April 2005 News Headlines

These are radiology news updates from other sites

Date this page was last updated: 01/07/2007 03:03:02 PM

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April 29, 2005   Arthroscopic Assessment for Intra-articular Disorders in Residual Ankle Disability After Sprain - American Journal of Sports Medicine In 3 cases of distal tibiofibular ligament injuries, 8 cases of osteochondral lesions, and all 3 cases of impingement of an abnormal fibrous band, ankle arthroscopy was the only method capable of diagnosing the cause of residual ankle pain after a sprain...Conclusion: The present results suggest that arthroscopy can be used to diagnose the cause of residual pain after an ankle sprain in most cases that are otherwise undiagnosable by clinical examination and imaging study... April 28, 2005   Imaging of the foot and ankle: summary and update - Current Opinion in Orthopedics Developments in the field of nuclear medicine with new radiotracers may lead to techniques for imaging of synovial abnormalities and inflammatory arthropathy. Exciting advances in computer-assisted surgery are being made that may significantly shorten operating time, reduce radiation exposure to the surgeon and the patient, and improve the accuracy of hardware placement...Summary: The orthopedist of today must understand these myriad new technologic advances, including their pitfalls, to most efficiently apply them for maximum patient benefit...     April 26, 2005   Performance of a decision rule for radiographs of pediatric knee injuries - Journal of Emergency Medicine In conclusion, assessment of the ability to bear weight would have decreased the use of radiography by 53% without missing any fractures in our study population. No additional value to the rule was found by adding assessment of the ability to flex the knee or bony tenderness... April 25, 2005   Imaging of Spine Instability - Seminars in Musculoskeletal Radiology Spine instability is an important cause of back pain and disability. The most common causes of clinical instability are spinal trauma, congenital anomalies, inflammatory disorders, degenerative disease, and prior surgery. Imaging of spine instability relies on both static anatomic imaging and functional assessment of spine motion. This chapter reviews the complexity of defining instability and reviews the common antecedents of spine instability and their imaging features...   Normal F-18 FDG Vertebral Uptake in Paget's Disease on PET Scanning - Clinical Nuclear Medicine Whole-body bone scans remain the standard of care in the management of patients with suspected bone metastases. They are very sensitive for bone disease but are nonspecific. Various benign bone pathologies can give rise to foci of increased activity, which may mimic osteoblastic bone metastases. Whole-body PET with FDG has been shown to be of great value for the evaluation of bone metastases, with high sensitivity and specificity... April 21, 2005   Spinal Instability: The Orthopedic Approach - Seminars in Musculoskeletal Radiology The determination of spinal stability remains an important task of the spine surgeon, as treatment strategies rely heavily on this assessment. However, a clinically useful definition of spine stability remains elusive. Numerous classification systems have been proposed: White and Panjabi proposed a checklist point system to assess spinal stability for each of the cervical, thoracic, and lumbar spines. This remains one of the best recognized systems to date...   Compression of the Anterior Mediastinum by Uremic Tumoral Calcinosis Unusually Involving the Sternoclavicular Joint - Clinical Nuclear Medicine Uremic tumoral calcinosis is an uncommon disease that occurs in patients with chronic renal failure receiving regular, long-term hemodialysis, and characterized by calcified periarticular soft tissue masses, often of considerable size and multiplicity. The present case describes a 36-year-old man who had been on hemodialysis for 8 years. Uremic tumoral calcinosis occurred at unusual sites, the sternoclavicular joints, with simultaneous involvement of the shoulder and hip joints, and accompanied by renal osteodystrophy on bone scintigraphy...     False Negative F-18 FDG PET/CT in Nonsmall Cell Lung Cancer Bone Metastases - Clinical Nuclear Medicine Tc-99m MDP bone scintigraphy is frequently performed for suspected skeletal metastases in lung cancer. F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has also proved useful for staging nonsmall cell lung cancer, and it offers superior spatial resolution and improved specificity for bone metastases. Although F-18 FDG-PET is superior to Tc-99m MDP bone scintigraphy for the detection of bone metastases, the sensitivity for sclerotic (osteoblastic) metastases by F-18 FDG PET/CT is lower than for lytic metastases...     April 20, 2005   Vertebral Sarcoidosis Mimicking Lytic Osseous Metastases: Development 16 Years After Apparent Resolution of Thoracic Sarcoidosis - Clinical Rheumatology Vertebral sarcoidosis is a rare condition that can present with persistent back pain, often with concurrent lung, lymph node, or skin involvement. It can produce lytic or blastic osseous lesions that are indistinguishable from metastatic cancer on bone scan and magnetic resonance imaging (MRI). It usually occurs at the time of initial diagnosis of sarcoidosis, but may in very rare cases appear many years after presumed resolution of thoracic sarcoidosis...   