Upper tibial MRI vascular marks lost in early knee osteoarthritis

Background: We describe upper tibial radiating vascular marks on MRI scans. They are lost in early osteoarthritis (OA). Methods: A literature search revealed no previous description of upper tibial MRI radial vascular marks. Fifty-six consecutive patients with anteroposterior knee X-rays and an axial PD_SPAIR MRI scan of the same knee within 1 year were studied. Their mean age was 53.1 years (range 22–85) with 27 males and 29 females. The medial and lateral compartments of each knee were scored for osteoarthritis using the Kellgren-Lawrence (K-L) classification. Marks on the MRI scans were counted by layer and quadrant position. Results: Radial vascular marks were present in the first axial upper tibial subchondral slice, peaked between 6 and 10 mm depth and were absent by 16 mm depth. There was no association with age, left or right knee, BMI, or weight. There was more K-L graded OA medially and more vascular marks laterally. There was an inverse correlation between the number of marks and early grades of osteoarthritis medially (p < 0.001) and laterally (p < 0.002). Conclusion: We demonstrate previously undescribed subchondral vascular marks on axial MRI scans of the tibia and their inverse correlation with the presence and severity of early knee osteoarthritis. Our work offers a new insight into the possible vascular aetiology of osteoarthritis and potentially a means of earlier diagnosis and a therapeutic target

Ultrasound of the nerves of the knee region: Technique of examination and normal US appearance

The diagnosis of disorders of the peripheral nerves (PN) has traditionally been based on clinical and electrophysiological data since nerve tissue cannot be visualized on standard radiographs. More recently, however, nerve structures have been evaluated with magnetic resonance imaging (MRI) and ultrasound (US). The former modality is expensive and not available in all institutions. There are also some contraindications to its use, and the assessment of long nerves can be time-consuming since different coils must be used. Thanks to recent advances in sonographic software and hardware, US can now be used for in-depth assessment of the PN of the upper and lower limbs. Most knee disorders involve lesions to the cruciate ligaments and/or the menisci, which are difficult to evaluate with US. However, similar symptoms may be caused by compression of one or more nerves in the knee region or intrinsic disorders involving these structures. Because of their superficial positions, the nerves around the knee can be clearly visualized with US. A thorough knowledge of the normal anatomy of this region and a careful scanning technique are essential for a successful diagnostic US examination. In this article, we will review the normal gross and microscopic anatomy of the nerves in the knee region, the US technique used for their examination, and their normal US appearance. \ua9 2007 Elsevier Masson

Ultrasound evaluation of the greater occipital nerve

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