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==Overview==
==Overview==
MRI may be helpful in the diagnosis of hemophilia. Findings on MRI suggestive of hemophilic arthropathy include effusion, synovial hyperplasia, erosion, subchondral cyst, cartilage loss, osteonecrosis, fibrocartilage tear, ligament tear, loose body.
[[Magnetic resonance imaging|MRI]] may be helpful in the [[diagnosis]] of hemophilia. Findings on [[Magnetic resonance imaging|MRI]] suggestive of [[Hemophilia|hemophilic]] [[arthropathy]] include effusion, [[synovial]] [[Hypertrophy (medical)|hypertrophy]], [[Erosion (dental)|erosion]], subchondral [[cyst]], [[cartilage]] loss, osteonecrosis, [[fibrocartilage]] [[Tears|tear]], [[ligament]] [[Tears|tear]], loose body.
==MRI==
==MRI==
===Additive European MRI scoring system===
===Additive European MRI scoring system===
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! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Score}}
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Score}}
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold " |
Subchondral cysts
Subchondral [[Cyst|cysts]]
*Present in at least one bone
*Present in at least one [[bone]]
*Present in at least two bones
*Present in at least two [[Bone|bones]]
*More than three cysts in at least one bone
*More than three [[Cyst|cysts]] in at least one [[bone]]
*More than three cysts in at least two bones
*More than three [[Cyst|cysts]] in at least two [[Bone|bones]]
*Largest size > 4 mm in at least one bone
*Largest size > 4 mm in at least one [[bone]]
*Largest size > 4 mm in at least two bones
*Largest size > 4 mm in at least two [[Bone|bones]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
<br>
<br>
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*1
*1
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold |
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold " |
Irregularity/erosion of subchondral cortex
Irregularity/erosion of subchondral [[cortex]]
*Present in at least one bone
*Present in at least one [[bone]]
*Present in at least two bones
*Present in at least two [[Bone|bones]]
*Involves more than half of joint surface in at least one bone
*Involves more than half of [[joint]] surface in at least one [[bone]]
*Involves more than half of joint surface in at least two bones
*Involves more than half of [[joint]] surface in at least two [[Bone|bones]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
<br>
<br>
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|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold |
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold " |
Chondral destruction
Chondral destruction
*Present in at least one bone
*Present in at least one [[bone]]
*Present in at least two bones
*Present in at least two [[Bone|bones]]
*Full-thickness defect in at least one bone
*Full-thickness [[defect]] in at least one [[bone]]
*Full-thickness defect in at least two bones
*Full-thickness [[defect]] in at least two [[Bone|bones]]
*Full-thickness defect involves more than one-third of joint surface in at least one bone
*Full-thickness [[defect]] involves more than one-third of [[joint]] surface in at least one [[bone]]
*Full-thickness defect involves more than one-third of joint surface in at least two bones
*Full-thickness [[defect]] involves more than one-third of [[joint]] surface in at least two [[Bone|bones]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
<br>
<br>
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*1
*1
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold |Effusion/hemarthrosis
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold " |Effusion/[[hemarthrosis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent    = 0
*Absent    = 0
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*Large    = 4
*Large    = 4
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold |Synovial hypertrophy
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold " |[[Synovial]] [[Hypertrophy (medical)|hypertrophy]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent    =  0
*Absent    =  0
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*Large    =  4
*Large    =  4
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold |Hemosiderin
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold " |[[Hemosiderin]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent    =  0
*Absent    =  0
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*Large = 3
*Large = 3
|-
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align="center" |Hemarthrosis
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align="center" |[[Hemarthrosis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent = 0
*Absent = 0
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*Large = 3
*Large = 3
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Synovial hyperplasia
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Synovial]] [[hyperplasia]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent = 0
*Absent = 0
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*Large = 6
*Large = 6
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Hemosiderin
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Hemosiderin]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent = 0
*Absent = 0
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*Full-surface erosion = 8
*Full-surface erosion = 8
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Subchondral cyst
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Subchondral [[cyst]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent = 0
*Absent = 0
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|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Cartilage loss
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Cartilage]] loss
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent = 0
*Absent = 0
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*Present
*Present
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Fibrocartilage tear
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Fibrocartilage]] [[Tears|tear]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent  
*Absent  
*Present
*Present
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |Ligament tear
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Ligament]] [[Tears|tear]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
*Absent
*Absent

