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Abstract
The knee is of the most complex joints in the entire bodies.
Non traumatic knee lesions in adults include wide variety of disorders, all of which should be well evaluated by imaging modalities before treatment begins.
Plain radiographic examination of the knee joint is the preliminary method of investigation, however, soft tissue and cartilaginous structures are beyond its scope.
Ultrasound is the preferred next line of investigation. It provides economic and non invasive imaging of tissue. It is widely available. The sonographer can image tissue in both static and dynamic state. It provides easy and rapid comparison between both knees. It can be repeated to evaluate therapeutic response. It can be used to guide aspiration of fluid or injection of medications. It is also the modality of choice if there’s any contraindication to MR imaging like pace makers and ferromagnetic fixation devices.
MRI has made great advances in imaging capabilities and its clinical value can no longer be questioned. It proved high accuracy in diagnosing a wide variety of intraosseous and soft tissue abnormalities within and around knee joint.
Two limitations on the widespread use of MRI have been the cost and availability.
The present study was undertaken in an attempt to assess the role of ultrasound and MRI as diagnostic modalities in evaluation of non traumatic knee lesions in adults.
The study included patients with osteoarthritis, rheumatoid arthritis, systemic lupus erythromatosus, septic arthritis, osteomyelitis, osteochondritis dissecans, tumours, Baker’s cyst, meniscal cyst, ganglion cysts and synovial osteochondromatosis.
In these patients cartilage lesions, effusion, synovial thickening, erosions, osteophytes, loose bodies, baker’s cyst, ligamentous lesions, meniscal tears and meniscal extrusion were evaluated by both ultrasound and MRI.
MRI showed higher sensitivity in detection of cartilage lesions, synovial thickening, erosions and meniscal tears.
The role of sonography and MRI in evaluation of the musculoskeletal system is evolving. With more interest, research and work experience, they will gain more popularity in evaluation of non traumatic lesions of the knee.
We recommend that ultrasound should be used regularly as a second line after plain radiography in radiological evaluation of the knee joint especially in cases of suspected osteoarthritis, in follow up of rheumatoid arthritis after treatment, in guided aspiration in suspected septic arthritis and in evaluation of cystic lesions around the knee joint.