Magnetic resonance imaging monitoring for osteonecrosis of the knee joints in recovered patients with severe acute respiratory syndrome after administration of glucocorticoids / 中华全科医师杂志

ABSTRACT

Objective To evaluate the magnetic resonance imaging (MRI) monitoring for osteonecrosis of the knee joints in recovered patients with severe acute respiratory syndrome (SARS) after the administration of glucocorticoids and its characteristics. Methods One hundred and ninety-eight knee joints in 99 recovered SARS patients after administration of glucocorticoids,22 males and 77 females,were examined by MRI and interpreted independently by four senior radiologists for determining osteonecosis. Results Osteonecrosis were found in 56 knee joints (28%,56/198) in 31 of 99 patients (31%,31/99),25 with bilateral lesions (81%,25/31) and six unilateral ones (19%,6/31). The lesions were symmetric (100%,25/25) in all the patients with bilateral osteonecosis,involving weight-bearing zone in 27,non-weight-bearing zone in 29 and subchondral zone in 47 knee joints (84%,47/56). The anterior zone of the medial femoral condyle was involved in 14 (8%) lesions,the posterior zone of the medial femoral condyle in 27 (16%) ,the anterior zone of the lateral femoral condyle in 29 (17%),the posterior of the lateral condyle in 44 (27%),the metaphysis of femur in 18 (11%),the anterior zone of the medial tibial plateau in three (2%),the posterior zone of the medial tibial plateaus in 13 (8%),the anterior zone of the lateral tibial plateaus in two (1%),the posterior zone of the lateral tibial plateau in seven (4%),the metaphsis of the tibia in nine (5%),and no lesion was found in the patella. Conclusions MRI can preferably be used to reveal changes of ischemia and necrosis in the knee joints. So,MRI for the knee joints should be earlier performed in the patients with glucocorticoids for diagnosis and therapy for them.