Synovitis (black arrows, B) is seen on MAVRIC image but is not visualized on corresponding FSE image. ?associated lesions (25%) and 0 cases in the group without the lesions. MR image shows synovitis to decompress anteriorly into iliopsoas bursa (arrows). All quantitative measurements were performed by one musculoskeletal radiologist. 38.5 cm3 (range, 9.3?? The Wilcoxon rank sum test was performed to detect differences in MRI findings in patients with and those without aseptic lymphocytic vasculitis?? ; in this case, fluid signal intensity with thickened intermediate-signal-intensity pseudocapsule (arrows) is seen. The finding of extracapsular low-signal-intensity lesions should therefore alert the radiologist to the possibility of aseptic lymphocytic vasculitis?? The scores were summed to yield the final aseptic lymphocytic vasculitis?? ?24 cm; number of signals acquired, 4?? 41), BMI (r = ?? [17] for classifying aseptic lymphocytic vasculitis?? TABLE 2: Demographic, Radiographic, MRI, Operative, and Histologic Findings in 19 Patients Who Underwent Revision Surgery. Interclass correlation coefficients and coefficients of repeatability [18] were calculated between the two examiners for synovitis and osteolysis volume measurements. A, 54-year-old woman who presented for follow-up imaging 16 months after resurfacing arthroplasty. The original implant type could not be determined in one case. MRI, because of its superior ability to image soft tissues, can detect early signs of total joint replacement failure and is now considered to be the ideal method for imaging total joint replacements … 83?? ?associated lesions were confirmed at revision surgery. ?4 was given for the presence of an inflammatory infiltrate. Find out more about how we use your information in our Privacy Policy and Cookie Policy. TABLE 3: Demographic and MRI Findings in Patients Who Underwent Revision Surgery Classified by Presence of Aseptic Lymphocytic Vasculitis?? Chi-square tests were performed to detect differences between the resurfacing arthroplasty and THA groups. The Hospital for Special Surgery receives research support from GE Healthcare. The MAVRIC technique minimizes image distortions by combining multiple individual datasets that are acquired at frequency bands incrementally offset from the dominant proton frequency [13]. Synovitis was seen to decompress into adjacent bursae in 13 hips (52.0%): trochanteric bursa, six hips; iliopsoas bursa, three hips; and trochanteric and iliopsoas bursae, four hips. The presence or absence of a tear was graded as follows: 1, no tear; 2, partial-thickness tear; or 3, full-thickness tear. In all cases, extracapsular disease consisted of low-signal-intensity lesions dissecting into the hip abductor muscles (two cases) or obturator internus muscle (one case). ?associated lesions. Ultimately, the hip replacement implant you end up with is selected by your surgeon depending on fit, your arthritic damage, activity level, weight, age, and other lifestyle factors. There are some limitations to our study. The parameters were as follows: TR range, 4000?? B, Combination of stainless steel replacement and stainless steel fixation device renders corresponding coronal 2D fast spin-echo (FSE) image nondiagnostic. A diagnosis of aseptic lymphocytic vasculitis?? But in some instances an MRI scan may not be recommended. The volume of synovitis did not correlate to sex (p = 0.39), age (r = 0.32, p = 0.10), or BMI (r = 0.31, p = 0.12) in the THA group. At the time of the study, one observer, a senior musculoskeletal MRI attending radiologist, had more than 10 years??? ?associated lesions had a significantly (p = 0.04) higher mean volume of synovitis (123.8 ?? Keywords: adverse local tissue reaction, aseptic lymphocytic vasculitis?? B, 51-year-old woman who presented for follow-up imaging 23 months after resurfacing arthroplasty. Extracapsular disease was observed in three cases in the group with aseptic lymphocytic vasculitis?? Our early results suggest that a greater volume of synovitis, the presence of extracapsular disease, and the finding of intramuscular edema without a known cause such as fracture or infection may indicate aseptic lymphocytic vasculitis?? MRI is, therefore, increasingly recognized as a valuable tool in the assessment of patients with hip pain after placement of a metal-on-metal prosthesis. MR image shows extensive proximal femoral osteolysis (arrows), which is seen as intermediate-signal-intensity material replacing normal high-signal-intensity fatty marrow. B, 42-year-old man who presented for follow-up imaging 31 months after resurfacing arthroplasty. ?associated lesion score (0???10). Histologic sections were scored using the system proposed by Campbell et al. The Wilcoxon rank sum test was performed for the subjects who underwent revision surgery to detect differences in demographic data, synovial volume, tendinosis, and tendon tears between patients with and those without aseptic lymphocytic vasculitis?? ?0.03, p = 0.87), or length of time since implant placement (r = 0.32, p = 0.08) in the resurfacing arthroplasty group. The presence of extracapsular disease was recorded. A, 67-year-old man who presented for follow-up imaging 11 months after resurfacing arthroplasty. The gluteus medius, gluteus minimus, and iliopsoas were assessed for the presence of tendinosis, which were graded as normal, defined as showing uniformly low signal intensity without tendon thickening; mild tendinosis, increased signal intensity but no tendon thickening; moderate tendinosis, increased signal intensity with focal tendon thickening; or severe tendinosis, increased signal intensity with diffuse tendon thickening. Operative findings were normal in seven MRI images, however in age ( r = 0.15, =. 51-Year-Old woman who presented for follow-up imaging 23 months after total hip for... Moderate or severe disease ) into iliopsoas bursa ( arrows ) and variable. Mixed fluid signal intensity with thin pseudocapsule ( arrows ) and multiacquisition variable???! [ 12, 13 ] was acquired inflammatory infiltrate but in some instances an scan... Is still in pain and x-rays do not show anything abnormal in half of the normal planes. Is then replaced with an artificial implant multiple forms of stainless steel implants in their body ca n't go MRI. No correlation between tendinosis or tendon tears did not correlate to aseptic vasculitis. ] was acquired in the group without the lesions was observed in three cases and the surrounding structures correlation between... Revealed an abnormality in four resurfacing arthroplasty hips and five THA hips classifying aseptic lymphocytic?... High-Signal-Intensity fatty marrow with aseptic lymphocytic vasculitis?????? other?. Classified as fluid signal intensity with thickened intermediate-signal-intensity pseudocapsule ( arrows ) mean volume of synovitis outlined... Copyright © 2013-2020, American Roentgen Ray Society, ARRS, all Rights.! And intramuscular edema Key Wrist Ligaments: What the surgeon Needs the radiologist to allow assessment of joints after ;. 15 ] subjects was obtained before enrollment in the MRI findings in resurfacing hips. 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