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Background: Joint effusion at 3 months after anterior cruciate ligament (ACL) reconstruction is a risk factor for ACL reinjury. However, factors associated with joint effusion at 3 months postoperatively and the effect of joint effusion on subsequent quadriceps muscle strength and graft remodeling remain unknown. Purposes: To identify factors associated with joint effusion and investigate the association between joint effusion and quadriceps muscle strength and graft remodeling in the postoperative period. Study Design: Case-control study; Level of evidence, 3. Methods: In this retrospective multicenter study, the medical records of patients who underwent single-bundle ACL reconstruction between 2015 and 2021 were reviewed. The study included the data of 174 patients (mean age, 23.5 ± 10.6 years). Demographic data, including sex, age at surgery, time from injury to surgery in months, body mass index, preinjury Tegner activity score, presence of meniscus, and chondral injuries, were collected. Magnetic resonance imaging was performed 3 months postoperatively. Joint effusion was defined as grade 3 (range of grades, 0-3) according to the ACL Osteoarthritis Score. Isokinetic strength testing was performed at 60 deg/s, while the limb symmetry index (LSI) of quadriceps strength was evaluated at 6 months postoperatively. Moreover, graft remodeling was evaluated using magnetic resonance imaging-derived signal intensity ratio (SIR) measures at 1 year postoperatively. The authors used multivariate logistic and linear regression analyses to identify the factors influencing joint effusion at 3 months and those associated with postoperative quadriceps strength LSI and SIR values, respectively. Results: Greater preinjury Tegner activity scores (odds ratio, 1.59; 95% CI, 1.08 to 2.34; P = .02) increased the odds of joint effusion at 3 months postoperatively. Multivariable linear regression analysis revealed that joint effusion (β = −23.8; 95% CI, −36.0 to −11.7; P < .001) was an independent factor associated with LSI of the quadriceps. Furthermore, joint effusion (β = 1.33; 95% CI, 0.53 to 2.14; P = .001) was associated with a higher SIR value of the reconstructed graft. Conclusion: The preinjury Tegner activity score was a factor associated with joint effusion at 3 months postoperatively, and joint effusion was associated with subsequent muscle weakness and delayed graft remodeling.

The objectives of this study are to investigate the prevalence of Baker's cyst (BC) in patients with knee pain, and to assess the correlation between BC and severity of osteophytes and joint effusion. A retrospective study was conducted on a group of patients with knee pain referred to our outpatient clinic for ultrasonography of the knee between January 2010 and February 2011. Patients underwent an ultrasonographic exam of the knees to assess the presence of marginal femorotibial osteophytosis, joint effusion and BC. A dichotomous score was assigned to each item (1 present, 0 absent) and severity of US signs of osteoarthritis and joint effusion were also graded semiquantitatively. Collected data were processed using logistic regression analysis to evaluate the correlation between degree of osteophytosis and joint effusion and BC. Patients affected by inflammatory joint conditions or with history of joint surgery or recent trauma were excluded. A total of 399 patients with knee pain were studied (299 women), in the age range 18-89 years (mean 56.2, SD 16.3 years). 293 patients (73.4%) showed sonographic features of osteoarthritis and 251 (62.9%) joint effusion. BC was found in 102 patients (25.8%) together with a positive association with sonographic features of osteoarthritis and joint effusion. Our data show a prevalence of BC of 25.8% in a population of patients with knee pain, and suggest that BC is positively related to osteoarthritis and joint effusion. Ultrasonographic examination of knee is worthwhile in patients with painful osteoarthritis or evidence of effusion.

