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[The MR tomography of hemophilic osteoarthropathy with special reference to the synovial and chondrogenic changes]
R Erlemann1, H Pollmann, T Vestring
1Institut für Radiologie des St. Johannes-Hospitals, Duisburg-Hamborn.
Abstract:
52 knee and ankle joints of hemophiliacs were examined by MRI using FLASH and FISP-3-D sequences; and the degree of synovial hypertrophy and of cartilage destruction were assessed. Findings of synovial hypertrophy varied between thin membranes and tumorous tissue destroying the joint cartilage. Degree of cartilage destruction varied between focal signal decrease and total loss. In spite of recurrent joint bleedings no synovial or cartilaginous changes were seen in 31% and 29% of joints, respectively. Changes were more frequently seen and degree was more marked in the ankle than in the knee joints. With the exception of cysts, osseous destruction was more obvious with radiographs. MRI is suitable for the investigation of joints of hemophiliacs showing no osseous destruction.
Insights
Magnetic resonance imaging (MRI) effectively assesses knee and ankle joint damage in hemophilia patients. While MRI reveals synovial hypertrophy and cartilage destruction, some joints show no changes despite recurrent bleeding.
Area of Science:
- Orthopedics
- Radiology
- Hematology
Background:
- Hemophilia commonly causes joint damage due to recurrent bleeding.
- Assessing this damage, particularly early changes, is crucial for patient management.
- Magnetic resonance imaging (MRI) offers detailed joint visualization.
Purpose of the Study:
- To evaluate the utility of MRI in detecting synovial hypertrophy and cartilage destruction in hemophilic joints.
- To compare MRI findings with radiographic assessments.
- To determine the prevalence of joint changes in hemophiliacs, even with recurrent bleeding.
Main Methods:
- 52 knee and ankle joints from hemophiliac patients were examined.
- MRI sequences used included FLASH and FISP-3D.
- Synovial hypertrophy and cartilage destruction were graded.
- Radiographs were used for comparison, especially for osseous destruction.
Main Results:
- MRI detected a range of synovial hypertrophy, from thin membranes to destructive tissue.
- Cartilage destruction varied from focal signal decrease to complete loss.
- 31% of joints showed no synovial changes and 29% showed no cartilage changes, despite recurrent bleeding.
- Ankle joints exhibited more frequent and severe changes than knee joints.
- Radiographs were superior for detecting osseous destruction, except for cysts.
Conclusions:
- MRI is a valuable tool for investigating hemophilic joint disease, particularly for soft tissue and cartilage assessment.
- MRI can identify joint damage not always apparent on radiographs.
- Despite recurrent bleeding, not all hemophilic joints display MRI-detectable synovial or cartilage abnormalities.