Assessment of anterior subcutaneous hypersignal on proton-density-weighted MR imaging of the knee and relationship with anterior knee pain

Abstract Purpose The purpose of this study was to evaluate the prevalence of anterior subcutaneous hypersignal indicating edema on proton-density (PD)-weighted MRI of the knee and to determine whether reporting anterior edema is clinically relevant. Materials and methods One hundred and ninety-one k...

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Published in:	Diagnostic and interventional imaging Vol. 98; no. 4; pp. 339 - 345
Main Authors:	Unlu, E.N, Turhan, Y, Kos, D.M, Safak, A.A
Format:	Journal Article
Language:	English
Published:	France Elsevier Masson SAS 01-04-2017
Subjects:	Adolescent Adult Aged Aged, 80 and over Arthralgia - diagnostic imaging Bone edema Bursitis Bursitis - diagnostic imaging Edema - diagnostic imaging Female Humans Joint Diseases - diagnostic imaging Knee Knee - diagnostic imaging Magnetic resonance imaging (MRI) Male Middle Aged Proton Magnetic Resonance Spectroscopy - methods Radiology Retrospective Studies Subcutaneous Tissue - diagnostic imaging Young Adult Knee Magnetic resonance imaging (MRI) Bursitis Bone edema
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Summary:	Abstract Purpose The purpose of this study was to evaluate the prevalence of anterior subcutaneous hypersignal indicating edema on proton-density (PD)-weighted MRI of the knee and to determine whether reporting anterior edema is clinically relevant. Materials and methods One hundred and ninety-one knee MRIs from 162 patients were reviewed for anterior subcutaneous edema. There were 92 men and 70 women with a mean age of 41.72 years ± 13.92 (SD) (range, 15–80 years) years and a mean body weight of 75.94 kg ± 12.54 (SD) (range, 50–130 kg). The MRI findings were compared with patient age, gender, body weight, history of repetitive microtrauma and clinical findings. Patellar and trochlear chondropathy, medial plica, joint effusion, synovitis, infrapatellar fat-pad signal intensity, suprapatellar fat-pad signal intensity with mass effect, quadriceps and patellar tendon abnormalities were also reviewed. Results An anterior hypersignal on PD-weighted MRI was detected in 158/191 MR examinations (82.7%) and 104 (84.6%) of these cases had histories of anterior knee pain. No correlation between anterior pain and anterior edema was found ( P = 0.42). Age ( P < 0.0001), weight ( P < 0.0001), and repetitive microtrauma ( P = 0.001) were identified as significant variables associated with anterior edema. Conclusion Anterior edema may be a physiological phenomenon or degenerative change related to patient age, weight, and knee movement or mechanics. It should not be reported as a pathological finding on MRI unless clinical findings support regional infection or inflammation.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2211-5684 2211-5684
DOI:	10.1016/j.diii.2016.08.008