Rolf Janka MD, PhD, Presenter: Nothing to Disclose

Philipp Schlechtweg, Abstract Co-Author: Nothing to Disclose

Johannes Gusinde, Abstract Co-Author: Nothing to Disclose

Friedrich F Henning, Abstract Co-Author: Nothing to Disclose

Michael Uder MD, Abstract Co-Author: Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG Research Consultant, Insight Agents GmbH Research Consultant, General Electric Company Research grant, Siemens AG Research grant, Koninklijke Philips Electronics NV

Matthias Brem MD, Abstract Co-Author: Nothing to Disclose

In patients with knee pain MRI findings after extensive physiotherapy can be of uncertain validity. The purpose of the study was to evaluate if extensive physiotherapy may mimicri a knee injury in MRI.

9 healthy volunteers with no known knee problems were scanned with a 1.5T MR scanner (Magnetom Avanto, Siemens, Erlangen, Germany) using a standard 8-channel knee coil at baseline (t0) and 1h after intensive physiotherapy for the treatment of medial knee pain at the level of the medial collateral ligament (t1). 24h later another follow up scan was performed (t2). Scan parameters were: axial orientation PD-weighted (TE 15ms, TR 2200s) and T2-weighted with fat saturation (TE 80ms, TR 2200ms), and coronal orientation T2-weighted with fat saturation (TE 80ms, TR 2200ms). Slice thickness in both orientations was 3mm. The images were blinded concerning the volunteer and the time point and analysed by a radiologist with more than 10 years experience in musculoskeletal MRI. For statistics paired two sample t-tests were applied.

At the time point t0 no edema was found. One hour after physiotherapy (time point t1) in all volunteers an edema at the level of the medial collateral ligament was found which increased significantly after 24 hours (time point t2).

After physiotherapy a significant increase of soft tissue edema can be found in MRI, which can be misinterpreted as an injury.

Extensive physiotherapy leads to a soft tissue edema which may mimicri a knee injury in MRI.

Janka, R, Schlechtweg, P, Gusinde, J, Henning, F, Uder, M, Brem, M, Can Physiotherapy Mimic Knee Injuries in MRI?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008892.html