Magnetic resonance (MR) imaging is the primary diagnostic imaging modality for the evaluation of patients with suspected internal derangement of the shoulder joint. Awareness and understanding of the ...complex anatomy of the shoulder articulation and the ability to recognize normal anatomic variants and potential imaging pitfalls are critical to accurate interpretation of conventional and arthrographic MR imaging studies. This review discusses the normal anatomy and anatomic variants of the glenoid labrum, articular cartilage, and glenohumeral ligaments. An improved understanding of normal anatomy, biomechanics, and variants will help to avoid potential pitfalls in the interpretation of noncontrast and arthrographic shoulder MR imaging examinations.
A tailored review of peer-reviewed abstracts presented at the 2010 Radiological Society of North America (RSNA) Annual Meeting was performed following oral presentation. This review will highlight 15 ...formal and informal scientific paper presentations focusing on three main topics: (1) 3D isotropic MR imaging of joints, (2) diffusion tensor imaging of peripheral nerves, and (3) dual-energy CT in the diagnosis of Gout.
Tendon disorders along the plantar aspect of the foot may lead to significant symptoms but are often clinically misdiagnosed. Familiarity with the normal anatomy of the plantar tendons and its ...appearance at magnetic resonance (MR) imaging and ultrasonography (US) is essential for recognizing plantar tendon disorders. At MR imaging, the course of the plantar tendons is optimally visualized with dedicated imaging of the midfoot and forefoot. This imaging should include short-axis images obtained perpendicular to the long axis of the metatarsal shafts, which allows true cross-sectional evaluation of the plantar tendons. Normal plantar tendons appear as low-signal-intensity structures with all MR sequences. At US, accurate evaluation of the tendons requires that the ultrasound beam be perpendicular to the tendon. The normal tendon appears as a compact linear band of echogenic tissue that contains a fine, mixed hypoechoic and hyperechoic internal fibrillar pattern. Tendon injuries can be grouped into six major categories: tendinosis, peritendinosis, tenosynovitis, entrapment, rupture, and instability (subluxation or dislocation) and can be well assessed with both MR imaging and US. The radiologist plays an important role in the diagnosis of plantar tendon disorders, and recognizing their imaging appearances at MR imaging and US is essential.
Objective
To evaluate the position of the peroneus longus (PL) tendon relative to the cuboid tuberosity and cuboid tunnel during ankle dorsiflexion and plantarflexion using ultrasound and MRI.
...Materials and methods
The study population included two groups: 20 feet of 10 asymptomatic volunteers who underwent prospective dynamic ultrasound and 55 ankles found through retrospective review of routine ankle MRI examinations. The location of the PL tendon at the cuboid tuberosity and cuboid tunnel was designated as completely within the tunnel, indeterminate, or subluxed with respect to ankle dorsiflexion and plantarflexion.
Results
On dynamic ultrasound, the PL tendon was perched plantar to the cuboid tuberosity in dorsiflexion, and glided to enter the cuboid tunnel distal to the tuberosity in plantarflexion in all 20 feet. On the MRI evaluation, there was a statistically significant difference (
p
= 0.0006) in the location of the PL tendon between the ankles scanned in dorsiflexion and plantarflexion.
Conclusion
Based on our findings on ultrasound and MRI, the PL tendon can glide in and out of the cuboid tunnel along the cuboid tuberosity depending on ankle position. Thus, “subluxation” of the tendon as it curves to enter the cuboid tunnel, which to the best of our knowledge has not yet been described, should be recognized as a normal, position-dependent phenomenon and not be reported as pathology.
Ligamentous injuries of the elbow are common in sports. The diagnosis is usually based on a combination of the assessment of the mechanism of injury during the sporting activity and physical ...examination. Imaging with radiographs and MR imaging has an important diagnostic role, particularly when the clinical presentation is unclear and to evaluate for other important potential associated injuries such as myotendinous injuries, fractures, dislocations, and osteochondral lesions. Treatment includes conservative and surgical measures depending on the severity of the instability and associated injuries. We provide a detailed review of sports-related injuries of the medial and lateral collateral ligament complexes of the elbow with an emphasis on imaging manifestations of disease and a discussion of the anatomy, biomechanics, and treatment options.
Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part ...provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
ACR Appropriateness Criteria Osteonecrosis of the Hip Murphey, Mark D., MD; Roberts, Catherine C., MD; Bencardino, Jenny T., MD ...
Journal of the American College of Radiology,
02/2016, Letnik:
13, Številka:
2
Journal Article
Recenzirano
Abstract Osteonecrosis of the hip (Legg-Calvé-Perthes) is a common disease, with 10,000-20,000 symptomatic cases annually in the United States. The disorder affects both adults and children and is ...most frequently associated with trauma and corticosteroid usage. The initial imaging evaluation of suspected hip osteonecrosis is done using radiography. MRI is the most sensitive and specific imaging modality for diagnosis of osteonecrosis of the hip. The clinical significance of hip osteonecrosis is dependent on its potential for articular collapse. The likelihood of articular collapse is significantly increased with involvement of greater than 30%-50% of the femoral head area, which is optimally evaluated by MRI, often in the sagittal plane. Contrast-enhanced MRI may be needed to detect early osteonecrosis of the hip in pediatric patients, revealing hypoperfusion. In patients with a contraindication for MRI, use of either CT or bone scintigraphy with SPECT (single-photon emission CT) are alternative radiologic methods of assessment. Imaging helps guide treatment, which may include core decompression, osteotomy, and ultimately, need for joint replacement. The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
ACR Appropriateness Criteria ® Chronic Hip Pain Mintz, Douglas N; Roberts, Catherine C; Bencardino, Jenny T ...
Journal of the American College of Radiology,
05/2017, Letnik:
14, Številka:
5S
Journal Article
Recenzirano
Odprti dostop
Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical ...scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
PDF
