Image-Guided Aspiration Knee If an effusion is present, US- or fluoroscopically guided joint aspiration can be performed for synovial fluid analysis if there is concern for crystal disease or infection. Corticosteroid injections can also be performed as they may result in a 1 to 2 week reduction in synovitis on MRI in two-thirds of patients. MRI also demonstrates a subsequent increase in the synovial volume in approximately 70% of patients that develop recurrent pain [61]. Chronic Knee Pain Radiography Hip An ipsilateral hip radiograph is usually not indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT Knee CT without IV contrast may be indicated to evaluate the patellofemoral anatomy in the setting of chronic knee pain related to repetitive patellofemoral subluxation, which can be suggested by a small osseous fragment along the medial patellar margin on axial knee radiographs [15]. CT knee without IV contrast may also be useful to confirm a prior osseous injury. CT with IV contrast is not usually indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT without and with IV contrast is not usually indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT Arthrography Knee CT arthrography may be used to evaluate the menisci, articular cartilage, and the presence of loose bodies with reported sensitivities and specificities ranging from 86% to 100% [16,62-64]. MRI Knee MRI without IV contrast may be indicated when radiographs demonstrate a small osseous fragment along the medial patellar margin or if there is a clinical concern for prior or chronic patellar dislocation-relocation. MRI can assess the integrity of the medial patellofemoral ligament and medial patellar retinaculum, define the extent of cartilage injury, and identify loose bodies [41]. MRI is useful for evaluating Osgood-Schlatter or Sinding-Larsen- Johansson syndrome [41].
Chronic Knee Pain. Image-Guided Aspiration Knee If an effusion is present, US- or fluoroscopically guided joint aspiration can be performed for synovial fluid analysis if there is concern for crystal disease or infection. Corticosteroid injections can also be performed as they may result in a 1 to 2 week reduction in synovitis on MRI in two-thirds of patients. MRI also demonstrates a subsequent increase in the synovial volume in approximately 70% of patients that develop recurrent pain [61]. Chronic Knee Pain Radiography Hip An ipsilateral hip radiograph is usually not indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT Knee CT without IV contrast may be indicated to evaluate the patellofemoral anatomy in the setting of chronic knee pain related to repetitive patellofemoral subluxation, which can be suggested by a small osseous fragment along the medial patellar margin on axial knee radiographs [15]. CT knee without IV contrast may also be useful to confirm a prior osseous injury. CT with IV contrast is not usually indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT without and with IV contrast is not usually indicated to evaluate patients with signs of prior (chronic) osseous knee injury. CT Arthrography Knee CT arthrography may be used to evaluate the menisci, articular cartilage, and the presence of loose bodies with reported sensitivities and specificities ranging from 86% to 100% [16,62-64]. MRI Knee MRI without IV contrast may be indicated when radiographs demonstrate a small osseous fragment along the medial patellar margin or if there is a clinical concern for prior or chronic patellar dislocation-relocation. MRI can assess the integrity of the medial patellofemoral ligament and medial patellar retinaculum, define the extent of cartilage injury, and identify loose bodies [41]. MRI is useful for evaluating Osgood-Schlatter or Sinding-Larsen- Johansson syndrome [41].