Absence of post-traumatic bone marrow edema in the setting of preeclampsia

2020 ◽  
Author(s):  
Tina Shiang ◽  
Ryan Tai ◽  
George Watts
Keyword(s):  
Bone Marrow ◽  
Rare Case ◽  
Bone Marrow Edema ◽  
Resonance Imaging ◽  
Acute Trauma ◽  
Physiologic Mechanism ◽  
Occult Fractures ◽  
Post Traumatic ◽  
Magnetic Resonance Imaging Mri ◽  
Marrow Edema

Magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of missed or occult fractures on radiographic and computed tomography (CT) imaging, through the detection of bone marrow edema. While radiologists often rely on bone marrow edema as a guide for diagnosing subtle underlying fractures, it is important to recognize its limitations as a diagnostic metric. We present a rare case demonstrating the absence of bone marrow edema after acute trauma and confirmed Lisfranc fracture in a patient with preeclampsia and propose an interesting physiologic mechanism to explain this manifestation.

Bone Marrow Edema on Magnetic Resonance Imaging (MRI) of the Sacroiliac Joints Is Associated with Development of Fatty Lesions on MRI over a 1-year Interval in Patients with Early Inflammatory Low Back Pain: A 2-year Followup Study

2014 ◽  
Vol 41 (6) ◽  
pp. 1088-1094 ◽  
Author(s):  
Marloes van Onna ◽  
Astrid van Tubergen ◽  
Désirée M. van der Heijde ◽  
Anne Grethe Jurik ◽  
Robert Landewé
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Structural Changes ◽  
Bone Marrow Edema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Magnetic Resonance Imaging Mri ◽  
Marrow Edema

Objective.To assess whether bone marrow edema (BME) detected on magnetic resonance imaging (MRI) of the sacroiliac joints (MRI-SIJ) is associated with development of structural changes on both MRI and pelvic radiographs in patients with early inflammatory back pain (IBP).Methods.Patients with IBP ≤ 2 years were followed for 2 years with annual MRI-SIJ. MRI were scored for BME and structural changes (erosions and fatty lesions). Pelvic radiographs were graded according to the modified New York (mNY) criteria. With generalized estimated equation analysis, a time trend in the structural change scores was investigated.Results.Sixty-eight patients [38% male; mean (SD) age 34.9 (10.3) yrs] were included. During the 2-year followup, pelvic radiograph grading remained constant. On MRI, the number of erosions per patient increased significantly (mean score 2.5 at baseline and 3.5 at 2-yr followup; p = 0.05). A trend was found for an increase in the number of fatty lesions per patient (mean score 5.4 at baseline and 8.5 at 2-yr followup; p = 0.06). Overall, BME was associated with the development of fatty lesions (right SIJ: OR 3.13, 95% CI 1.06–9.20; left SIJ: OR 22.13, 95% CI 1.27–384.50), preferentially in quadrants showing resolution of BME. In contrast, BME (or the resolution thereof) was not associated with the development of erosions.Conclusion.BME at baseline, especially when it disappears over time, results in the development of fatty lesions, but an association with erosions could not be demonstrated.

AB1100 PERFORMANCE OF MAGNETIC RESONANCE IMAGING FOR DETECTING SACROILIITIS IN EARLY STAGES OF SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1839.1-1839
Author(s):  
F. Ladeb ◽  
D. Ben Nessib ◽  
M. Bouaziz ◽  
W. Hamdi ◽  
E. Labbene ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Bone Marrow Edema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Early Stages ◽  
The Mean ◽  
Marrow Edema

Background:In view of the limited accuracy of clinical evaluation to recognize sacroiliitis, several imaging techniques such as conventional radiographs, scintigraphy, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) have been used to examine the sacroiliac joints (SIJ).Objectives:The aim of this study was to assess the performance of MRI for detecting sacroiliitis in early stages of spondyloarthritis (SpA).Methods:This cross-sectional prospective monocentric double-blind study included 57 patients consulting for symptoms suggestive of SpA during more than 3 months between February 2014 and February 2017. Patients with conventional radiograph showing a confirmed sacroiliitis (grade 3 or 4) were not included. After clinical examination and blood sampling, eligible patients underwent MRI of SIJ. MR images were interpreted by 2 experimented musculoskeletal radiologists blinded to clinical and laboratory data. Two professors in rheumatology blinded to radiologists’ conclusions, analyzed clinical data, laboratory tests, HLA typing, X-rays and MRI images and divided the patients into 2 groups: confirmed non radiographic SpA (nr-SpA) or no SpA. This classification was considered as the gold standard when analyzing the results.Results:Fifteen men and 42 women were enrolled. The mean age at inclusion was 39.75 ± 11 years [17-59]. The mean duration from the first symptom was 47 ± 39 months [6.6-180]. Forty-three patients were assessed as nr-SpA (75.4%) and 14 patients as no SpA (24.6%). Thirty-three percent of patients were HLA B27 positive. Totally 22 patients had sacroiliitis at MRI, all of them classified as confirmed nr-SpA. Among the nr-SpA group, MRI showed bone marrow edema (BME) in 34.9% of patients and erosions in 44.2% of patients. Among the patients in whom the diagnosis of SpA was excluded, MRI showed bone marrow edema (BME) in 7% of patients and erosions in 7% of patients. A statistically significant association was observed between the presence of sacroiliitis at MRI and rheumatologists’ diagnosis of SpA (p=0.001). The diagnostic value of MRI lesions is presented in the following table:Sensitivity (%)Specificity (%)Positive Predictive Value (%)Positive Predictive Value (%)BME34.992.993.731.7Erosions44.292.99535.1MRI conclusion: sacroiliitis51.210010040Conclusion:SIJ MRI had an excellent specificity for the diagnosis of SpA but a moderate sensitivity. Consequently, some patients in early stages of SpA might be missed by MRI. In addition, we found that diagnostic based solely on BME lacked sensitivity. Detection of erosions in addition to BME enhanced sensitivity (from 34.9% to 44.9%) without changing specificity. Indeed, many recent studies have pointed out the importance of considering structural lesions of SIJ in addition to inflammatory lesions [1, 2].References:[1]Weber U, Lambert RGW, Pedersen SJ, et al (2010) Assessment of structural lesions in sacroiliac joints enhances diagnostic utility of magnetic resonance imaging in early spondylarthritis. Arthritis Care Res 62:1763–1771.https://doi.org/10.1002/acr.20312[2]Weber U, Jurik AG, Lambert RGW, Maksymowych WP (2016) Imaging in Spondyloarthritis: Controversies in Recognition of Early Disease. Curr Rheumatol Rep 18:58.https://doi.org/10.1007/s11926-016-0607-7Disclosure of Interests:None declared

