The Air Inside Joint: A Sign of Disease Pathology or a Benign Condition?

Nagarajan, Krishnan; Mishra, Pranaya; Velagada, Sandeep; Trıpathy, Sujit Kumar

doi:10.7759/cureus.8479

Cited by 3 publications

(8 citation statements)

References 18 publications

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“…VP, also known as pneumoarthrosis, is defined by air or gas-like density-lower than approximately -300 HUwithin a joint [1,2,8,9]. VP can be classified into acute, due to a rapid increase in the volume of a joint space and subacute or chronic seen with degenerative changes [1].…”

Section: Discussionmentioning

confidence: 99%

“…VP has been described in multiple joints, most commonly within the spine [2]. It is usually an incidental finding in patients scanned for other reasons [1].…”

Section: Discussionmentioning

confidence: 99%

“…This phenomenon can be acute, caused by a rapid increase in joint volume, or chronic, due to degenerative changes [1]. VP has been described in multiple joints and is most commonly seen within the intervertebral discs, and will be referred to as intradiscal gas in the rest of this article [1,2]. It is usually reported as an incidental finding since it can be seen after normal joint motion [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…Vacuum phenomenon (VP) is defined as air within a joint [2]. This phenomenon can be acute, caused by a rapid increase in joint volume, or chronic, due to degenerative changes [1].…”

Section: Introductionmentioning

confidence: 99%

“…It is usually reported as an incidental finding since it can be seen after normal joint motion [1,3]. However multiple pathologies have been associated with VP, mainly degenerative disease and trauma [1][2][3]. Although patients with intradiscal gas may be asymptomatic, it promotes disc degeneration and can eventually become painful [1].…”

Section: Introductionmentioning

confidence: 99%

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Vacuum Phenomenon in the Lumbar Spine: Pilot Study for Accuracy of Magnetic Resonance Imaging

Buttiens,

Simko,

Van Goethem

2023

Journal of the Belgian Society of Radiology

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Objectives: Vacuum phenomenon (VP) is defined as air within a joint. Many pathologies are associated with VP, mainly degenerative disease and trauma. Although patients with intradiscal gas may be asymptomatic, it promotes disc degeneration and can eventually become painful. VP is suspected to be an indicator of segmental mobility, helping in determining the extent of spinal fusion in a preoperative setting. This could make the detection of VP useful on routine magnetic resonance imaging (MRI) of the lower spine. We determined the accuracy of MRI in detecting intradiscal gas through a retrospective observational study. Materials and methods:The study population consists of 37 consecutive patients with low back pain who were scheduled for treatment with spinal infiltrations and received a computed tomography and MRI scan within a maximum time interval of 3 months. Spin echo (SE) T1 and T2 and gradient echo (GE) T1 sequences were analyzed. All scans were randomly coded and evaluated by two observers: an experienced neuroradiologist and a radiology resident for the presence of VP.Results: GE-imaging revealed a high accuracy with a sensitivity of 89.3%-92% and a specificity of 89.7-95.3% between both observers. In comparison to a sensitivity of 31.5%-76.3% for T1-and 8.5%-86.4% for T2-imaging and a specificity of 95%-100% for T1-and 63.7%-100% for T2-imaging with respective accuracy of 68.1%-85.7% and 54.6%-68.9%. We notice a moderate interobserver variability for the T1 (κ = 0.462) weighted imaging, no agreement for T2 (κ = 0.057) weighted imaging, and almost perfect interobserver variability for the GE sequence (κ = 0.889). Conclusion:The presence of VP in degenerative disc disease is a sign of segmental instability which is important for planning spinal fusion surgery. Our study showed that VP can be detected on MRI of the lumbar spine with high accuracy and almost perfect interobserver agreement by adding GE sequences to the scanning protocol.

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Section: Discussionmentioning

confidence: 99%

“…VP has been described in multiple joints, most commonly within the spine [2]. It is usually an incidental finding in patients scanned for other reasons [1].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Vacuum phenomenon (VP) is defined as air within a joint [2]. This phenomenon can be acute, caused by a rapid increase in joint volume, or chronic, due to degenerative changes [1].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vacuum Phenomenon in the Lumbar Spine: Pilot Study for Accuracy of Magnetic Resonance Imaging

Buttiens,

Simko,

Van Goethem

2023

Journal of the Belgian Society of Radiology

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Can magnetic resonance imaging findings effectively diagnose the instability observed on radiographs in patients with degenerative lumbar spinal stenosis?

Moradi,

Bagheri,

Ataee

et al. 2024

J Orthop Surg Res

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An Omitted Radiological finding in the Pediatric Age Group: Physiological Sacroiliac Joint Vacuum Normal Variant

Doğan

Aydoğmuş

2021

Spartan Medical Research Journal

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Gas accumulation in human joint spaces has been generally described as the vacuum phenomenon (VP). To date, the sacroiliac joint VP has been associated mostly with pathological, particularly degenerative conditions (e.g., arthritis, obesity, discal degenerations, fractures, dislocations, avascular necrosis). OBJECTIVEThe study aimed to examine the characteristics of the physiological form of VP and its radiological patterns in a sample of pediatric patients. METHODSA sample of seventy patients between 0 and 17 years old (mean age, 11.4 ± 5.54) were included in the study. Sample VP cases was evaluated according to types, age group, anatomic localization, gender, and sides. RESULTS: Two (2.9%) of sample children had degenerative VP, with 24 (34.2%) of patients demonstrating physiological VP in the sacroiliac joints. VP rates significantly increased after nine years of age (p < 0.01) and 83% of physiological VP cases were determined to be bilateral. CONCLUSIONSAlthough degenerative VP is a rare entity in children, non-pathological VP can be a more common aspect of sacroiliac anatomy. Although sacroiliac VP is frequently an underreported or omitted finding in imaging studies, this condition may be clinically important as a clue for other degenerative diagnoses. Normal variants of VP may be clinically important in children since they may mimic inflammatory and infectious pathologies during magnetic resonance imaging and computed tomography images.

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The Air Inside Joint: A Sign of Disease Pathology or a Benign Condition?

Cited by 3 publications

References 18 publications

Vacuum Phenomenon in the Lumbar Spine: Pilot Study for Accuracy of Magnetic Resonance Imaging

Vacuum Phenomenon in the Lumbar Spine: Pilot Study for Accuracy of Magnetic Resonance Imaging

Can magnetic resonance imaging findings effectively diagnose the instability observed on radiographs in patients with degenerative lumbar spinal stenosis?

An Omitted Radiological finding in the Pediatric Age Group: Physiological Sacroiliac Joint Vacuum Normal Variant

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