PubMed · 8787311
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G Leblanc, C Michel, P Y Laffy. 1995. [Bone and digitalization].. https://pubmed.ncbi.nlm.nih.gov/8787311/
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The purpose of this review article is to present the advantages and limitations of magnetic resonance imaging (MRI), computed tomography (CT) and arthrography for evaluating articular pathology. Techniques, patient selection, indications and contraindications for each modality are reviewed. MRI provides superior soft tissue contrast and image plane selection, making it the ideal technique for most articular abnormalities. However, obese patients and patients with certain electrical or metallic implants cannot be examined with MRI. CT provides superior detail for fine cortical bone and subtle calcifications, but lacks the soft tissue contrast provided by MRI. Arthrography is an invasive technique with minimal risk of allergy to contrast material or infection. This technique permits accurate measurement of capsular volume, allows for fluid aspiration for laboratory studies and permits injection of anesthetic and/or steroid compounds for purposes of treatment or confirming the site of the patient's pain. Magnetic resonance imaging, computed tomography and arthrography are useful techniques for evaluating articular pathology. Careful review of the clinical symptoms and patient's condition is necessary to select the most appropriate technique.
A 61-year-old man with a slow-growing, painless mass in the area of the right knee underwent radiographic, computed tomographic (CT), arthrographic, arteriographic, and bone scintigraphic imaging studies. Scintigraphy showed an area of intense uptake in the anterolateral part of the knee; the uptake of the knee was much higher than that of the knee joints, but the area was not connected to the joint. Radiographic findings suggested an osteocartilaginous mass which was seen to contain low-density fatty tissue on the CT exam. Arthrography revealed that there was no connection of the mass to the knee joint. Arteriography showed a mildly vascularized tumor mass. Upon removal, the mass was well encapsulated, measuring 10 x 7 x 7 cm, and consisted of integrated nodules of bone, cartilage, and fat tissue. Microscopic examination confirmed lipoma with osteochondromatous metaplasia. The intense uptake in the lipoma near the bone or joint on the bone scan and multiple osteochondromatous nodules shown on CT may serve as characteristic features of the rare chondrosseous metaplasia within a lipoma.
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