Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

The Role of Magnetic Resonance Imaging in the Evaluation of Synovitis and Occult Infection Following Total Knee Arthroplasty: A Systematic review

Articles in Press

Document Type : Systematic Review

Authors

Hamed Ghafari 1
Mahnaz Ranjkesh 2

1 Assistant Professor of Orthopaedics, Department of Orthopedics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

2 Associate Professor of Radiology, Department of Radiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

10.22034/jampbr.2026.600779.1126
Abstract
Introduction: Magnetic resonance imaging has emerged as a valuable adjunctive tool for evaluating persistent symptoms following total knee arthroplasty, particularly in differentiating synovitis from occult periprosthetic infection. Advances in metal artifact reduction techniques have expanded MRI’s diagnostic utility, enabling improved visualization of periprosthetic soft tissues and inflammatory changes that are often inadequately assessed by conventional diagnostic methods.

Material and methods: This systematic review comprehensively searched major databases without time limits to evaluate the effectiveness of MRI in detecting synovitis and occult infection after total knee arthroplasty.

Results: Magnetic resonance imaging provides a comprehensive assessment of symptomatic patients after total knee arthroplasty by capturing both prevalent inflammatory changes and diagnostically specific features. While synovitis is common and often reflects aseptic pathology, findings such as bone marrow edema, periprosthetic fluid collections, and sinus tracts enhance diagnostic discrimination, supporting MRI as a valuable adjunct for identifying or excluding occult periprosthetic joint infection.

Conclusion: The relatively high negative predictive value of MRI has significant clinical implications, particularly in excluding infection in symptomatic patients. A negative MRI study, characterized by the absence of marrow edema, significant fluid collections, or aggressive soft tissue abnormalities, provides reassurance that infection is unlikely.

Keywords

MRI
Occult Infection
Total Knee Arthroplasty
Synovitis Infection
Subjects
Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Articles in Press, Accepted Manuscript
Available Online from 05 September 2026

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