PurposeTo analyze the accuracy of MRI in diagnosis of distal tibiofibular syndesmosis instability (DTSI) and construct new diagnostic parameters.Materials and methodsThis retrospective study evaluated 212 patients with history of ankle sprains and 3 T MRI and received a final diagnosis of distal tibiofibular syndesmosis instability by ankle arthroscopic surgery from October 2017 and December 2021. We compared the accuracy of syndesmotic injury, qualitative index of distal tibiofibular joint effusion (DTJE), and quantitative index of distal tibiofibular joint effusion (DTJE) in diagnosing distal tibiofibular syndesmosis instability. The criteria for syndesmotic injury were consistent with previous literature, and DTJE was grouped according to the pre-experimental results.ResultsA total of 212 patients (mean age, 35.64 ± 11.79, 74 female and 138 male) were included. Independent predictive MRI features included syndesmotic injury, qualitative index of distal tibiofibular joint effusion, and quantitative index of DTJE including the height, projected area of equal-point method, and projected area of incremental-value method. The quantitative index of DTJE showed a higher area under the receiver operating characteristic curve (0.805/0.803/0.804/0.811/0.817/0.805 > 0.8, P < 0.05; in comparison with all other method). The height measurement method was simpler and easier to operate, that could be gotten only by measuring the DTJE distance of a MRI independent layer, and the cut-off value of the effusion height was 8.00 mm and the Youden index (0.56) was the best.ConclusionsOur research translated a complicated string of MRI multi-dimensional spatial measurements into a simple measuring process, and established the significance of quantifying DTJE in the diagnosis of DTSI. We found that the 8-mm height of DTJE was a more specific indicator for DTSI and could serve as a novel MRI diagnostic cutoff in clinical practice.

Background The relationship between joint effusion and temporomandibular disorders (TMD) remains unclear. The purpose of this study was to investigate the correlation among joint effusion, clinical features and MRI imaging features of TMD. Methods A total of 1532 temporomandibular joints (TMJs) from 766 patients (605 females and 161 males) with the mean age of 31.68 ± 13.71 years from January 2022 to June 2023 were included in the study. Clinical and MRI features were collected and analyzed. Chi-Square test, Spearman correlation coefficient and binary logistic regression analysis were performed. Results Patients with joint effusion were significantly older and had smaller value of MIO ( p  < 0.001). There were significant differences in the distribution of joint sounds (with or without), joint pain (with or without), disc morphology (biconcave, contracture, irregular and lengthened) and disc position between joint effusion group (JE) and non-joint effusion group (NA) ( P  < 0.05).The odds of having joint effusion were 1.726 higher in patients with joint sounds when compared to those without joint sounds. The odds of having joint effusion were 8.463 higher in patients with joint pain when compared to those without joint pain. The odds of having joint effusion were 2.277 higher in patients with contracture when compared to those with biconcave. The odds of having joint effusion were 1.740 higher in patients with anterior disc displacement with reduction (ADDWR) when compared to those with normal disc position. The prediction accuracy of this model is 74.9%, and the area under curve (AUC) is 79.5%, indicating that it can be used for the prediction and the judgment effect is average. Conclusions The results demonstrated that joint sounds, joint pain, contracture, and ADDWR are high risk factors for joint effusion, especially joint pain. Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics Committee of Affiliated Stomatology Hospital of Guangzhou Medical University (LCYJ2022014).

Purpose To evaluate whether joint effusion at 3 months after anterior cruciate ligament (ACL) reconstruction is associated with ACL reinjury. Methods The medical records of 227 consecutive patients who underwent single-bundle ACL reconstruction between 2015 and 2018 were reviewed in this retrospective single-center study. Demographic data such as sex and age at surgery, as well as data on preinjury Tegner activity scale score, time from injury to surgery, presence of meniscus and cartilage injuries, and the occurrence of ACL reinjury within 2 years, were collected. Joint effusion was defined as grade 3 (range 0–3) according to the ACL Osteoarthritis Score by magnetic resonance imaging at 3 months postoperatively. Multivariate logistic regression analysis was performed to control for potential confounders. Results A total of 176 patients (mean age 22.5 ± 9.9 years) were included. Among these patients, 18 (10.2%) had ACL reinjury. At the multivariate logistic regression analysis, higher Tegner activity scale (odds ratio [OR] 3.12; 95% confidence interval [CI] 1.61–6.04; p  < 0.001) and presence of joint effusion (OR 34.5; 95% CI 6.63–179.7; p  < 0.001) increased the odds of ACL reinjury, and older age (OR 0.68; 95% CI 0.51–0.92; p  = 0.012) decreased the odds of ACL reinjury. Conclusions Joint effusion with a larger fluid volume at 3 months postoperatively was one of the risk factors for ACL reinjury independent of confounders, such as age and activity level. This result suggests the possibility of postoperative intervention for ACL reinjury. Level of evidence III.

