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MR imaging of transient synovitis: differentiation from septic arthritis

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Abstract

Background

Transient synovitis is the most common cause of acute hip pain in children. However, MR imaging findings in transient synovitis and the role of MR imaging in differentiating transient synovitis from septic arthritis have not been fully reported.

Objective

To describe the MR findings of transient synovitis and to determine whether the MR characteristics can differentiate this disease entity from septic arthritis.

Materials and methods

Clinical findings and MR images of 49 patients with transient synovitis (male/female 36/13, mean age 6.1 years) and 18 patients with septic arthritis (male/female 10/8, mean age 4.9 years) were retrospectively reviewed.

Results

MR findings of transient synovitis were symptomatic joint effusion, synovial enhancement, contralateral joint effusion, synovial thickening, and signal intensity (SI) alterations and enhancement in surrounding soft tissue. Among these, SI alterations and enhancement in bone marrow and soft tissue, contralateral joint effusion, and synovial thickening were statistically significant MR findings in differentiating transient synovitis from septic arthritis.

Conclusions

The statistically significant MR findings in transient synovitis are contralateral (asymptomatic) joint effusions and the absence of SI abnormalities of the bone marrow. It is less common to have SI alterations and contrast enhancement of the soft tissues. The statistically significant MR findings in septic arthritis are SI alterations of the bone marrow, and SI alterations and contrast enhancement of the soft tissue. Ipsilateral effusion and synovial thickening and enhancement are present in both diseases.

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Acknowledgements

We thank Bonnie Hami, Department of Radiology, University Hospitals Health System, Cleveland, OH, for editorial assistance in preparing the manuscript.

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Authors and Affiliations

  1. Department of Radiology, Kangnam St. Mary’s Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea

    Wan Jik Yang, Soo Ah Im, Gye-Yeon Lim, Ho Jong Chun, Na Young Jung, Mi Sook Sung & Byung Gil Choi

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  1. Wan Jik Yang
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Correspondence to Soo Ah Im.

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Yang, W.J., Im, S.A., Lim, GY. et al. MR imaging of transient synovitis: differentiation from septic arthritis. Pediatr Radiol 36, 1154–1158 (2006). https://doi.org/10.1007/s00247-006-0289-9

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  • DOI: https://doi.org/10.1007/s00247-006-0289-9

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