MR imaging of baker cysts—prevalence and relation to internal derangements of the knee (original) (raw)
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Meniscal and ganglion cysts of the knee: MR evaluation
American Journal of Roentgenology, 1988
and ganglion cysts frequently present as palpable masses of the knee but occur at different locations than do popliteal cysts. Meniscal cysts also may be discovered incidentally on studies performed for suspected internal derangement. Sixteen cystic lesions of the knee were evaluated with MR, including I I meniscal cysts and five ganglion cysts. Scans were performed at 1.5 T by using a transmit/receive extremity coil or a receive-only surface coil. Standard spin-echo imaging, including at least one Iong-TR/asymmetric-TE sequence, was performed in all cases. In six patients, gradientecho, reduced flip-angle sequences also were done. All meniscal cysts (but none of the ganglion cysts) were associated with horizontal meniscal tears. Cysts were visualized best on the Iong-TR/TE images; meniscal tears were seen best on the short-TRITE and Iong-TR/short-TE images. Meniscal tears and cysts were also seen well on the fastscanning sequences. Septations were noted in four meniscal cysts and in four ganglion cysts on the long-TRITE images. Long-TRITE images were also useful in showing the relationship between the cyst and joint capsule in three of the ganglion cysts.
Arthritis Research & Therapy, 2010
The purpose of the present study was to determine the prevalence of cystic lesions and cyst-like bursitides in subjects with frequent knee pain and to assess their relation to radiographic osteoarthritis (OA) severity; to describe bilaterality and size fluctuation of the lesions over 6 months; and to assess relations between the prevalence of synovium-lined lesions communicating with the joint capsule and severity of magnetic resonance imaging (MRI)-detected effusion and synovitis. Methods: One hundred and sixty-three subjects (total 319 knees) aged 35 to 65 with chronic, frequent knee pain were included. Imaging with 3 Tesla MRI was performed at baseline and 6-month follow-up with the same protocols as those used in the Osteoarthritis Initiative. Severity of radiographic OA was assessed using the Kellgren-Lawrence grade (0 to 4). Severity of effusion and synovitis was graded 0 to 3 based on the Whole Organ Magnetic Resonance Imaging Score system. The associations of cysts and cyst-like bursitides and severity of radiographic OA, MRI-detected effusion and synovitis were analyzed using logistic regression controlling for clustering by person. The Wilcoxon signed-rank test was used to determine whether there was a significant change in the size of lesions between baseline and follow-up.
Journal of Family Medicine and Primary Care, 2020
Objective: This study aimed to assess the meniscus and cruciate ligament lesions of the knee using magnetic resonance imaging (MRI) and to investigate the correlation between clinical and MRI diagnoses. Patients and Methods: Herein, we reviewed the electronic medical records of 240 patients who underwent knee MRI. The images were evaluated and then the clinical and MRI diagnoses were compared. Results: Of the 240 patients, 66% were male and the mean age was 40.6 ± 15.5 years (range, 2‑79 years). Knee pain alone was the most common presenting symptom (50.64%) followed by pain after trauma (47.92%). Majority of the knee lesions were medial meniscus (MM) lesions (63%) followed by osteoarthritis (48%) and ACL lesions (35%). The majority of the MM and ACL lesions were tears (54.6% and 69.41%, respectively) followed by degeneration (33.55% and 17.65%, respectively). However, the MM lesions were predominantly observed in the posterior horn (Odds ratio [OR], 152; 95% confidence interval (CI), 21.550–1072.113; P < 0.001). The ACL lesions were significantly more common in men than in women (OR, 0.355; 95% CI, 0.191‑0.661; P = 0.001), and altered signal intensity on T2‑ and proton density–weighted images was the most common sign (P < 0.001). A strong compatibility was observed between the clinical and MRI diagnoses (Kappa = 0.141; P < 0.001). Conclusion: MM and ACL lesions are the most common injuries of the knee, which can be diagnosed by physical examination in most cases. Further confirmation by MRI should be reserved for doubtful cases only. Keywords: Clinical diagnosis, cruciate ligament lesions, meniscus lesions, magnetic resonance imaging diagnosis
THE ROLE OF CLINICAL DIAGNOSIS IN MENISCAL LESIONS OF THE KNEE
Ab s t r a c t: The aim of the present paper is to evaluate the importance of clinical examination in the process of diagnosing meniscal lesions, as well as to establish the accuracy of clinical examination in comparison to the arthroscopic diagnosis. In the last 5 years, in the Orthopedic Surgery Clinic in Skopje, the authors have diagnosed and treated 205 patients suffering from meniscal lesions. The method of anamnestic testing, and of clinical examination and the statistical method have been applied. All the patients were subjected to the following tests: well taken anamnesis of the knee injury mechanism, standard orthopedic examination (Stainman I and II, McMurray and Appley test), standard radiographic images of the knee, additional examination with MRI for some of the patients and arthroscopic examination. The results obtained with clinically established diagnosis were compared to the results obtained with arthroscopic diagnosis. Comparing the results of the clinical and arthroscopic diagnoses, an insuf-ficiency of the clinical diagnosis of almost 20% was established. The results are close to those given in the professional literature which refers to the standardized approach in taking the anamnestic data and the realization of the physical signs and tests examination technique. It means that the physical signs and tests, as well as the well-taken anamnesis, are the foundation for establishing a diagnosis of meniscal lesions. Arthro-scopy is truly the only golden standard for the diagnosis of all entities of the knee joint, including meniscal lesions.