Purpose We aimed to investigate associations between joint effusion (JE) and age, sex, disc displacement, and degenerative condylar changes in the temporomandibular joints (TMJ) through multivariate analysis of a large MRI dataset and to determine its clinical significance. Materials and methods This retrospective study analysed MRI data from 761 outpatients (1,522 TMJs; average age: 45.8 ± 18.2 years; 582 women, 179 men) with temporomandibular disorder symptoms who underwent MRI examination. Degenerative condylar changes were assessed, and JE was classified into five categories: none, trivial, mild, moderate, and severe. Ordinal logistic regression, accounting for mixed effects, identified associations between JE and predictors (age, sex, disc displacement, and degenerative bone changes: concavity, atrophy, erosion, flattening, osteophytes, and subchondral cysts). Two examiners independently evaluated MRI images, resolving discrepancies through forced consensus. Results Forced consensus was required for 8.5% (129/1,522) of TMJs. JE classifications of none, trivial, mild, moderate, and severe were observed in 45%, 11.8%, 21%, 14.1%, and 7.7% of TMJs, respectively. Ordinal logistic regression revealed significant associations between JE and age, erosion, osteophytes, and concavity. JE occurrence decreased with age, with erosion showing the strongest association. Disc displacement was not significantly associated with JE. Conclusions Within the limitations of this study, JE was significantly associated with degenerative condylar changes rather than disc abnormalities, suggesting its potential as an imaging marker of progressive bone changes. Future large-scale longitudinal investigations are essential to confirm the causal pathways between JE and degenerative condylar changes.

Background This study aimed to analyze T lymphocyte subsets and several biological indicators in children with transient synovitis (TS) to provide insights for subsequent diagnosis and treatment. Methods We retrospectively studied 126 patients admitted to Changchun Children’s Hospital from May 2020 to August 2023 with suspected acute TS or bone and joint infections (BJIs). The study comprised two parts: (1) description and analysis of clinical and laboratory features of all patients under 16 years old ; (2) comparison of laboratory data between children with TS and a control group of children undergoing elective surgery. Univariate analysis was used to determine the significant differences. Linear regression analysis was used to analyze the correlation between the variables in the study. Results Among the 126 patients, 121 were diagnosed with TS and 5 with BJIs. We analyzed the clinical and laboratory features of these children. Most patients achieved remission after treatment. In children with transient synovitis of the hip (TSH), the amount of joint effusion was negatively correlated with the CD4 + T lymphocyte count. Median IL-6 levels were significantly higher in TSH children with a preceding upper respiratory infection (URI) compared to those without. Conclusions Alterations in T lymphocyte subsets, particularly CD4 + count, may be associated with joint effusion volume in TSH. Detection of T lymphocyte subsets and several specific biomarkers (IL-6, TNF-α, IL-2) reflects the changes of immune status in children with TS, potentially aiding clinical assessment.

