Magnetic resonance imaging/ultrasound fusion-guided sacroiliac joint corticosteroid injection in patients with axial spondyloarthritis.

Local glucocorticoid injections are used in the treatment of isolated sacroiliitis in patients with spondyloarthritis. Sacroiliac joint injections can be performed intraarticularly or periarticularly. Since the accuracy of blind injections is low, fluoroscopy, magnetic resonance imaging, computed tomography, or ultrasonography guidance are used to increase the accuracy of sacroiliac joint injections. Currently, imaging fusion software is successfully used in sacroiliac joint interventions with three-dimensional anatomic information added to ultrasonography. Herein, we present two cases of sacroiliac joint corticosteroid injections under ultrasonography-magnetic resonance imaging fusion guidance.

Do Patients Really Have Pain with Quadriceps Fat Pad Edema?

OBJECTIVE: To determine the appropriate MRI criteria for the radiological diagnosis of significant quadriceps fat pad edema, to investigate the relationship between these criteria and anterior knee pain, and to evaluate possible structural and positional factors in the etiology. MATERIAL AND METHODS: In this retrospective case-control study, individuals with and without quadriceps fat pad edema in the knee MRIs taken between May 2016 and December 2018 were determined as the case and control groups, respectively, in a ratio of 1:1. The MRI criteria for significant quadriceps fat pad edema were set as 10 mm and above the anterior-posterior diameter of the quadriceps fat pad, posterior convexity, and an increased signal in the fat-suppressed proton density sequence. The groups were compared for anterior knee pain, pain characteristics, working positions (sitting and standing), and MRI findings of structural factors. P < 0.05 was considered statistically significant. RESULTS: A total of 108 individuals were evaluated. Anterior knee pain was more common in the case group (49/54, p < 0.001) and was highly correlated with signs of quadriceps fat pad edema (R = -0,657). Frequent pain at night (18/54, p = 0.013), increased pain when walking upstairs (40/54, p = 0.003), knees are flexed (43/54, p < 0.001), and decreased pain when knees are extended (42/54, p < 0.001) were significantly high in the case group. No significant differences were observed in working position and structural factors. CONCLUSION: Quadriceps fat pad edema is significantly associated with anterior knee pain and certain specific pain characteristics.