Remitting seronegative symmetrical synovitis with pitting edema of the hands: Ultrasound, color doppler ultrasound, and magnetic resonance imaging findings - Arthritis Care and Research Conclusion: Ultrasound, CDUS, contrast-enhanced CDUS, and MRI are valuable tools in the diagnostic evaluation of involved anatomic structures in patients with RS3PE. Contrast-enhanced CDUS is superior to CDUS in assessment of inflammatory edema, effusion, and synovitis...   Normal F-18 FDG Vertebral Uptake in Paget's Disease on PET Scanning - Clinical Nuclear Medicine Whole-body bone scans remain the standard of care in the management of patients with suspected bone metastases. They are very sensitive for bone disease but are nonspecific. Various benign bone pathologies can give rise to foci of increased activity, which may mimic osteoblastic bone metastases. Whole-body PET with FDG has been shown to be of great value for the evaluation of bone metastases, with high sensitivity and specificity...   Accumulation of Tc-99m HDP in Adductor Magnus Caused by Squatting Exercises - Clinical Nuclear Medicine Tc-99m HDP bone scintigraphy is used primarily for skeletal imaging to detect abnormalities of bone. However, soft tissue abnormalities can be detected through accumulation of Tc-99m HDP at these sites. A 45-year-old man with a history of performing squatting exercises 1 week prior had increased HDP uptake in the adductor magnus muscles of the gluteal region in association with the use of this muscle in squatting exercises...   Unsuspected Metastatic Male Breast Nodule From Synovial Sarcoma Detected by FDG PET - Clinical Nuclear Medicine The literature of serendipitous findings on whole-body FDG PET continues to grow. Whole-body FDG PET imaging of a 24-year-old man with treated synovial sarcoma of the right upper extremity showed an abnormal focus of activity over the right chest in addition to abnormal uptake in the lungs. On reexamination, he was found to have a hitherto unknown 2.5-cm mobile nodule in the right breast. Histopathology confirmed it to be metastasis from the synovial sarcoma...     April 19, 2005   Arthroscopic reconstruction of an isolated avulsion fracture of the lesser tuberosity - Arthroscopy Isolated avulsion fracture of the lesser tuberosity represents an extremely rare injury that occurs mainly in younger patients. This report outlines the case of a 35-year-old healthy man who sustained a bony avulsion of the subscapularis tendon during an abduction external rotation trauma to his left shoulder. The injury was diagnosed by physical examination, standard radiographs, and magnetic resonance imaging. An arthroscopic reconstruction including closed reduction and internal fixation using suture anchors was performed...   Magnetic Resonance Imaging of Elbow Instability - Seminars in Musculoskeletal Radiology Traumatic injury of the elbow, both in the acute setting as well as in the setting of chronic repetitive microtrauma, is quite common. Specifically, the frequency of elbow dislocation is second only to that of the shoulder. Unlike the shoulder, however, the elbow is an inherently stable articulation, considered one of the most congruous joints in the body...   Honda Sign and Variants in Patients Suspected of Having a Sacral Insufficiency Fracture - Clinical Nuclear Medicine Conclusions: A "Honda sign or variation" with evidence of fractures elsewhere or no evidence of other metastatic disease should be strong evidence for a sacral insufficiency fracture. The likelihood of having a solitary metastasis to the sacrum is small... April 18, 2005   Elbow Instability: The Orthopedic Approach - Seminars in Musculoskeletal Radiology In recent years significant progress has been made in the diagnosis and treatment of elbow instability. Elbow instability represents a spectrum from the acute traumatic dislocation to chronic laxity resulting in transient joint subluxation. In general, acute elbow dislocations represent the second most common joint dislocation in the adult population and the most common joint dislocation in the pediatric age group...   Comparison of SPECT bone scintigraphy with MRI for diagnosis of meniscal tears - BMC Musculoskeletal Disorders Conclusions: SPECT and MRI are both valuable imaging techniques. SPECT is a useful alternative when MRI is unavailable or unsuitable and it is beneficial when more possible accuracy is desired (such as when MRI results are either inconclusive or conflict with other clinical data)...   April 15, 2005   Glenohumeral Joint Instability: The Orthopedic Approach - Seminars in Musculoskeletal Radiology The goal of this article is to present a concise review of the current concepts of shoulder instability. This chapter supplements the radiologic assessment of glenohumeral instability, which follows this section...   