Perspective on Idiopathic Subchondral, Osteochondral, and Chondral Lesions with Emphasis on the Knee

2019 ◽  
Vol 23 (05) ◽  
pp. 534-546 ◽  
Author(s):  
Wolfgang Fischer
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Osteochondrosis Dissecans ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Chondral Lesions ◽  
Everyday Work ◽  
And Cartilage ◽  
Marrow Edema

AbstractSubchondral, osteochondral, and chondral lesions of unknown cause are often encountered, especially in the knee joint. These are mainly idiopathic bone marrow edema syndrome, osteochondrosis dissecans, and cartilage delaminations. The literature on these diseases is sparse and often confusing and inconsistent. Because there is little evidence, this article was written as a perspective on these conditions. It offers an overview of the literature with personal comments and opinions based on observations from many years of clinical practice. The main goal is to highlight clinically important features and provide a practical guide for dealing with various magnetic resonance imaging findings in everyday work. The article also discusses several terms commonly used in relation to these diseases and their differential diagnoses.

scholarly journals A rare case of post traumatic isolated bilateral abducens nerve palsy

2014 ◽  
Vol 21 (4) ◽  
pp. 497-499
Author(s):  
Manish Jaiswal ◽  
Saurabh Jain ◽  
Ashok Gandhi ◽  
Achal Sharma ◽  
R.S. Mittal
Keyword(s):  
Rare Case ◽  
Nerve Palsy ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Resonance Imaging ◽  
Intracranial Lesion ◽  
Mri Brain ◽  
Post Traumatic ◽  
Magnetic Resonance Imaging Mri ◽  
Bilateral Abducens

Abstract Although unilateral abducens nerve palsy has been reported to be as high as 1% to 2.7% of traumatic brain injury, bilateral abducens nerve palsy following injury is extremely rare. In this report, we present the case of a patient who developed isolated bilateral abducens nerve palsy following minor head injury. He had a Glasgow Coma Score (GCS) of 15 points. Computed tomography (CT) images & Magnetic Resonance Imaging (MRI) brain demonstrated no intracranial lesion. Herein, we discuss the possible mechanisms of bilateral abducens nerve palsy and its management.

Longitudinal evaluation of the occurrence of MRI-detectable bone marrow edema in osteoarthritis of the knee

2008 ◽  
Vol 49 (9) ◽  
pp. 1031-1037 ◽  
Author(s):  
M. H. Brem ◽  
P. M. Schlechtweg ◽  
J. Bhagwat ◽  
M. Genovese ◽  
M. F. Dillingham ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Spin Echo ◽  
Time Correlation ◽  
Fast Spin Echo ◽  
Osteoarthritis Of The Knee ◽  
Point Image ◽  
Magnetic Resonance Imaging Mri ◽  
Marrow Edema ◽  
Over Time

Background: Bone marrow edema (BME) is a condition detectable with magnetic resonance imaging (MRI) and is present in different stages of osteoarthritis (OA). Its pathogenesis is still not completely known. Purpose: To evaluate the longitudinal occurrence and persistence of BME in early OA of the knee. Material and Methods: Twenty-three patients (eight females, 15 males; mean age 55.5±10.3 years) were scanned with a 1.5T MR imaging unit (sagittal fat-suppressed intermediate-weighted fast spin echo; 4-mm section thickness, 1-mm intersection gap, 256x192 matrix, 120-mm field of view). Images were obtained in all 23 patients at two time points (TPs) and in 12 patients at three TPs. Images were evaluated by two readers independently; discrepancies in image grading were reviewed and evaluated in consensus. A four-point image-grading scale was used (absence of BME to severe BME). Four main anatomical regions were evaluated (medial femur, lateral femur, medial tibia, lateral tibia), which were subcategorized into anterior, central, and posterior regions. Results: One hundred five areas of BME in the 23 patients were found at all three TPs. In 16 areas, the BME was consistent at the same location over time, in seven locations the BME became larger, in six areas the BME became smaller, and in 16 locations it could not be detected in follow-up MRIs. In one case, the BME was smaller at TP2 but increased at TP3. In eight cases, only at the last time point could a BME be detected. Conclusion: BME is not a static phenomenon but changes over time. Correlation to physical activity and local inflammatory reaction should be evaluated.

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