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Magnetic resonance imaging-based diagnosis of occult osseous injuries in traumatic knees.

Mutlu S, Mutlu H, Kömür B, Guler O, Yucel B, Parmaksızoğlu A - Open Orthop J (2015)

Bottom Line: The majority of Type I lesions resolved spontaneously, whereas 80% of Type II injuries remained following 3 months, and 30% persisted at 9 months.However, ligament and meniscal lesions were observed in the majority of patients, and these individuals required longer treatment and recuperation.Overall, these findings can contribute to improving the management of occult osseous knee injuries.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303 Küçükçekmece/Istanbul, Turkey.

ABSTRACT

Background: Occult osseous knee injuries, such as bone bruises, can produce persistent pain and functional loss. Although bone bruises cannot be identified through direct examination or traditional radiographs, magnetic resonance imaging (MRI) has emerged as an effective diagnostic method. Nevertheless, the natural history of these injuries remains to be fully defined. Therefore, we used MRI to detect and follow bone bruise injuries secondary to knee trauma.

Methods: We retrospectively reviewed knee MRIs from patients with bone bruising caused by trauma. Occult injuries were initially identified by MRI and subsequently rescanned for follow-up at 3 and 9 months. All patients underwent physical examinations, direct radiological imaging, and MRI.

Results: Although direct radiographs showed no abnormalities, we used MRI to identify a total of 22 patients (age range: 19-42 years; mean: 28 years) with bone bruising. After 3 months, injuries remained detectable in 68.2% of the subjects, whereas 18.2% displayed bone bruising after 9 months. The majority of Type I lesions resolved spontaneously, whereas 80% of Type II injuries remained following 3 months, and 30% persisted at 9 months. Ligament and meniscal lesions were observed in 63.6% of patients with bone bruising and appeared to hinder recovery.

Conclusion: Bone bruises generally resolved within 3 to 9 months in subjects with no soft tissue lesions and minor trauma. However, ligament and meniscal lesions were observed in the majority of patients, and these individuals required longer treatment and recuperation. Overall, these findings can contribute to improving the management of occult osseous knee injuries.

No MeSH data available.


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Magnetic resonance T2-weighted images of Type II injury: A) first sagittal MRI of the knee; B) first coronal MRI of the knee; C)third sagittal MRI of the knee (after 9 months); D) third coronal MRI of the knee (after 9 months).
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Figure 3: Magnetic resonance T2-weighted images of Type II injury: A) first sagittal MRI of the knee; B) first coronal MRI of the knee; C)third sagittal MRI of the knee (after 9 months); D) third coronal MRI of the knee (after 9 months).

Mentions: In the present study, we retrospectively reviewed knee MRIs from patients with bone bruising caused by traumatic injury. A total of 22 patients were enrolled in the study (8 females and 14 males; age range 19-42 years; mean: 28 years). All patients were admitted to the hospital with knee injuries, which resulted from falling (from a height) in nine patients and sports trauma in thirteen patients. Notably, no pathological signs could be detected through direct radiological evaluations (Fig. 1). However, these patients presented bone bruise abnormalities in an initial MRI analysis, with bone marrow edema detected and classified as Type I lesions (Fig. 2) in twelve patients and Type II lesions (Fig. 3) in ten patients (see Table 1). We observed no Type III lesions.


Magnetic resonance imaging-based diagnosis of occult osseous injuries in traumatic knees.

Mutlu S, Mutlu H, Kömür B, Guler O, Yucel B, Parmaksızoğlu A - Open Orthop J (2015)

Magnetic resonance T2-weighted images of Type II injury: A) first sagittal MRI of the knee; B) first coronal MRI of the knee; C)third sagittal MRI of the knee (after 9 months); D) third coronal MRI of the knee (after 9 months).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384224&req=5

Figure 3: Magnetic resonance T2-weighted images of Type II injury: A) first sagittal MRI of the knee; B) first coronal MRI of the knee; C)third sagittal MRI of the knee (after 9 months); D) third coronal MRI of the knee (after 9 months).
Mentions: In the present study, we retrospectively reviewed knee MRIs from patients with bone bruising caused by traumatic injury. A total of 22 patients were enrolled in the study (8 females and 14 males; age range 19-42 years; mean: 28 years). All patients were admitted to the hospital with knee injuries, which resulted from falling (from a height) in nine patients and sports trauma in thirteen patients. Notably, no pathological signs could be detected through direct radiological evaluations (Fig. 1). However, these patients presented bone bruise abnormalities in an initial MRI analysis, with bone marrow edema detected and classified as Type I lesions (Fig. 2) in twelve patients and Type II lesions (Fig. 3) in ten patients (see Table 1). We observed no Type III lesions.

Bottom Line: The majority of Type I lesions resolved spontaneously, whereas 80% of Type II injuries remained following 3 months, and 30% persisted at 9 months.However, ligament and meniscal lesions were observed in the majority of patients, and these individuals required longer treatment and recuperation.Overall, these findings can contribute to improving the management of occult osseous knee injuries.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Kanuni Sultan Suleyman Training and Research Hospital, Atakent Mh., 1. Cd, 34303 Küçükçekmece/Istanbul, Turkey.

ABSTRACT

Background: Occult osseous knee injuries, such as bone bruises, can produce persistent pain and functional loss. Although bone bruises cannot be identified through direct examination or traditional radiographs, magnetic resonance imaging (MRI) has emerged as an effective diagnostic method. Nevertheless, the natural history of these injuries remains to be fully defined. Therefore, we used MRI to detect and follow bone bruise injuries secondary to knee trauma.

Methods: We retrospectively reviewed knee MRIs from patients with bone bruising caused by trauma. Occult injuries were initially identified by MRI and subsequently rescanned for follow-up at 3 and 9 months. All patients underwent physical examinations, direct radiological imaging, and MRI.

Results: Although direct radiographs showed no abnormalities, we used MRI to identify a total of 22 patients (age range: 19-42 years; mean: 28 years) with bone bruising. After 3 months, injuries remained detectable in 68.2% of the subjects, whereas 18.2% displayed bone bruising after 9 months. The majority of Type I lesions resolved spontaneously, whereas 80% of Type II injuries remained following 3 months, and 30% persisted at 9 months. Ligament and meniscal lesions were observed in 63.6% of patients with bone bruising and appeared to hinder recovery.

Conclusion: Bone bruises generally resolved within 3 to 9 months in subjects with no soft tissue lesions and minor trauma. However, ligament and meniscal lesions were observed in the majority of patients, and these individuals required longer treatment and recuperation. Overall, these findings can contribute to improving the management of occult osseous knee injuries.

No MeSH data available.


Related in: MedlinePlus