Abstract:

Objective To compare the application value of CT and MRI in the diagnosis of adult knee joint tuberculosis. Methods Thirty-six patients with unilateral knee joint tuberculosis confirmed by surgical pathology from January 2017 to June 2018 in the Zhejiang Integrated Traditional and Western Medicine Hospital affiliated to Zhejiang Chinese Medical University were selected. The age of 36 patients (26 males and 10 females) ranged from 18 to 85 years, with an average of (52.3±18.9) years old. All patients underwent CT and MRI examinations after admission. The diagnostic discovery rates of the two methods was compared. Results The diagnostic discovery rates of bone destruction, bone death, synovium thickening, joint effusion and calcification were 58.3% (21/36), 52.8% (19/36), 22.2% (8/36), 36.1% (13/36), 30.6% (11/36) by CT, and 91.7% (33/36), 5.6% (2/36), 97.2% (35/36), 80.6% (29/36), 0.0% (0/36) by MRI. The diagnostic discovery rates of bone destruction, synovium thickening, and joint effusion by CT were significantly lower than those by MRI, while the diagnostic discovery rates of bone death, and calcification by CT were obviously higher than those by MRI, all with the statistically significant differences between groups (χ ² values were 8.96, 17.21, 39.03, 14.63, 17.24, P values were 0.003, 0.000, 0.000, 0.000 and 0.000, respectively). The diagnostic discovery rates of abnormal joint space, cold abscess around the joint, and concurrent sinus formation were 97.2% (35/36), 75.0% (27/36), 11.1% (4/36) by CT, and 94.4% (34/36), 80.6% (29/36), 11.1% (4/36) by MRI, without significant difference between the groups (χ ² values were 0.00, 0.32, 0.00, P values were 1.000, 0.571, and 1.000, respectively). Conclusion CT examination is dominant in finding dead bone and calcification predominate, while MRI examination has significant advantages in observing knee joint bone destruction, synovial thickening and assessing the degree of joint destruction.

Key words: Tuberculosis,osteoarticular, Knee joint, Tomography,X-ray computed, Magnetic resonance imaging, Diagnostic imaging, Comparative study