Revision as of 00:10, 23 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

MRI may be helpful in the diagnosis of hemophilia. Findings on MRI suggestive of hemophilic arthropathy include effusion, synovial hypertrophy, erosion, subchondral cyst, cartilage loss, osteonecrosis, fibrocartilage tear, ligament tear, loose body.

MRI

Additive European MRI scoring system

The additive European MRI scoring system[1]

Type of change Score

Subchondral cysts

  • Present in at least one bone
  • Present in at least two bones
  • More than three cysts in at least one bone
  • More than three cysts in at least two bones
  • Largest size > 4 mm in at least one bone
  • Largest size > 4 mm in at least two bones


  • 1
  • 1
  • 1
  • 1
  • 1
  • 1

Irregularity/erosion of subchondral cortex

  • Present in at least one bone
  • Present in at least two bones
  • Involves more than half of joint surface in at least one bone
  • Involves more than half of joint surface in at least two bones


  • 1
  • 1
  • 1
  • 1

Chondral destruction

  • Present in at least one bone
  • Present in at least two bones
  • Full-thickness defect in at least one bone
  • Full-thickness defect in at least two bones
  • Full-thickness defect involves more than one-third of joint surface in at least one bone
  • Full-thickness defect involves more than one-third of joint surface in at least two bones


  • 1
  • 1
  • 1
  • 1
  • 1
  • 1
Effusion/hemarthrosis
  • Absent = 0
  • Equivocal = 1
  • Small = 2
  • Moderate = 3
  • Large = 4
Synovial hypertrophy
  • Absent = 0
  • Equivocal = 1
  • Small = 2
  • Moderate = 3
  • Large = 4
Hemosiderin
  • Absent = 0
  • Equivocal = 1
  • Small = 2
  • Moderate = 3
  • Large = 4

Progressive Denver MRI scoring system

The progressive Denver MRI scoring system[2]

Type of change Findings and Score
Effusion
  • Absent = 0
  • Small = 1
  • Moderate = 2
  • Large = 3
Hemarthrosis
  • Absent = 0
  • Small = 1
  • Moderate = 2
  • Large = 3
Synovial hyperplasia
  • Absent = 0
  • Small = 4
  • Moderate = 5
  • Large = 6
Hemosiderin
  • Absent = 0
  • Small = 4
  • Moderate = 5
  • Large = 6
Erosion
  • Absent = 0
  • Partial-surface erosion = 7
  • Full-surface erosion = 8
Subchondral cyst
  • Absent = 0
  • 1 cyst = 7
  • >1 cyst = 8
Cartilage loss
  • Absent = 0
  • >50% loss = 9
  • ≥ 50% loss = 10

Ancillary findings of Denver MRI scale[2]

Type of change Finding
Effusion
  • Absent
  • Present
Osteonecrosis
  • Absent
  • Present
Fibrocartilage tear
  • Absent
  • Present
Ligament tear
  • Absent
  • Present
Loose body
  • Absent
  • Present

References

  1. ↑ Lundin B, Pettersson H, Ljung R (July 2004). "A new magnetic resonance imaging scoring method for assessment of haemophilic arthropathy". Haemophilia. 10 (4): 383–9. doi:10.1111/j.1365-2516.2004.00902.x. PMID 15230954.
  2. ↑ 2.0 2.1 Nuss R, Kilcoyne RF, Geraghty S, Shroyer AL, Rosky JW, Mawhinney S, Wiedel J, Manco-Johnson M (May 2000). "MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage". Haemophilia. 6 (3): 162–9. PMID 10792474.

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