Limited CT without IV contrast can be used for surgical planning. CT Arthrography Knee CT arthrography is not commonly utilized as a second test in patients with arthritis even though CT is the most accurate method for evaluating cartilage abnormalities extending to the articular surface that is due to the high spatial resolution between the contrast and the cartilage [11]. MRI Knee MRI without IV contrast is not usually indicated in patients for whom radiographs are diagnostic of osteoarthritis unless symptoms are not explained by the radiographic findings (eg, stress fractures) or the appropriate treatment option requires additional imaging [11,19]. Patellofemoral cartilage loss is closely associated with chronic knee pain with active knee pain correlated with BMLs [56]. Since MRI is more accurate than physical examination in identifying severe grades of chondromalacia patellae, it may be an appropriate screening tool prior to arthroscopy [58]. MR Arthrography Knee MR arthrography is usually not indicated to evaluate patients with osteoarthritis or chondrocalcinosis. US Knee US is not often useful as a screening test or a comprehensive examination. US can detect synovial pathology, effusions, and cortical erosive changes [11]. Power Doppler US can demonstrate increased synovial blood flow that is associated with knee pain and can demonstrate reduced blood flow, which correlates with reduced knee pain following joint injections [60]. US can also demonstrate meniscal extrusion, a finding that suggests an underlying meniscal tear, and, on occasion, chondrocalcinosis and peripheral meniscal tears [11]. Bone Scan Knee Radionuclide bone scan is usually not indicated to evaluate patients with chronic knee pain given the low specificity and decreased anatomic resolution compared to CT or MRI [11]. However, it may help distinguish between bone and soft-tissue origins for pain as well as localize pain to one or more joints [11].
Chronic Knee Pain. Limited CT without IV contrast can be used for surgical planning. CT Arthrography Knee CT arthrography is not commonly utilized as a second test in patients with arthritis even though CT is the most accurate method for evaluating cartilage abnormalities extending to the articular surface that is due to the high spatial resolution between the contrast and the cartilage [11]. MRI Knee MRI without IV contrast is not usually indicated in patients for whom radiographs are diagnostic of osteoarthritis unless symptoms are not explained by the radiographic findings (eg, stress fractures) or the appropriate treatment option requires additional imaging [11,19]. Patellofemoral cartilage loss is closely associated with chronic knee pain with active knee pain correlated with BMLs [56]. Since MRI is more accurate than physical examination in identifying severe grades of chondromalacia patellae, it may be an appropriate screening tool prior to arthroscopy [58]. MR Arthrography Knee MR arthrography is usually not indicated to evaluate patients with osteoarthritis or chondrocalcinosis. US Knee US is not often useful as a screening test or a comprehensive examination. US can detect synovial pathology, effusions, and cortical erosive changes [11]. Power Doppler US can demonstrate increased synovial blood flow that is associated with knee pain and can demonstrate reduced blood flow, which correlates with reduced knee pain following joint injections [60]. US can also demonstrate meniscal extrusion, a finding that suggests an underlying meniscal tear, and, on occasion, chondrocalcinosis and peripheral meniscal tears [11]. Bone Scan Knee Radionuclide bone scan is usually not indicated to evaluate patients with chronic knee pain given the low specificity and decreased anatomic resolution compared to CT or MRI [11]. However, it may help distinguish between bone and soft-tissue origins for pain as well as localize pain to one or more joints [11].