scholarly journals Bone marrow edema in terms of joint pathology

2020 ◽  
pp. 58-64
Author(s):  
G. A. Airapetov ◽  
A. A. Vorotnikov ◽  
V. A. Vasyukov
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
General Practitioners ◽  
Bone Marrow Edema ◽  
Medical Science ◽  
Laboratory Diagnostics ◽  
Clinical Recommendations ◽  
Pathological Conditions ◽  
Joint Pathology ◽  
Marrow Edema

New possibilities of modern medical science open up prospects for instrumental and laboratory diagnostics of many pathological conditions, unknown or not previously diagnosed in the practice of an orthopedist. These include bone marrow edema. Not only orthopedic traumatologists, but also rheumatologists, neurosurgeons, general practitioners, rehabilitation therapists, morphologists, and many others today face this concept in a variety of definitions, concepts of etiology, pathogenesis, and clinical recommendations for treatment.The authors performed a systematic review by using four open resources: electronic scientific library (elibrary), PubMed, SciVerse (Science Direct), and Scopus.The complexity of pathology lies in the fact that in each specific case, the development of treatment tactics requires a personal interpretation of the entire variety of data obtained and a case by case approach.

scholarly journals Diagnostic Accuracy of Dual-energy CT for Bone Marrow Edema in Patients with Acute Knee Injuries: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Xuelong Chen ◽  
Zhizhuo Li ◽  
Hui Fang ◽  
Xiangyang Yin ◽  
Chengxin Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Knee Injury ◽  
Bone Marrow Edema ◽  
Meta Analysis ◽  
Knee Injuries ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Acute Knee ◽  
Marrow Edema

Abstract Background: The prevalence of knee injury is high and early diagnosis is significant to guide clinical treatment. MRI is recognized as the gold standard for detecting bone marrow edema (BME) in patients with acute knee injury, but limitations still exist. Dual-energy CT (DECT) is investigated as a promising alternative.Methods: We systematically retrieved studies from EMBASE, Scopus, PUBMED, and the Cochrane Library and collected gray literatures. According to PRISMA-DTA guidelines, a systematic review was performed from inception to July 31, 2021, assessing the diagnostic accuracy of DECT for detecting BME in at least 10 adult patients with acute knee injuries and with an MRI reference standard. Study details were independently extracted by two reviewers. Meta-analysis was performed using a bivariate mixed-effects regression model with subgroup analysis performed to evaluate for sources of variability. Results: Nine studies evaluating 290 patients between the ages of 23–53 with acute knee injuries undergoing DECT and MRI were included in analysis. Summary sensitivity, specificity, and AUC values for BME were 85% (95% confidence interval (CI) 77–90%), 96% (95% CI 93–97%), and 0.97 (95% CI 0.95–0.98), respectively. There were no statistically significant differences in specificity and sensitivity amongst comparative subgroups to account for presumed variability amongst studies.Conclusion: DECT is accurate for detecting BME in patients with acute knee injuries and can be used as an alternative to MRI, particularly when MRI is contraindicated or unavailable.

scholarly journals DECT in Detection of Vertebral Fracture–associated Bone Marrow Edema: A Systematic Review and Meta-Analysis with Emphasis on Technical and Imaging Interpretation Parameters

Radiology ◽  
2021 ◽  
pp. 203624
Author(s):  
Farzaneh Ghazi Sherbaf ◽  
Haris I. Sair ◽  
Delaram Shakoor ◽  
Jan Fritz ◽  
Benedikt J. Schwaiger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Vertebral Fracture ◽  
Bone Marrow Edema ◽  
Meta Analysis ◽  
Marrow Edema

Cortical and trabecular alterations in patients with bone marrow edema of the lower limb

2013 ◽  
Author(s):  
Afrodite Zendeli ◽  
Christian Muschitz ◽  
Roland Kocijan ◽  
Lukas Fischer ◽  
Daniela Suess ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lower Limb ◽  
Bone Marrow Edema ◽  
Marrow Edema

Calcium-Suppressed Technique in Dual-Layer Detector Computed Tomography to Evaluate Knee Articular Cartilage

