Rheumatoid Arthritis of Knee Joints: MRI–Pathological Correlation

Meng, Xiangjun; Zhi, Wang; Zhang, Xue-ning; Xu, Jin; Hu, Yongcheng

doi:10.1111/os.12389

Cited by 17 publications

(12 citation statements)

References 34 publications

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“…Our exclusion criteria were: (i) previous knee surgery; (ii) acute patellar dislocation; (iii) rheumatoid arthritis 25 ; and (iv) patellofemoral arthritis greater than grade II, with the patellofemoral joint surface having bone contact (Iwano classification) 26 .…”

Section: Patientsmentioning

confidence: 99%

Assessment of Patellar Morphology in Trochlear Dysplasia on Computed Tomography Scans

Liu

et al. 2021

Orthopaedic Surgery

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Objective To evaluate the patellar morphology of trochlear dysplasia and normal knees in different genders and in different severities of trochlear dysplasia on CT scans. Methods A total of 75 patients with trochlear dysplasia (110 knees) treated at the Third Hospital of Hebei Medical University from December 2013 to December 2018 were included in an experimental group, and an age‐matched and sex‐matched cohort of 46 patients with normal trochlear shape (61 knees) were randomly selected into a control group. The experimental group was divided into a female experimental group (Group FE, 47 patients, 72 knees) and a male experimental group (Group ME, 28 patients, 38 knees); the control group was divided into a female control group (Group FC, 31 knees, 24 female patients) and a male control group (Group MC, 30 knees, 22 male patients). Furthermore, according to the severity of trochlear dysplasia, Group FE was divided into a female low‐grade dysplasia group (Group FL, 20 knees) and a female high‐grade dysplasia group (Group FH, 52 knees); Group ME was divided into a male low‐grade dysplasia group (Group ML, 16 knees) and a male high‐grade dysplasia group (Group MH, 22 knees). All participants had undergone CT scans in the supine position; the patellar width and thickness, the lateral patellar facet angle, the Wiberg angle, and the Wiberg index were measured and compared. Results In trochlear dysplasia knees, the mean patellar width and thickness and the lateral patellar facet angle were significantly smaller; the mean Wiberg index was significantly larger than in normal knees, regardless of gender (P < 0.05); and there was no statistically significant difference in the mean Wiberg angle (P > 0.05). In the female groups, the mean patellar width and thickness and the Wiberg angle were significantly smaller; the mean lateral patellar facet angle was significantly larger than those in the male groups (P < 0.05); and there was no significant difference in the mean Wiberg index (P > 0.05). In the low‐grade dysplasia group, the mean Wiberg index was smaller than that in the high‐grade dysplasia group (P < 0.05), regardless of gender; however, there was no significant difference in the mean patellar width and thickness, the lateral patellar facet angle, and the Wiberg angle in low‐grade and high‐grade dysplasia (P > 0.05). Conclusion On CT scans, the patella in trochlear dysplasia had a smaller width, a thinner thickness, a lengthened lateral facet, and a more flattened articular facet. In addition, the patellar articular facet was more prominent in female patients. With the severity of trochlear dysplasia increased, the lateral patellar facet became longer. In addition, the abnormal stress distribution on the patella influenced the patellar morphology in trochlear dysaplasia.

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Section: Patientsmentioning

confidence: 99%

Assessment of Patellar Morphology in Trochlear Dysplasia on Computed Tomography Scans

Liu

et al. 2021

Orthopaedic Surgery

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“…The stage of knee joints in RA patients was assessed based on the evaluation criteria of Larsen et al In their study, the extent of articular destruction was classified as grade 4 for the medial and lateral femoral condyles and the medial and lateral tibial plateaus for most patients, with an average destruction grade of 3.6 (F=5.455, P=0.002), with the least amount of destruction identified on the lateral femoral condyle. The majority of knee joints in the RA patients were at stage 3 (21/26, 80.8%), followed by stage 4 (4/26, 15.4%) [14]. Punctate hemorrhages over femoral condyle and patchy destruction of the condyles was noted in 21 of the 24 patients in our study.…”

Section: Discussionmentioning

confidence: 48%

“…We faced various challenges intra-operatively. Meng XH et al conducted a prospective study of 26 knee joints in 22 patients [14]. The stage of knee joints in RA patients was assessed based on the evaluation criteria of Larsen et al In their study, the extent of articular destruction was classified as grade 4 for the medial and lateral femoral condyles and the medial and lateral tibial plateaus for most patients, with an average destruction grade of 3.6 (F=5.455, P=0.002), with the least amount of destruction identified on the lateral femoral condyle.…”

Section: Discussionmentioning

confidence: 99%

Challenges Faced During Primary Total Knee Arthroplasty in Rheumatoid Knee in Females in the 5th Decade with Severe Osteoporosis

2018

J Orth Rheumatol10.13188/2334-2846

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“…8): in this case, it is a product of bone inflammation, consisting in the replacement of the medullary fat with a cellular infiltration leading to an increase in the local water content and edema. According to one of the most accredited theories, ELMSI is initially located in the "bare areas," regions of bone that are uncovered by cartilage, where the pannus, which is a hyperplastic synovium filled with inflammatory cells and dilated vessels, acts on the underlying marrow [58,72]. ELMSI appears after a few weeks from occurrence of symptoms and correlates with elevated markers of acute inflammatory phase; furthermore, it is a reversible phenomenon and may become attenuated due to biological treatment [73].…”

Section: Edema-like Marrow Signal Intensity With Known Causementioning

confidence: 99%

Edema-like marrow signal intensity: a narrative review with a pictorial essay

et al. 2020

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The term edema-like marrow signal intensity (ELMSI) represents a general term describing an area of abnormal signal intensity at MRI. Its appearance includes absence of clear margins and the possibility of exceeding well-defined anatomical borders (for example, physeal scars). We can define “ELMSI with unknown cause” an entity where the characteristic MR appearance is associated with the absence of specific signs of an underlying condition. However, it is more often an important finding indicating the presence of an underlying disease, and we describe this case as “ELMSI with known cause.” It presents a dynamic behavior and its evolution can largely vary. It initially corresponds to an acute inflammatory response with edema, before being variably replaced by more permanent marrow remodeling changes such as fibrosis or myxomatous connective tissue that can occur over time. It is important to study ELMSI variations over time in order to evaluate the activity state and therapeutic response of an inflammatory chronic joint disease, the resolution of a trauma, and the severity of an osteoarthritis. We propose a narrative review of the literature dealing with various subjects about this challenging topic that is imaging, temporal evolution, etiology, differential diagnoses, and possible organization, together with a pictorial essay.

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Rheumatoid Arthritis of Knee Joints: MRI–Pathological Correlation

Cited by 17 publications

References 34 publications

Assessment of Patellar Morphology in Trochlear Dysplasia on Computed Tomography Scans

Assessment of Patellar Morphology in Trochlear Dysplasia on Computed Tomography Scans

Challenges Faced During Primary Total Knee Arthroplasty in Rheumatoid Knee in Females in the 5th Decade with Severe Osteoporosis

Edema-like marrow signal intensity: a narrative review with a pictorial essay

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