Fast-sequence, contrast-enhanced MRI could be well suited to detecting lesions and disease affecting the proximal tibiofibular joint, according to a presentation at the RSNA meeting Friday morning.

A study of 572 patients evaluated MRI's usefulness in finding and characterizing a number of abnormalities of the tibiofibular joint including trauma, infection, and tumor. These are usually hard to assess using conventional imaging.

MRI accurately diagnosed lesions in 101 patients and was generally better than clinical examination, helical CT, x-ray, and scintigraphy in the assessment of patients with PTFJ anomalies.

Researchers obtained T1- and T2-weighted images using fast spin-echo sequences and orthogonal FSE/STIR sequences followed by contrast-enhanced studies when tumors or infection were suspected.

Patients with PTFJ lesions are most likely to be misdiagnosed on clinical examination as having lateral knee joint derangement or masses because they usually present with lateral knee pain, swelling, locking, or paresthesias, according to Dr. Lorraine G. Shapeero, chief of musculoskeletal radiology at the Uniformed Services University of the Health Sciences in Bethesda, MD. Exceptions are patients with rheumatoid arthritis or trauma with specific tenderness over the lateral collateral ligament.

"Careful MRI examination of this joint is essential to enhance early diagnosis and treatment," Shapeero said.

MRI diagnosed 59 patients with osteoarthritis, five with inflammatory synovitis, 20 with ligament tears, two with popliteus sprains, and 10 with femoral and tibial contusions. Multiple benign and malignant bone tumors were also found.