2020 ◽  
Vol 16 ◽  
Author(s):  
Qinglin Meng ◽  
Mengqi Liu ◽  
Weiwei Deng ◽  
Ke Chen ◽  
Botao Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Articular Cartilage ◽  
Bone Marrow Edema ◽  
Knee Joints ◽  
Infrapatellar Fat Pad ◽  
Proton Density ◽  
Knee Cartilage ◽  
Significant Difference ◽  
Marrow Edema

Background: Calcium-suppressed (CaSupp) technique involving spectral-based images has been used to observe bone marrow edema by removing calcium components from the image. Objective: This study aimed to evaluate the knee articular cartilage using the CaSupp technique in dual-layer detector computed tomography (DLCT). Methods: Twenty-eight healthy participants and two patients with osteoarthritis were enrolled, who underwent DLCT and magnetic resonance imaging (MRI) examination. CaSupp images were reconstructed from spectral-based images using a calcium suppression algorithm and were overlaid conventional CT images for visual evaluation. The morphology of the knee cartilage was evaluated, and the thickness of the articular cartilage was measured on sagittal proton density– weighted and CaSupp images in the patellofemoral compartment. Results: No abnormal signal or density, cartilage defect, and subjacent bone ulceration were observed in the lateral and medial femorotibial compartments and the patellofemoral compartment on MRI images and CaSupp images for the 48 normal knee joints. CaSupp images could clearly identify cartilage thinning, defect, subjacent bone marrow edema, and edema of the infrapatellar fat pad in the same way as MRI images in the three knee joints with osteoarthritis. A significant difference was found in the mean thickness of the patellar cartilage between MRI images and CaSupp images, while the femoral cartilage presented no significant difference in thickness between MRI images and CaSupp images over all 48 knee joints. Conclusion: The present study demonstrated that CaSupp images could effectively be used to perform the visual and quantitative assessment of knee cartilage.

scholarly journals Detection of Bone Marrow Edema in Patients with Osteoid Osteoma Using Three-Material Decomposition with Dual-Layer Spectral CT

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 953
Author(s):  
Florian T. Gassert ◽  
Johannes Hammel ◽  
Felix C. Hofmann ◽  
Jan Neumann ◽  
Claudio E. von Schacky ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Osteoid Osteoma ◽  
Bone Marrow Edema ◽  
Volume Fraction ◽  
Imaging Findings ◽  
Spectral Ct ◽  
Material Decomposition ◽  
Negative Imaging ◽  
Interreader Agreement ◽  
Marrow Edema

The aim of this study is to assess whether perifocal bone marrow edema (BME) in patients with osteoid osteoma (OO) can be accurately detected on dual-layer spectral CT (DLCT) with three-material decomposition. To that end, 18 patients with OO (25.33 ± 12.44 years; 7 females) were pairwise-matched with 18 patients (26.72 ± 9.65 years; 9 females) admitted for suspected pathologies other than OO in the same anatomic location but negative imaging findings. All patients were examined with DLCT and MRI. DLCT data was decomposed into hydroxyapatite and water- and fat-equivalent volume fraction maps. Two radiologists assessed DLCT-based volume fraction maps for the presence of perifocal BME, using a Likert scale (1 = no edema; 2 = likely no edema; 3 = likely edema; 4 = edema). Accuracy, sensitivity, and specificity for the detection of BME on DLCT were analyzed using MR findings as standard of reference. For the detection of BME in patients with OO, DLCT showed a sensitivity of 0.92, a specificity of 0.94, and an accuracy of 0.92 for both radiologists. Interreader agreement for the assessment of BME with DLCT was substantial (weighted κ = 0.78; 95% CI, 0.59, 0.94). DLCT with material-specific volume fraction maps allowed accurate detection of BME in patients with OO. This may spare patients additional examinations and facilitate the diagnosis of OO.

scholarly journals THU0484 FIBROMYALGIA AND MULTIPLE SWITCHING OF BIOLOGICS IN SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 479.2-480
Author(s):  
A. Negm ◽  
J. Alsaleh
Keyword(s):  
Bone Marrow ◽  
Disease Activity ◽  
Bone Marrow Edema ◽  
Disease Duration ◽  
Hla B27 ◽  
Tender Points ◽  
Conventional Dmards ◽  
Likelihood Ratio Testing ◽  
Multiple Switching ◽  
Marrow Edema