Bone Acquisition in Healthy Children and Adolescents: Comparisons of Dual-Energy X-Ray Absorptiometry and Computed Tomography Measures - Journal of Clinical Endocrinology and Metabolism The effect that growth has on dual-energy x-ray absorptiometry (DXA) bone measurements is yet to be fully defined. The purpose of this study was to determine the best method for optimizing pediatric bone measurements using DXA. Height, weight, body mass index, skeletal age, and Tanner stage of sexual development were determined for 64 healthy boys and 60 healthy girls ages 6-17 yr...   Magnetic Resonance Imaging of Glenohumeral Joint Instability - Seminars in Musculoskeletal Radiology Shoulder instability is common, especially anterior subluxation and dislocation. The sequelae are well seen on magnetic resonance imaging and include tears of the labrum, glenohumeral ligaments, capsule, tendons, and muscles. This article seeks to discuss and illustrate common pitfalls and lesions associated with instability. Anatomic and technical considerations, including the use of magnetic resonance arthrography, are also addressed...     April 13, 2005   Successful treatment with intraarticular infliximab for resistant knee monarthritis in a patient with spondylarthropathy: A role for scintigraphy with 99mTc-infliximab - Arthritis & Rheumatism Positive experiences with intraarticular infliximab have been reported in patients with rheumatoid arthritis, ankylosing spondylitis, and Behcet's disease. We used intraarticular infliximab to treat resistant knee monarthritis in a patient with spondylarthropathy. Clinical and laboratory improvement was associated with improvement in scintigraphic findings. This approach is less expensive than intravenous administration of infliximab...   Technology & Industry: Osteoporosis assessment - Applied Radiology Osteoporosis poses a signi?cant public health threat. It is estimated that approximately 55% of Americans >50 years of age are affected by this disease.1 According to the National Osteoporosis Foundation (NOF), 8 million women and 2 million men already have osteoporosis and an additional 34 million Americans are at risk of developing it due to low bone mass.1 Furthermore, the organization notes that osteoporosis is responsible for >1.5 million fractures a year, including 300,000 hip fractures and 700,000 vertebral factures... April 12, 2005   Successful treatment of severe bleeding in hemophilic target joints by selective angiographic embolization - Blood Bleeding into the joints is common in patients with hemophilia. After total knee or elbow replacement, profuse intraarticular bleeding unresponsive to high-dose clotting factor replacement sometimes occurs. In some patients who have severely damaged elbow or knee joints the same profuse bleeding pattern can be seen. To control bleeding in these patients, selective catheterization with a microcatheter and therapeutic embolization with microcoils was performed whenever a severe blush or microaneurysm was observed on angiography...   Geometrical analysis of Copeland surface replacement shoulder arthroplasty in relation to normal anatomy - Journal of Shoulder and Elbow Surgery This study examines the effect of humeral head surface replacement on the geometry of the arthritic glenohumeral joint and correlates changes to clinical outcome. Thirty-nine patients undergoing resurfacing arthroplasty were prospectively followed up clinically and radiologically for a mean of 38 months (range, 24 to 72 months). Measurements were taken from coronal radiographs by use of a validated technique...   Osteonecrosis of Hip and Knee in Patients with Severe Acute Respiratory Syndrome Treated with Steroids - Radiology Conclusions: An appreciable dose-related risk was found for osteonecrosis in patients receiving steroid therapy for SARS. Additional nonspecific bone marrow abnormalities were frequent. Joint pain was common after SARS infection and was not a useful clinical indicator of osteonecrosis...   Magnetic Resonance Imaging of Knee Instability - Seminars in Musculoskeletal Radiology Patellar retinaculum and cruciate and collateral ligaments are major passive stabilizers of the knee joint. Injuries to these ligaments may alter the overall articular motion and lead to instability. Experienced as a sense of the knee "giving way," instability is a predisposing factor for recurring injuries and osteoarthritis. This section presents a practical imaging approach to knee instability based on a major injury to a specific ligament, with routine radiographic and magnetic resonance imaging findings discussed in detail...   Knee Instability: The Orthopedic Approach - Seminars in Musculoskeletal Radiology Clinical management of knee ligament injuries ranges from simple observation to complex multiligament reconstruction. Radiographic evaluation, including magnetic resonance imaging, is an important part of the diagnostic regimen that may significantly alter the treatment plan. This article reviews the clinical presentation and evaluation of isolated and combined knee ligament injuries and presents the indications, utility, and clinical impact of radiographic imaging on surgical management...     April 11, 2005   Imaging the joint and enthesis: insights into pathogenesis of psoriatic arthritis - Annals of Rheumatic Diseases The distinct radiographic features of psoriatic arthritis (PsA) help confirm it as a distinct entity from rheumatoid arthritis and highlight some unique non-synovial based disease imaging features. The advent of magnetic resonance imaging and a better understanding of joint microanatomy including the complexity of joint entheses provide a unifying anatomical and biomechanical concept that links disease at the apparently disparate sites of involvement in PsA, including the synovium, the enthesis, the bone and the periosteum...   