Radiology, 2005
To prospectively evaluate the clinical course of asymptomatic meniscal lesions diagnosed by using magnetic resonance (MR) imaging. Institutional review board approval and informed consent were obtained. The clinical courses of meniscal lesions in 84 asymptomatic knees (in 48 men and 36 women; mean age, 43.6 years; age range, 18-73 years) were assessed. Thirty-one asymptomatic meniscal lesions were depicted among the 84 knees at MR imaging. The follow-up period was at least 2 years (mean, 29.8 months; range, 24-36 months). Knee pain, stiffness, and function during daily and sports activities were assessed by using a visual analogue scale (VAS), on which a score of 0 indicated no pain or complaints and a score of 100 indicated maximal pain and/or complaints. The chi2 test was used for statistical analysis. At follow-up, 12 (39%) of the 31 patients with and 10 (19%) of the 53 patients without meniscal lesions reported having knee pain (P = .046). Nine (29%) patients with and five (9%) ...
Diagnostic and interventional imaging, 2018
This article characterizes common meniscal pathologies, reviews magnetic resonance imaging (MRI) diagnostic criteria for meniscal tears, and identifies difficult-to-detect tears and fragments and the best MRI sequences and practices for recognizing these lesions. These difficult-to-diagnose meniscal lesions that radiologists should consider include tears, meniscocapsular separation lesions, and displaced meniscal fragments. Meniscus tears are either vertical, which are generally associated with traumatic injury, horizontal, which are associated with degenerative injury, or combinations of both. MRI has a high sensitivity for tears but not for fragments; MRI performance is also better for medial than lateral meniscal lesions. Fragment detection can be improved by recognizing signs secondary to migration, especially signs of epiphyseal irritation and mechanical impingement. Radial and peripheral tears, as well as those close to the posterior horn insertion, have been traditionally dif...
Knee MR-arthrography in assessment of meniscal and chondral lesions
Orthopaedics & Traumatology: Surgery & Research, 2009
Introduction. -No study, so far in France, has investigated the diagnosis value of knee MRarthrography since the recent approval of intra-articular gadolinium use, by this country's healthcare authorities. This study objective is to verify the MR-arthrography superiority on conventional knee MRI, in meniscus and cartilage knee lesions diagnosing accuracy both in regard to sensitivity and specificity. Hypothesis. -MR-arthrography, represents in some pathologic situations, a more accurate source of information than conventional MRI. Materials and methods. -Over a 27 months period, 25 patients, scheduled to undergo a knee arthroscopy volunteered, after having been fully informed of the possible interest and risk of the MR-arthrography examination, to participate in this study. Twenty-one of them were finally included since in four cases the surgical indication was not confirmed. The group consisted of 15 males and six females with an average age of 35.7 years. All of them consecutively underwent conventional MRI, MR-arthrography finally followed by arthroscopy. The MRI and MR-arthrograms results were compared to the arthroscopy findings using the nonparametric Kappa test.
MRI versus Ultrasonography to Assess Meniscal Abnormalities in Acute Knees
Journal of Knee Surgery, 2014
While magnetic resonance imaging (MRI) is often considered the "gold standard" diagnostic imaging modality for detection of meniscal abnormalities, it is associated with misdiagnosis in as high as 47% of cases, is costly, and is not readily available to a large number of patients. Ultrasonographic examination of the knee has been reported to be an effective diagnostic tool for this purpose with the potential to overcome many of the shortcomings of MRI. The purpose of this study is to determine the clinical usefulness of ultrasonography for diagnosis of meniscal pathology in patients with acute knee pain and compare its diagnostic accuracy to MRI in a clinical setting. With Institutional Review Board approval, patients (n ¼ 71) with acute knee pain were prospectively enrolled with informed consent. Preoperative MRI (1.5 T) was performed on each affected knee using the hospital's standard equipment and protocols and read by faculty radiologists trained in musculoskeletal MRI. Ultrasonographic assessments of each affected knee were performed by one of two faculty members trained in musculoskeletal ultrasonography using a 10 to 14 MHz linear transducer. Arthroscopic evaluation of affected knees was performed by one of three faculty orthopedic surgeons to assess and record all joint pathology, which served as the reference standard for determining presence, type, and severity of meniscal pathology. All evaluators for each diagnostic modality were blinded to all other data. Data were collected and compared by a separate investigator to determine sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), correct classification rate (CCR), likelihood ratios (LR[þ] and LR[À]), and odds ratios. Preoperative ultrasonographic assessment of meniscal pathology was associated with Sn ¼ 91.2%, Sp