Background:Fibromyalgia (FM) is a condition characterized by chronic widespread pain, tender points, fatigue and disturbed sleep rhythm. Some of these symptoms such as fatigue, tender points and diffuse pain seen in patients with spondylarthritis (SpA). Moreover, FM and SpA can coexist creating a diagnostic challenge, particularly in early disease course and influence clinical disease activity assessment.Objectives:With this cross-sectional study, we aim to estimate the prevalence of FM in SpA and to elaborate its effect on biological treatments.Methods:FM was identified according to the ACR 2010 diagnostic criteria. SpA patients identified according to rheumatologist using various SpA subsets criteria. A review of the electronic medical files for SpA patients attending the rheumatology outpatient clinic and infusion unit at a major tertiary hospital during the period from June to December 2018 were included. Patients’ demographics, socioeconomics, disease characteristics, activity, HLA status and abnormal MRI sacroiliac were explored. Regarding SpA medications, number, frequency and dose of DMARDs and biological agents were obtained.Continuous variables were reported by their mean and standard deviation (SD) and qualitative variables by frequency and percentage. Statistical significance was set at p <0.05. Statistical analysis was performed using SPSS version 23.Results:Of the 305 enrolled SpA patients, 43 (14.1%) had FM. Females represents 57.4% of the patients, mean age was 44.07 ± 11.85 years. Arab ethnicity represents most of our cohort 84.9%, the majority were Emirati 64.6%. Smokers were 8.2% and ex-smokers were 3.3%. Axial SpA represents 38.4% while peripheral SpA 61.6% of our cohort according to ASAS classification.HLA B27 tested in a sample of 180 patients; it was positive in only 17.8%. CRP found to be elevated in 20.3% of the patients at baseline. Abnormal MRI SIJ bone marrow edema changes were found in 10.8%, while other SIJ changes was seen in additional 20.6%. The prevalence of FM showed no statistically significant difference between axial and peripheral SpA. Patients SpA and FM have longer disease duration than SpA alone, P= 0.034. Table.1 show demographics, socioeconomics and clinical data of our cohort.Regarding medication, the use of biologics among SpA patients with FM is more frequent than SpA patients without FM (74.4% vs 51.5 % respectively), P= 0.005. Interestingly, the likelihood ratio testing showed that SpA patient with Fibromyalgia switch more frequently to another biologics than SpA without fibromyalgia, P= 0.015.Cramer’s V test showed that there is a high statistically significant (P= 0.002) and very strong association (> 0.25) between presence of Fibromyalgia and multiple switching of biologics in SpA.There was no difference in the exposure to prednisolone nor conventional DMARDs between SpA patients with or without FM, P= 0.64 & 1 respectively.Gender, Female, n (%)175 (57.4)Age, mean ± SD (min- max), years44.07 ± 11.85 (18- 78)Type of A, n (%)AxialPeripheral117 (38.4)188 (61.6)Fibromyalgia, n (%)FM in axial SpAFM in Peripheral SpA43 (14.1)18 (41.9)25 (58.1)SpA Disease duration (months)FM+, mean ±SDFM-, mean ±SD107.7± 50.486± 57.9Elevated CRP, n (%)62 (20.3)HLA B27 in180 patients, n (%)PositiveNegative32 (17.8)148 (82.2)Abnormal MRI SIJ, n (%)Bone marrow edemaSubchondral sclerosisFatty transformation of bone marrowErosion92 (30.2)33 (10.8)21 (6.9)5 (1.6)2 (0.7)Number of conventional DMARDs ever tired, n (%)NoneOneTwoThree81 (26.6)166 (54.4)46 (15.1)12 (3.9)Frequency of DMARDs usage, n, (%)Conventional DMARDsPrednisoloneBiologic DNARDs224 (73.4)56 (18.4)164 (53.8)Conclusion:FM coexistence with SpA might impact clinical evaluation of disease activity and possibly negatively affect self-measurement of treatment response. In our study, SPA patients exposed to more biologics if they have coexisting FM; Moreover, they are more frequent switchers among biologics including TNFi and IL17i.Acknowledgments:N Elsidig, A Al Marzooqi, N Zamani, A HossainiDisclosure of Interests: :None declared

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