Imaging of Acute Ankle and Foot Sprains Beltran, Luis S; Zuluaga, Nicolas; Verbitskiy, Anna ...
The Radiologic clinics of North America
61, Številka:
2
Journal Article
Recenzirano
Ankle and foot injuries are very common injuries in the general population, and more so in athletes. MR imaging is the optimal modality to evaluate for ligamentous injuries of the ankle and ...associated conditions after ankle sprain. In this article, the authors discuss the epidemiology, biomechanics, normal anatomy, and pathology of the ankle as well as injuries of the hindfoot and midfoot that are often associated with ankle injuries.
Imaging of Nerve Disorders in the Elbow Gunio, Drew; Babaa, Ahmad; Bencardino, Jenny T
Seminars in musculoskeletal radiology
26, Številka:
2
Journal Article
Recenzirano
Neuropathies of the elbow represent a spectrum of disorders that involve more frequently the ulnar, radial, and median nerves. Reported multiple pathogenic factors include mechanical compression, ...trauma, inflammatory conditions, infections, as well as tumor-like and neoplastic processes. A thorough understanding of the anatomy of these peripheral nerves is crucial because clinical symptoms and imaging findings depend on which components of the affected nerve are involved. Correlating clinical history with the imaging manifestations of these disorders requires familiarity across all diagnostic modalities. This understanding allows for a targeted imaging work-up that can lead to a prompt and accurate diagnosis.
Nerve Entrapments in the Pelvis and Hip Lo, Lawrence; Duarte, Alejandra; Bencardino, Jenny T
Seminars in musculoskeletal radiology
26, Številka:
2
Journal Article
Recenzirano
Clinical symptoms of pelvic entrapment neuropathies are widely variable and frequently nonspecific, thus rendering it difficult to localize and diagnose. Magnetic resonance imaging (MRI), and in ...particular MR neurography, has become increasingly important in the work-up of entrapment neuropathies involving the pelvic and hip nerves of the lumbosacral plexus. The major sensory and motor peripheral nerves of the pelvis and hip include the sciatic nerve, superior and inferior gluteal nerves, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and pudendal nerve. Familiarity with the anatomy and imaging appearance of normal and pathologic nerves in combination with clinical presentation is crucial in the diagnosis of entrapment neuropathies.
Evaluation of traumatic peripheral nerve injuries has classically been based on clinical and electrophysiologic criteria. US and MRI have been widely used for morphologic assessment of nerve injury ...sites and concomitant lesions. In the past few years, morphologic MR neurography has significantly increased its clinical applications on the basis of three-dimensional or two-dimensional images with and without fat-suppression techniques. However, these sequences have a major drawback: absence of pathophysiologic information about functional integrity or axonal flow of peripheral nerves. In this scenario, functional MRI techniques such as diffusion-weighted imaging (DWI) or diffusion tensor imaging (DTI) can be used as a complementary tool in initial evaluation of peripheral nerve trauma or in assessment of trauma undergoing surgical repair. These approaches provide not only morphologic but also functional information about extent and degree of nerve impairment. Functional MR neurography can also be applied to selection, planning, and monitoring of surgical procedures that can be performed after traumatic peripheral nerve injuries, such as neurorrhaphy, nerve graft, or neurolysis, as it provides surgeons with valuable information about the functional status of the nerves involved and axonal flow integrity. The physical basis of DWI and DTI and the technical adjustments required for their appropriate performance for peripheral nerve evaluation are reviewed. Also, the clinical value of DWI and DTI in assessment of peripheral nerve trauma is discussed, enhancing their potential impact on selection, planning, and monitoring of surgical procedures employed for peripheral nerve repair. Online supplemental material is available for this article.
RSNA, 2019.
Postoperative imaging after surgery for anterior glenohumeral instability poses a great challenge, which can be compounded by a lack of familiarity with the many different operative techniques and ...their expected normal appearances and complications. In this article, we discuss the postoperative imaging appearances of anterior glenohumeral instability surgery with a review of currently recommended treatment guidelines.
It is important for radiologists to accurately detect complications of anterior shoulder instability surgery at postoperative imaging.
In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Glenohumeral instability encompasses a broad ...spectrum of clinical complaints and presentations. The diagnosis can be obvious or entirely unsuspected. Imaging findings depend on numerous factors and range from gross osseous defects to equivocal labral abnormalities and undetectable capsular lesions. This review focuses on the imaging findings in three distinct clinical scenarios: acute first-time shoulder dislocation, chronic instability with repeated dislocation, and chronic instability without repeated dislocation. The biomechanics of dislocation and the pathophysiology of labral-ligamentous injury are discussed. The authors distinguish the findings that occur in the acutely traumatized shoulder from those that typify the chronic unstable joint. The roles of different imaging modalities are also distinguished, including magnetic resonance arthrography and the value of specialized imaging positions. The goal of imaging depends on the clinical scenario. Image interpretation and reporting may need to emphasize diagnosis and the identification of lesions that are associated with instability or the characterization of lesions for treatment planning.
The article reviews a select group of traumatic upper extremity injuries that can be easily misinterpreted on radiographs.
The awareness of these specific injuries and an understanding of their ...underlying pathophysiology and the role that radiographs can play in their evaluation will give the reader the best opportunity to make the important imaging findings and guide appropriate treatment.
We are fortunate to live in a time when real advances in medicine are happening at an increasingly rapid pace. This is especially true in the field of radiology, and keeping abreast of these advances ...is one of the main challenges of clinical practice. Traditionally, cutting edge techniques in our field have been researched and validated at major academic medical centers before slowly making their way into the armamentarium of routine clinical practice. However, the improved ability to communicate and disseminate information in our modern age has facilitated more rapid implementation of new techniques to allow us to better serve our patients.
As such, this article aims to review the current standards for MRI of the shoulder used in routine practice. Furthermore, we will discuss some of the most recent advances in shoulder MRI, with particular emphasis on the applicability of an additional axial 3D T1-weighted FLASH sequence with Dixon-based water-fat separation in routine clinical practice that can be useful in characterizing several commonly encountered pathologic processes of the shoulder joint.
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