What are false positives and negatives in MRI for septic arthritis (SA)?

Updated: May 12, 2016
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Infected and noninfected joint effusions have the same signal-intensity characteristics and cannot be distinguished by using MRI.

On T2-weighted images, high signal intensity in the adjacent bone marrow helps differentiate septic arthritis from synovitis. However, increased signal intensity does not necessarily indicate osteomyelitis. It can be secondary to hyperemia due to nearby infection or other etiologies. Thus, MRI is sensitive but is not always specific. [11]

Bone marrow edema and bone erosions caused by the infection of the joint can persist after successful treatment of septic arthritis  [27]

Gadolinium-based contrast agents have been linked to the development of nephrogenic systemic fibrosis (NSF) or nephrogenic fibrosing dermopathy (NFD). For more information, see Nephrogenic Fibrosing Dermopathy. The disease has occurred in patients with moderate to end-stage renal disease after being given a gadolinium-based contrast agent to enhance MRI or MRA scans.

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