39 It was also reported that in patients with knee osteoarthritis, an automated system for knee joint effusion volume measurement using T2-weight MRI images achieved excellent correlations with manual quantification (r = 0.98; p < 0.0001) and invasive knee aspiration (r = 0.88; p = 0.0008). 40 It was also reported that manual calculation had excellent inter-observer reliability (r = 0.935; p < 0.0001).…”

Section: Magnetic Resonance Imagingmentioning

confidence: 86%

Swelling assessment after total knee arthroplasty

Yau

Hong

et al. 2022

J Orthop Surg (Hong Kong)

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Background Total knee arthroplasty is a commonly performed elective orthopaedic surgery. Patients may endure substantial knee swelling following surgery, which are attributable to both effusion and edema. Studies have been aiming to identify an accurate and reliable method to quantify post-operative knee swelling to aid monitoring progress and treatment. The aim of this article was to review the means of clinically applicable measurements for knee swelling post TKA. Methods The medical literature was searched using PubMed to search for articles published using the terms knee edema, effusion, swelling, knee arthroplasty, knee replacement, total knee arthroplasty, total knee replacement, TKA, TKR. Year of publication was not restricted. Only English language publications were included. Only full-text published articles from peer-reviewed journals were eligible for inclusion. The knee swelling measurement methods used in post TKA were reviewed. Results Advancement in bioimpedance spectroscopy and handheld 3D scanning technology allows quick and precise quantification of knee swelling volume that the traditional clinical circumferential measurement and volumetric measurement lack. Handheld 3D scanning is also a potential tool to estimate the change of knee effusion volume and muscular volume after the surgery. Magnetic resonance imaging is accurate in effusion measurement but also the most time and resource demanding method. Conclusion Bioimpedance spectroscopy and 3D scanning technology can be the future tools for clinically measurement of knee swelling after total knee arthroplasty.

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Volume and Distribution of Early Knee Effusion After TKA with a PEEK-Based Knee Prosthesis

Lyu,

Yang,

Yuan

et al. 2024

Journal of Bone and Joint Surgery

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Background: Early knee effusion is a common phenomenon after total knee arthroplasty (TKA), with potential clinical implications. Unlike traditional alloy knee prostheses, the polyetheretherketone (PEEK) knee system has radiographic transparency on magnetic resonance (MR) scans, which allows analysis of prosthetic knee effusion. We aimed to identify the distribution and volume of knee effusion after TKA with the PEEK prosthesis with use of MR imaging and to analyze whether dynamic changes in effusion were correlated with serum inflammatory marker changes and knee function recovery. Methods: Nine patients with osteoarthritis who were 59 to 74 years old underwent unilateral TKA with the PEEK prosthesis between June 2021 and August 2021. Dynamic early postoperative changes in the volume and distribution of knee effusion were evaluated with use of 3D MR stereoscopic images. Serum inflammatory markers were measured via blood tests, and joint function was evaluated with use of the subjective functional score of the Knee Society Score (KSS) and knee range of motion (ROM). Linear regression analyses were performed to assess for correlations between knee effusion volume and inflammatory markers and between knee effusion volume and joint function. Results: The mean serum inflammatory marker levels increased significantly at 1 week after TKA with the PEEK prosthesis and then gradually decreased with time from 1 to 6 months. The mean total knee effusion volume gradually decreased over time. Concurrently, the mean KSS subjective functional score and mean knee ROM improved with time. Total knee effusion volume was positively correlated with C-reactive protein level (R2 = 0.16; p = 0.007) and negatively correlated with the change in KSS score between the preoperative and postoperative time points (R2 = 0.19; p = 0.003). Using the 1-week total knee effusion volume as a reference, a positive correlation was observed between the reduction in total knee effusion volume and the actual value of the ROM (R2 = 0.36; p = 0.0001) from 3 to 24 months postoperatively. Conclusions: Through 3D MR imaging, the precise distribution and volume of, and dynamic changes in, knee effusion after TKA with the PEEK prosthesis were confirmed and were found to be correlated with inflammation and joint function in the early postoperative period. The results demonstrate the potential clinical benefit of the PEEK-based knee system for future use. Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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MRI Determination of Knee Effusion Volume: A Cadaveric Study

Abstract: Background: There is currently limited literature on quantitative determination of knee effusion volume using magnetic resonance imaging (MRI).

Cited by 3 publications

References 16 publications

Diagnostic Utility of Ultrasound Versus Physical Examination in Assessing Knee Effusions

Diagnostic Utility of Ultrasound Versus Physical Examination in Assessing Knee Effusions

Swelling assessment after total knee arthroplasty

Volume and Distribution of Early Knee Effusion After TKA with a PEEK-Based Knee Prosthesis

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