| Summary: | Purpose To compare the MR findings of septic and acute gouty arthritis of the knee joint.
Materials and Methods This retrospective study included patients who underwent knee MRI for septic
or gouty arthritis at our hospital between October 2012 and October 2018. The MR findings were
analyzed for the presence of bone marrow edema, soft tissue edema, abscess, pattern of synovial
thickening (frondlike, lamellated, diffuse linear), maximum thickness of the synovium, and joint effusion
volume. The gouty (n = 5) and septic arthritis (n = 10) groups were compared using the Wilcoxon
rank-sum test and Fisher’s exact test.
Results No statistically significant differences were observed for each item. One patient in the gouty
arthritis group and seven in the septic arthritis group had bone marrow edema. Soft tissue abscess
formation was only observed in the septic group. The incidence of each synovial thickening pattern
was as follows: 100% (diffuse linear) in the gouty arthritis group and 20% (frondlike), 50% (lamellated),
and 30% (diffuse linear) in the septic arthritis group.
Conclusion Differentiation of gouty arthritis and septic arthritis based on imaging findings is difficult.
However, lamellated synovial thickening patterns, bone marrow edema, and soft tissue abscess formation
are more commonly observed in patients with septic arthritis than in those with gouty arthritis.
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