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Magnetic resonance imaging in knee synovitis: clinical utility in differentiating asymptomatic and symptomatic
John M Troupis1, Michael Jethro Batt, Sundeep Singh Pasricha
1Diagnostic Imaging, Monash Health, Melbourne, Victoria, Australia; Medical Imaging & Radiation Science, Monash University, Melbourne, Victoria, Australia.
Abstract:
It is well documented that meniscal tears may be found frequently by MRI as an incidental finding in asymptomatic knees. We aim to review the literature regarding the ability of MRI to differentiate between asymptomatic and symptomatic meniscal tears. Ovid MEDLINE, MEDLINE inProcess, Cochrane reviews, Web of Science, Embase and CINAHL were systematically searched. A total of 1251 publications were screened based on their titles, abstracts and full texts, of which 1213 publications were excluded because they did not address the relationship between synovitis and meniscal tears, were case reports or reviews, concerned atypical patient populations or reported surgical research. Of the 38 retained publications, only two reported results specific to perimeniscal synovitis, while 36 discussed less specific but relevant findings. The small number of heterogeneous results describing perimeniscal synovitis precluded meta-analysis. In the symptomatic knee, identification of the likelihood of a meniscal tear contributing to the patient's pain is of significance to the orthopaedic surgeon. In our literature review, we have identified that localised synovitis and displacement of the meniscus are two features that may assist in identifying the subgroup of patients that may benefit from meniscal intervention.
Insights
Magnetic Resonance Imaging (MRI) can detect incidental meniscal tears in asymptomatic knees. Localized synovitis and meniscus displacement on MRI may help identify patients who benefit from meniscal intervention.
Area of Science:
- Orthopedic Surgery
- Radiology
- Biomedical Imaging
Background:
- Meniscal tears are frequently found incidentally on MRI in asymptomatic knees.
- Differentiating between symptomatic and asymptomatic meniscal tears is crucial for effective treatment planning.
Purpose of the Study:
- To systematically review the literature on the ability of MRI to distinguish between asymptomatic and symptomatic meniscal tears.
- To identify imaging features that may help predict which meniscal tears are likely to be causing symptoms.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Ovid MEDLINE, MEDLINE in-Process, Cochrane reviews, Web of Science, Embase, CINAHL).
- Publications were screened based on titles, abstracts, and full texts, with specific exclusion criteria applied.
- A total of 38 publications were retained for review, though only two focused specifically on perimeniscal synovitis.
Main Results:
- The literature review found limited studies specifically addressing perimeniscal synovitis in relation to meniscal tear symptoms.
- A meta-analysis was not feasible due to the heterogeneity and scarcity of relevant data.
- Localized synovitis and meniscal displacement were identified as potential MRI indicators of symptomatic tears.
Conclusions:
- MRI findings, particularly localized synovitis and meniscal displacement, may aid orthopedic surgeons in identifying patients with symptomatic meniscal tears.
- These findings can help guide decisions regarding meniscal intervention for patients experiencing knee pain.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...