MRI of knee osteonecrosis in children with leukemia and lymphoma

Part 2, clinical and imaging patterns

Evguenia J. Karimova, Shesh N. Rai, David Ingle, Amy C. Ralph, Xin Deng, Michael D. Neel, Scott Howard, Ching Hon Pui, Sue C. Kaste

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

OBJECTIVE. This aim of this study was to explore the relationship between MRI findings and clinical symptoms of knee osteonecrosis in children and to determine the significance of this relationship. Such information is important for early diagnosis of this frequent complication and for choosing an appropriate treatment strategy. MATERIALS AND METHODS. Osteonecrotic lesion size and location were determined in a retrospective analysis of MR images of the knee obtained in our institution during the past 10 years. Association between MRI findings and clinical symptoms expressed by the knee scores was tested for a subgroup of our patient population who had clinical evaluation of the knees in the orthopedic clinic within 6 weeks of their MRI studies. RESULTS. In 80% of patients, osteonecrosis was bilateral. Lesions were distributed as follows: femur and tibia, 66% of the knees; femur alone, 26%; and tibia alone, 8%. Clinical symptoms of knee osteonecrosis were associated with lesions involving the articular surface of the distal femur, large lesions, and involvement of any part of the tibia. MR images showed milder osteonecrosis in patients who were less than 10 years old at the time of primary diagnosis. CONCLUSION. Osteonecrosis affecting the knees of children treated for leukemia and lymphoma is mostly asymptomatic. Children who are 10 years old or older have signs of more advanced osteonecrosis. Clinical symptoms often lag MRI presentation and may develop late in the course of the disease. Routine MRI evaluation is recommended for timely diagnosis of treatment-induced osteonecrosis.

Original languageEnglish (US)
Pages (from-to)477-482
Number of pages6
JournalAmerican Journal of Roentgenology
Volume186
Issue number2
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

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Osteonecrosis
Lymphoma
Knee
Leukemia
Tibia
Femur
Orthopedics
Early Diagnosis
Joints
Therapeutics
Population

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Karimova, E. J., Rai, S. N., Ingle, D., Ralph, A. C., Deng, X., Neel, M. D., ... Kaste, S. C. (2006). MRI of knee osteonecrosis in children with leukemia and lymphoma: Part 2, clinical and imaging patterns. American Journal of Roentgenology, 186(2), 477-482. https://doi.org/10.2214/AJR.04.1597

MRI of knee osteonecrosis in children with leukemia and lymphoma : Part 2, clinical and imaging patterns. / Karimova, Evguenia J.; Rai, Shesh N.; Ingle, David; Ralph, Amy C.; Deng, Xin; Neel, Michael D.; Howard, Scott; Pui, Ching Hon; Kaste, Sue C.

In: American Journal of Roentgenology, Vol. 186, No. 2, 01.02.2006, p. 477-482.

Research output: Contribution to journalArticle

Karimova, EJ, Rai, SN, Ingle, D, Ralph, AC, Deng, X, Neel, MD, Howard, S, Pui, CH & Kaste, SC 2006, 'MRI of knee osteonecrosis in children with leukemia and lymphoma: Part 2, clinical and imaging patterns', American Journal of Roentgenology, vol. 186, no. 2, pp. 477-482. https://doi.org/10.2214/AJR.04.1597
Karimova, Evguenia J. ; Rai, Shesh N. ; Ingle, David ; Ralph, Amy C. ; Deng, Xin ; Neel, Michael D. ; Howard, Scott ; Pui, Ching Hon ; Kaste, Sue C. / MRI of knee osteonecrosis in children with leukemia and lymphoma : Part 2, clinical and imaging patterns. In: American Journal of Roentgenology. 2006 ; Vol. 186, No. 2. pp. 477-482.
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