Psoriatic arthritis imaging: a review of scoring methods - Annals of Rheumatic Diseases Further evaluation of the various methods is needed, including performance in clinical trials as well as comparisons of the proposed scoring methods. A working group has been formed to accomplish this task, and the first study on the comparison of the methods is underway. The ultimate purpose is to select the most appropriate method for evaluation in clinical trials and the most appropriate method for evaluating disease severity and in long-term (observational) studies...   Reliability of Stress Radiography for Evaluation of Posterior Knee Laxity - American Journal of Sports Medicine Conclusion: Stress radiography was found to be a measurement method with a useful reliability for evaluation of posterior laxity in patients with posterior cruciate ligament lesions. The reproducibility of stress radiography may be influenced by multiple variables, and standardized methods are needed to minimize measurement error... April 08, 2005   Psoriatic arthritis and imaging - Annals of Rheumatic Diseases Psoriatic arthritis (PsA) has historically been considered a milder rheumatic disease not yielding significant clinical damage. However, recent studies have shown that PsA can be deforming and debilitating and that joint damage can be severe...   Rheumatoid Arthritis: A Practical Guide to State-of-the-Art Imaging, Image Interpretation, and Clinical Implications - Radiographics Rheumatoid arthritis (RA) is a chronic systemic disease of unknown origin that predominantly involves synovial tissue. RA affects 0.5%-1.0% of the global population, with females affected more frequently than males. Early diagnosis and initiation of proper therapy help modify the course of the disease and reduce the degree of severe late sequelae... April 07, 2005   Avascular Necrosis of the Talus: A Pictorial Essay - Radiographics The talus is predisposed to avascular necrosis (AVN), or bone death due to ischemia, owing to its unique structure, characteristic extraosseous arterial sources, and variable intraosseous blood supply. Both traumatic and atraumatic causes have been implicated in talar AVN. The risk of posttraumatic AVN can be predicted using the Hawkins classification system...   Dynamic magnetic resonance of the wrist in psoriatic arthritis reveals imaging patterns similar to those of rheumatoid arthritis - Arthritis Research & Therapy This dynamic magnetic resonance imaging (MRI) study is concerned with a prospective evaluation of wrist synovitis in patients with psoriatic arthritis (PsA) in comparison with patients with rheumatoid arthritis (RA) and healthy controls. Fifteen consecutive patients with PsA, 49 consecutive patients with RA, 30 RA patients matched for disease severity with those with PsA, and 8 healthy controls were studied. MRI was performed with a low-field (0.2T), extremity-dedicated machine....   Magnetic resonance imaging of the hip: Detection of labral and chondral abnormalities using noncontrast imaging - Arthroscopy Conclusions: This study shows that noncontrast MRI of the hip, using an optimized protocol, can noninvasively identify labral and chondral pathology. Such information may facilitate deciding which patients warrant surgical intervention, thus preserving hip arthroscopy as a therapeutic tool...     April 05, 2005   The determinants of change in tibial plateau bone area in osteoarthritic knees: a cohort study - Arthritis Research & Therapy Bone is integral to the pathogenesis of osteoarthritis (OA). Whether the bone area of the tibial plateau changes over time in subjects with knee OA is unknown. We performed a cohort study to describe this and identify factors that might influence the change. One hundred and twenty-six subjects with knee OA underwent baseline knee radiography and magnetic resonance imaging on their symptomatic knee... April 04, 2005   Imaging in early rheumatoid arthritis: roles of magnetic resonance imaging, ultrasonography, conventional radiography and computed tomography - Best Practice & Research: Clinical Rheumatology Efficient methods for diagnosis, monitoring and prognostication are essential in early rheumatoid arthritis (RA). While conventional X-rays only visualize the late signs of preceding disease activity, there is evidence for magnetic resonance imaging (MRI) and ultrasonography being highly sensitive for early inflammatory and destructive changes in RA joints, and for MRI findings being sensitive to change and of predictive value for future progressive X-ray damage... April 01, 2005   MR Arthrography of Rotator Interval, Long Head of the Biceps Brachii, and Biceps Pulley of the Shoulder - Radiology The rotator interval and the long head of the biceps brachii tendon are anatomically closely associated structures believed to confer stability to the shoulder joint. Abnormalities of the rotator interval may be acquired or congenital and are associated with instability of the long head of the biceps brachii tendon...