TY - JOUR
T1 - Contrast-enhanced MRI findings of the knee in healthy children; establishing normal values
AU - Hemke, Robert
AU - van den Berg, J. Merlijn
AU - Nusman, Charlotte M.
AU - van Gulik, E. Charlotte
AU - Barendregt, Anouk M.
AU - Schonenberg-Meinema, Dieneke
AU - Dolman, Koert M.
AU - Kuijpers, Taco W.
AU - Maas, Mario
PY - 2018
Y1 - 2018
N2 - Objectives: To define normative standards for the knee in healthy children using contrast-enhanced MRI, focusing on normal synovial membrane thickness. Secondly, presence of joint fluid and bone marrow oedema was evaluated. Methods: For this study, children without disorders potentially resulting in (accompanying) arthritis were included. Patients underwent clinical assessments, followed by contrast-enhanced MRI. MRI features were evaluated in consensus using the Juvenile Arthritis MRI Scoring (JAMRIS) system. Additionally, the presence of joint fluid was evaluated. No cartilage lesions or bone abnormalities were observed. Results: We included 57 healthy children. The overall mean thickness of the normal synovial membrane was 0.4 mm (min–max; 0.0–1.8mm). The synovium was thickest around the cruciate ligaments and retropatellar and suprapatellar regions. The mean overall diameter of the largest pocket of joint fluid was 2.8 mm (min–max; 0.9–8.0mm). Bone marrow changes were observed in three children (all in the apex patellae). Conclusions: The normal synovial membrane was maximally 1.8 mm thick, indicating that the JAMRIS cut-off value of 2 mm can be considered a valid measure for evaluating synovial hypertrophy. Some joint fluid and bone marrow changes suggestive of bone marrow oedema in the apex patellae can be seen in healthy children. Key Points: • Knowledge on the normal synovial appearance using contrast-enhanced MR is lacking. • In healthy children, normal synovial membrane is maximally 1.8 mm thick. • Normal synovium is thickest around the cruciate ligaments, retropatellar and suprapatellar. • Bone marrow oedema in the apex patellae is seen in healthy children.
AB - Objectives: To define normative standards for the knee in healthy children using contrast-enhanced MRI, focusing on normal synovial membrane thickness. Secondly, presence of joint fluid and bone marrow oedema was evaluated. Methods: For this study, children without disorders potentially resulting in (accompanying) arthritis were included. Patients underwent clinical assessments, followed by contrast-enhanced MRI. MRI features were evaluated in consensus using the Juvenile Arthritis MRI Scoring (JAMRIS) system. Additionally, the presence of joint fluid was evaluated. No cartilage lesions or bone abnormalities were observed. Results: We included 57 healthy children. The overall mean thickness of the normal synovial membrane was 0.4 mm (min–max; 0.0–1.8mm). The synovium was thickest around the cruciate ligaments and retropatellar and suprapatellar regions. The mean overall diameter of the largest pocket of joint fluid was 2.8 mm (min–max; 0.9–8.0mm). Bone marrow changes were observed in three children (all in the apex patellae). Conclusions: The normal synovial membrane was maximally 1.8 mm thick, indicating that the JAMRIS cut-off value of 2 mm can be considered a valid measure for evaluating synovial hypertrophy. Some joint fluid and bone marrow changes suggestive of bone marrow oedema in the apex patellae can be seen in healthy children. Key Points: • Knowledge on the normal synovial appearance using contrast-enhanced MR is lacking. • In healthy children, normal synovial membrane is maximally 1.8 mm thick. • Normal synovium is thickest around the cruciate ligaments, retropatellar and suprapatellar. • Bone marrow oedema in the apex patellae is seen in healthy children.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85030721921&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/28986634
U2 - https://doi.org/10.1007/s00330-017-5067-6
DO - https://doi.org/10.1007/s00330-017-5067-6
M3 - Article
C2 - 28986634
SN - 0938-7994
VL - 28
SP - 1167
EP - 1174
JO - European Radiology
JF - European Radiology
IS - 3
ER -