Background: It is known that giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) often occur together. So far, the prevalence of GCA in newly diagnosed PMR patients has not been evaluated in a prospective ultrasound study. Objective: The aim of this study was to assess the prevalence of GCA using vascular ultrasound in patients with newly diagnosed PMR. Design: A consecutive cohort of newly diagnosed PMR patients was prospectively evaluated for the presence of GCA with the use of systematic musculoskeletal and vascular ultrasound examination. Methods: Overall, 60 patients with newly diagnosed PMR were prospectively enrolled. Symptoms and laboratory findings were collected. All patients underwent ultrasound of shoulder and hip joints, and vascular ultrasound evaluating the facial, temporal, carotid, vertebral and axillary arteries. Patients were diagnosed with GCA if they had ultrasound imaging findings of GCA. Patients with PMR (PMR-group) and patients with PMR and GCA (PMR–GCA-group) were compared, and a C-reactive protein (CRP) cut-off value was evaluated. Results: GCA was diagnosed in 28 of 60 PMR patients (46%). The PMR-group consisted of 20 (62.5%) females with a mean age of 69 (±9.9) years, while the PMR–GCA-group consisted of 11 (39.3%) females with a mean age of 74 (±8.4) years. In 13 of 28 patients (46%) in the PMR–GCA-group, GCA was subclinical and only diagnosed by ultrasound. The PMR–GCA-group showed higher values of joint effusion and significantly higher CRP values. A CRP cut-off value of 26.5 mg/litre (reference range 0–5 mg/litre) yielded a sensitivity of 66% with a specificity of 73% for GCA. Conclusion: GCA was found in 46% of newly diagnosed PMR patients; 22% of the patients with PMR had asymptomatic GCA. Joint effusions were higher in the PMR–GCA-group, with significant results for the hip joint. A CRP cut-off value of ⩾26.5 mg/litre in PMR can help in the identification of subclinical GCA.

Background Magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) in temporomandibular disorder (TMD) patients of different ages are still unclear. The aim of this study was to analyze and compare the characteristics of MRI features of TMJs in different age groups. Methods A total of 1760 TMJs from 880 patients were included in the study and divided into three groups: ≤ 18Y (n = 195, 14.89 ± 2.35Y); 19-30Y (n = 475, 24.09 ± 3.23Y); and > 30Y (n = 210, 41.73 ± 10.45Y). T2-weighted image (T2WI) of MRI was obtained to evaluate the relationship between age and disc morphology, the degree of disc displacement, joint effusion, joint movement and changes of condylar bone morphology. Data were analyzed by Pearson Chi square test and Spearman correlation coefficient. Results There was no statistical difference between left and right sides in all age groups. Except condylar morphology (χ2 = 0.943, P = 0.624), there were significant differences in the distribution of disc morphology, disc position, joint effusion and joint motion among different age groups (χ2 = 24.450, χ2 = 24.829, χ2 = 19.855, χ2 = 39.259, respectively). There were significant differences in the distribution of the degree of anterior disc displacement, condyle morphology and joint effusion in different types of disc morphology among the different age groups (except for joint effusion in > 30Y), among which the first two were significantly correlated with the disc morphology. Conclusions The morphology and position of the articular disc changed significantly with age, but the proportion of abnormal condylar bone remained about 50%. The greater the degree of disc folding, the more prone to bone abnormalities. Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).

Purpose This study aimed to assess the risk factors for prolonged joint effusion in patients undergoing double-bundle anterior cruciate ligament reconstruction (ACLR). Methods In total, 160 patients who underwent primary ACLR using autograft hamstring between 2015 and 2018 were retrospectively reviewed. Joint effusion was defined as any grade ≥ 2 (range, 0–3) according to the MRI Osteoarthritis Knee Score (MOAKS). Univariate and multivariate logistic regression analyses were performed. Results The median age of the patients was 25 years (range 14–68 years) at the time of the surgery; there were 89 women and 71 men. At 1 year, 46 (28.8%) patients experienced knee joint effusion, as defined by the MOAKS. Univariate analysis revealed that age, preoperative Kellgren–Lawrence (K–L) grade, and joint effusion at 6 months were significantly associated with joint effusion at 1 year. In the multivariate analysis, joint effusion at 6 months was significantly associated with joint effusion at 1 year (odds ratio, 68.0; 95% confidence interval, 22.1–209.4). No significant difference in the Lysholm scores was observed between patients with and without joint effusion at 1 year (n.s.). Conclusions Joint effusion at 6 months was significantly associated with joint effusion 1 year after ACLR. Level of evidence III.