Knee joint bursal abnormalities in rheumatoid arthritis

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Radiology

Background:

• Rheumatoid arthritis (RA) commonly affects joints, including the knee.
• Bursal abnormalities and joint capsule ruptures are known complications of RA.
• These complications can present with varied and sometimes misleading clinical symptoms.

Purpose of the Study:

• To describe the spectrum of knee joint bursal abnormalities in patients with rheumatoid arthritis.
• To characterize the imaging findings of posterior joint capsule ruptures and their relationship with the semimembranosus-gastrocnemius (S-G) bursa.
• To differentiate these findings from conditions like thrombophlebitis.

Main Methods:

• Retrospective review of 25 patients with rheumatoid arthritis and knee joint abnormalities.
• Analysis of imaging findings, including bursal abnormalities, S-G bursa status, and joint capsule integrity.
• Correlation of imaging findings with clinical presentations.

Main Results:

• Twenty-five RA patients showed knee bursal abnormalities.
• Nineteen patients had symptoms mimicking thrombophlebitis.
• Sixteen patients experienced posterior joint capsule rupture, with or without an enlarged S-G bursa.
• Two patients had additional cephalad ruptures.

Conclusions:

• Knee joint bursal abnormalities and posterior capsule ruptures are significant findings in rheumatoid arthritis.
• These entities can present with symptoms that simulate thrombophlebitis, necessitating careful radiological evaluation.
• Understanding these specific patterns aids in accurate diagnosis and management of RA-related knee complications.