March 2006 News Headlines

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Date this page was last updated: 01/07/2007 03:02:54 PM

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March 31, 2006

The rheumatoid shoulder: current consensus on diagnosis and treatment
Joint, Bone, Spine
Magnetic resonance imaging is useful for assessing the lesions and guiding the treatment strategy. Stepwise use of local interventions as indicated by imaging findings is recommended. Joint replacement should not be left too late, and surgical procedures on the shoulder should be built into the overall treatment plan...
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March 30, 2006

Clinical and Radiographic Assessment of a Modular Cementless Ingrowth Femoral Stem System for Revision Hip Arthroplasty
Journal of Arthroplasty
This article presents 6-year mean (2-12�year) clinical and radiographic follow-up of 62 proximally porous-coated modular S-ROM femoral revisions...This represents a mechanical failure rate of 5%. Stems greater than 16 mm in diameter were more likely to show stress shielding (P = .009) and not to be ingrown (P = .0006)...


Imaging of congenital anomalies and variations of the caudal spine and back in neonates and small infants
European Journal of Radiology
Spinal dysraphisms are categorized in open dysraphisms with prominent abnormal nervous tissue above the skinlevel and closed dysraphisms with a skin covered malformation. Especially the occult dysraphisms are marked by suspect skin masses and other dermal anomalies...

Imaging of infectious spinal disorders in children and adults
European Journal of Radiology
The aim of this review article is to outline the imaging of infectious disorders of the spine in adults and children. The clinical presentation, potential routes of infection and the pathogens commonly identified are discussed. The value of different imaging modalities in the diagnosis of spinal infection is presented including radiographic, CT, MR imaging and Nuclear Medicine including PET...

Degenerative spine disorders in the context of clinical findings
European Journal of Radiology
Hardly any other structure in the human body is held responsible for so many complaints, pain, and costs as the spine and its degenerative disorders. In the following article, the role of imaging procedures in diagnosing disorders of the spine is presented. Due to the fact that disk herniation represents the most frequent cause for degenerative disorders the anatomy of the intervertebral disk and the pathology of the entities that can cause diseases of the disks are described...

Imaging in scoliosis from the orthopaedic surgeon's point of view
European Journal of Radiology
For treating patients with scoliosis orthopaedic surgeons need diagnostic imaging procedures in order to provide answers about a possible underlying disease, choice of treatment, and prognosis. Once treatment is instituted, imaging is also critical for monitoring changes of the deformity so as to optimize therapy...

Transarterial embolization of primary and secondary tumors of the skeletal system
European Journal of Radiology
Percutaneous transcatheteral embolizations of primary and secondary bone tumors are important minimal invasive angiographic interventions of the skeletal system. In most of the cases embolization is performed for preoperative devascularization or as a palliative measure to treat tumor-associated pain or other tumor bulk symptoms...

Diagnostic strategies in spinal trauma
European Journal of Radiology
Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed...

Imaging and differential diagnosis of primary bone tumors and tumor-like lesions of the spine
European Journal of Radiology
Primary bone tumors and tumor-like lesions of the spine and sacrum are rare. A wide variety of benign and malignant lesions can arise in the spine and sacrum. Specific diagnosis is based on the location, matrix appearance and patient's age at time of presentation. In this location CT is often necessary for matrix characterization, particularly, detection of mineralization...


March 29, 2006

Atlantoaxial Osteoarthritis in Rheumatoid Arthritis: FDG PET/CT Findings
Clinical Nuclear Medicine
The cervical spine is a common focus of destruction in patients with rheumatoid arthritis, and the resultant instability and neural compression represent severe complications in these patients. Evaluation of disease activity at the level of the atlantoaxial joint is important in such cases. Here, we report a 47-year-old man with a 3-year history of rheumatoid arthritis. FDG PET/CT clearly demonstrated a hot spot in the atlantoaxial area, suggesting high metabolic activity of synovitis...

PET/CT of a Brodie Abscess
Clinical Nuclear Medicine
Brodie abscess is a rare, localized type of subacute or chronic pyogenic osteomyelitis, usually of staphylococcal origin. Imaging with standard radiographs, bone scintigraphy, and MRI has been described in the literature. We present the case of a 28-year-old patient with pain in the right knee...



