Degenerative Changes of Femoral Articular Cartilage in the Knee: Comparative Study of Specimen Sonography and Pathology

PURPOSE: To determine the sonographic findings of degenerative change in femoral articular cartilage of the knee by comparative study of specimen sonography and pathology. MATERIALS AND METHODS: We obtained 40 specimens of cartilage of the femur (20 medial and 20 lateral condylar) from 20 patients with osteoarthritis of the knee who had undergone total knee replacement. The specimens were placed in a saline-filled container and sonography was performed using a 10MHz linear transducer. Sonographic abnormalities were evaluated at the cartilage surface, within the cartilage, and at the bone-cartilage interface, and were compared with the corresponding pathologic findings. In addition, cartilage thickness was measured at a representative portion of each femoral cartilage specimen and was compared with the thickness determined by sonography. RESULTS: 'Dot 'lesions, irregularity or loss of the hyperechoic line, were demonstrated by sonography at the saline-cartilage interface of 14 cartilages. Pathologic examination showed that these findings corresponded to cleft, detachment, erosion, and degeneration. Irregularities in the hyperechoic line at the bone-cartilage interface were revealed by sonography in eight cartilages and were related to irregularity or loss of tidemark, downward displacement of the cartilage, and subchondral callus formation. Dot lesions, corresponding to cleft and degeneration, were noted within one cartilage. Cartilage thickness measured on specimen and by sonography showed no significant difference (p=0.446). CONCLUSION: Specimen sonography suggested that articular cartilage underwent degenerative histopathological change. Cartilage thickness measured by sonography exactly reflected real thickness.

Gd-DTPA Enhanced Dynamic Renal MR Imaging of Experimentally

PURPOSE: The purpose of this study was to evaluate the utility of Gd-DTPA-enhanced dynamic MRI (DMRI) in earlydiagnosis and the assessment of disease processing in experimentally-induced crescentic glomerulonephritis (CGN)in rabbits. MATERIALS AND METHODS: In six rabbits, CGN was induced by an injection of anti-glomerular basementmembrane Ab. A time-signal intensity curve (TSC) was obtained from DMRI on the day before, and at 1, 4, 7, 15, 45and 113 days after the induction of CGN. Sequential renal biopsies and blood sampling (serum creatinine) wereperformed on the same days, and the results of DMRI and TSC, were compared. RESULTS: In normal kidneys, sequentialDMRI demonstrated the intratubular passage of Gd-DTPA as an inwardly migrating, thin, dark, band pattern. On days1 and 4, the thin dark band appeared but was poorly defined and TSC revealed a delay in peak time. On days 7 and15, movement of the band was seen to be weak and slow, and there was no centripetal migration. The maximal signalintensity of TSC was delayed, and the curves declined very slowly. On days 45 and 113, the dark band pattern wasvery weak and slow, and again there was no centripetal migration. CONCLUSION: GD-DTPA-enhanced DMRI may be ofvalue in the evaluation of disease processing and the severity of CGN.

POEMS Syndrome: Two Cases Report

Two patients with an unusual multisystemic syndrome characterized by polyneuropathy, organomegaly(especiallyhepatosplenomegaly), endocrine dysfunction, M-protein, and skin abnormalites(POEMS syndrome) are discussed.Characteristic radiographic features include hepatosplenomegaly, lymph node enlargement, sclerotic bony lesions,and a peculiar variety of bony proliferation.