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Post-arthrogram synovitis: MRI and histopathologic findings.

Alexander Oserowsky¹, Lester J Layfield¹, Julia Crim²

¹University of Missouri at Columbia, Columbia, MO, USA.

Skeletal Radiology

|July 31, 2021

Summary

This summary is machine-generated.

A patient experienced severe joint pain and synovitis after iodinated contrast injection for MR arthrography. This case highlights a severe, albeit likely reactive, inflammatory response to intra-articular contrast.

Keywords:

Arthrography Iodinated contrast Synovitis

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Area of Science:

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Pathology

Background:

Iodinated contrast agents are frequently used in medical imaging, including MR arthrography.
Adverse reactions to intra-articular injections can occur, but severe inflammatory responses are uncommon.

Observation:

A 57-year-old patient developed severe, persistent pain and new-onset synovitis post-MR arthrography with iodinated contrast.
Arthroscopy revealed severe synovitis with lymphocytes, neutrophils, and necrosis on histopathology.
Intraoperative cultures were negative for infection, and inflammatory markers normalized within a month.

Findings:

The patient's condition was ultimately attributed to a severe reactive synovitis, not infectious arthritis.
Repeat MRI two years later showed degenerative changes without signs of infection.

Implications:

This case expands the understanding of potential severe inflammatory reactions to intra-articular contrast media.
Clinicians should consider reactive synovitis in the differential diagnosis of joint pain following contrast injection procedures.