(Fig 5-E.01) Earliest Findings of Septic Arthritis

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📌 Septic Arthritis

✅ Noncontrast MR Imaging

• On noncontrast MR imaging, joint effusion and perisynovial edema are commonly seen with septic joints. 
• Unlike other etiologies for joint effusion, with infection, the surrounding soft tissues demonstrate marked inflammation and edematous changes, including fasciitis and myositis.

 

✅ Postcontrast Imaging

• Postcontrast imaging helps to evaluate the degree of synovial inflammation and the presence of perisynovial abscess. 
• These associated findings increase the degree of confidence in suggesting septic arthritis. 
• Imaging protocol should include T1-weighted sequences to evaluate for concomitant osteomyelitis.

 

✅ Earliest Findings of Septic Arthritis

The earliest findings in septic arthritis, including synovial inflammation and effusions, are readily demonstrated.

 

✅ Acute Stage of Septic Arthritis

• Bone marrow signal abnormality is also a frequent finding in the acute stage. 
• At this stage, bone marrow edema usually represents inflammation. 
• If contrast is administered intravenously, a marked rim enhancement of the synovium or of a thickened abscess wall (if present) can be seen.

 

References

• Magn Reson Imaging Clin N Am. 2016 May;24(2):369-89
• Magn Reson Imaging Clin N Am 12 (2004) 111–124

 

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#SepticArthritis, #MRI, #Radiology, #JointEffusion, #SynovialInflammation, #PerisynovialEdema, #Osteomyelitis, #Fasciitis, #Myositis, #BoneMarrowEdema