Septic knee: multimodality approach

Area of Science:

• Orthopedics
• Infectious Diseases
• Radiology

Background:

• Septic arthritis of the knee is a severe infection potentially causing rapid cartilage destruction.
• Early diagnosis is complicated by nonspecific symptoms and overlapping conditions like crystal arthropathies.
• Synovial fluid analysis is key, but imaging is vital for comprehensive assessment and complication detection.

Purpose of the Study:

• To review the role of various imaging modalities in diagnosing knee septic arthritis.
• To highlight the importance of a stepwise, multimodality imaging strategy.
• To discuss emerging imaging technologies for improved accuracy.

Main Methods:

• Review of current literature on imaging techniques for septic arthritis of the knee.
• Discussion of radiography, ultrasound, CT, MRI, and nuclear medicine studies.
• Emphasis on a stepwise, multimodality approach.

Main Results:

• Ultrasound is sensitive for effusion and guides aspiration.
• CT is useful for cortical bone and deep soft tissue evaluation.
• MRI provides comprehensive early assessment, including bone marrow edema and occult abscesses.
• Nuclear medicine aids in complex cases and therapy monitoring.

Conclusions:

• A stepwise, multimodality imaging strategy improves diagnostic confidence and guides intervention for knee septic arthritis.
• Advances in imaging, including radiomics and hybrid imaging, show promise for enhanced accuracy.
• Prompt diagnosis and treatment are essential to prevent joint destruction.