SIR 2024
Pain Management/MSK
Wali Badar, MD
Resident
University of Illinois at Chicago
Financial relationships: Full list of relationships is listed on the CME information page.
Qian Yu, MD (he/him/his)
Resident
University of Chicago
Financial relationships: Full list of relationships is listed on the CME information page.
Sara Wallace, MD
Assistant Professor of Orthopedic Surgery
University of Chicago Medical Center
Disclosure information not submitted.
Magdalena Anitescu, MD, PhD
Professor of Anesthesia and Critical Care
University of Chicago Medical Center
Disclosure information not submitted.
Brendon Ross, DO, MS
Assistant Professor of Orthopedic Surgery and Rehabilitation Medicine
University of Chicago Medical Center
Disclosure information not submitted.
Rosemary Uy-Palmer, NP
IR Nurse Practioner
University of Chicago Medical Center
Disclosure information not submitted.
In this retrospective single center, single arm study, 15 patients (13 female, 2 male) underwent either unilateral (n=13) or bilateral GAE (n=2) GAE for symptomatic knee OA (summarized in table 1). Prior to GAE, a non-contrast knee MRI was obtained for each treated knee (10 right, 7 left). Synovial thickening was measured in greatest axial dimension on fluid sensitive sequences using Philips® Intellipacs. Using intraprocedural DSA images, a region of interest (ROI) was placed on 46 of 48 target hyperemic vessels that were eventually embolized. Peak intensity (PI) was measured for each ROI, a surrogate for contrast concentration, using Image J® [3]. Correlation between PI for each knee (n=17) and synovial thickening was performed using simple linear regression.
Results: Synovial thickening exhibited positive correlation with PI with β0=0.04 (95% CI: -3.21-3.30) and β1=8.52 (95% CI: 5.16-11.87). The coefficient of determination, R2, was 0.66 with F-stat of 29.26 and p< < 0.001. Measures of synovial thickening as well as PI are summarized in table 2.
Conclusion: Synovitis, as seen on non-contrast MRI, demonstrates positive correlation with perfusion assessed from intra-procedural DSA during GAE. Future studies with contrast can be performed to localize hyperemic vessels prior to GAE.