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New MRI scoring system differentiated tuberculous arthritis from osteonecrosis
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A new MRI scoring system was effective in differentiating tuberculous arthritis from advanced osteonecrosis of the femoral head, according to study results.
Researchers reviewed MRI findings in 18 hips with tuberculous arthritis and 36 hips with advanced osteonecrosis of the femoral head, analyzing the findings with an emphasis on the changes in femoral head marrow, joint cavity, synovium, acetabulum and contrast enhancement patterns. The researchers assigned a score of two for the presence of T2 hyperintensity of the femoral head, synovial hypertrophy, articular cartilage erosion, unilateral involvement of the femoral head, acetabular edema/sclerosis and enhancement of the involved head, whereas a score of one was assigned for joint effusion, edema of adjacent marrow and enhancement of adjacent soft tissue.
Study results showed 16 of 18 cases of tuberculous arthritis reached the cutoff value of 10 out of 15 possible points, which the researchers considered to be positive for tuberculous arthritis. The other two cases received a score of nine. No case of osteonecrosis of the femoral head scored more than a nine, according to the researchers.
The researchers determined that a score of 10 for a positive diagnosis of tuberculous arthritis had a sensitivity of 88.89% and a specificity of 100%.
Disclosure: The authors have no relevant financial disclosures.
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