March 28, 2006

Magnetic resonance imaging in psoriatic arthritis: a review of the literature
Arthritis Research & Therapy
The MRI features discussed include synovitis, tendonitis, dactylitis, bone oedema, bone erosions, soft tissue oedema, spondylitis/sacroiliitis and subclinical arthropathy. Comparisons have been drawn with the more extensive literature describing the MRI features of rheumatoid arthritis and ankylosing spondylitis...


Non-destructive studies of tissue-engineered phalanges by magnetic resonance microscopy and X-ray microtomography
One of the intents of tissue engineering is to fabricate biological materials for the augmentation or replacement of impaired, damaged, or diseased human tissue. In this context, novel models of the human phalanges have been developed recently through suturing of polymer scaffolds supporting osteoblasts, chondrocytes, and tenocytes to mimic bone, cartilage, and tendon, respectively...

Comparison of ultrasonography and radiography in assessment of the heel pad compressibility index of patients with plantar heel pain syndrome. Measurement of the fat pad in plantar heel pain syndrome
Joint, Bone, Spine
Conclusion: Measuring unloaded and loaded heel pad thickness by ultrasonography is reliable in the adult feet with heel pain. The preference of ultrasonography is reasonable in the studies involving the heel fat pad...
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March 27, 2006

Imaging Characteristics of Bone Graft Materials
Bone graft materials are widely used in reconstructive orthopedic procedures to promote new bone formation and bone healing, provide a substrate and scaffolding for development of bone structure, and function as a means for direct antibiotic delivery. Bone graft materials include autografts, allografts, and synthetic substitutes...


March 24, 2006

Magnetic Resonance Imaging of Articular Cartilage
American Journal of Sports Medicine
The assessment of articular cartilage using magnetic resonance imaging has seen considerable advances in recent years...An overview of the advances, current techniques, and impact of magnetic resonance imaging in the setting of trauma, degenerative arthritides, and surgical treatment for cartilage injury is presented...



March 20, 2006

Benign primary tumours of the ribs
Clinical Radiology
Benign primary tumours of the ribs are rare and may be identified during the investigation of a clinically suspected abnormality or as an incidental finding. This review describes the spectrum of benign tumours that can involve the rib and illustrates the radiographic, computed tomography (CT) and magnetic resonance (MR) imaging appearances that may facilitate diagnosis...

Computed tomography whole body imaging in multi-trauma: 7 years experience
Clinical Radiology
Conclusion: Over the 7-year period in a large acute National Health Service (NHS) hospital trust currently averaging 85,000 ED attendances per year only 296 patients fulfilled the stated criteria for an immediate multi-trauma CT study. Although disruptive in the short-term, the overall impact on workload was small. A wide range of significant injuries were demonstrated rapidly, accurately and safely, including 19 cervical spine fractures and 26 pneumothoraces not detected on plain radiographs...


March 17, 2006

The Postoperative Patellofemoral Joint: Expected Radiological Appearances and Complications
Current Problems in Diagnostic Radiology
The following learning objectives will be covered in this article: (1) To briefly review the range of surgical options for patellofemoral joint disorders; and (2) to recognize the expected appearances and complications of the postoperative patellofemoral joint on conventional radiography and cross sectional imaging...



March 16, 2006

Conventional radiography requires a MRI-estimated bone volume loss of 20% to 30% to allow certain detection of bone erosions in rheumatoid arthritis metacarpophalangeal joints
Arthritis Research & Therapy
The aim of this study was to demonstrate the ability of conventional radiography to detect bone erosions of different sizes in metacarpophalangeal (MCP) joints of rheumatoid arthritis (RA) patients using magnetic resonance imaging (MRI) as the standard reference...Conventional radiography required a MRI-estimated bone erosion volume of 20% to 30% to allow a certain detection, indicating that MRI is a better method for detection and grading of minor erosive changes in RA MCP joints...



March 15, 2006

Meniscal Extrusion in Young Athletes: Associated Knee Joint Abnormalities
American Journal of Roentgenology
Meniscal extrusion is a common finding on MRI of athletes' knees. Meniscal extrusion in association with meniscal tear and joint effusion is postulated as a significant injury in athletes and its recognition as such in this group is important because it may prompt orthopedic intervention...

Axial Rotation of the Lumbar Spinal Motion Segments Correlated with Concordant Pain on Discography: A Preliminary Study
American Journal of Roentgenology
One possible cause of back pain in patients with intervertebral disk degeneration is decreased stability of the motion segment. Axial rotations between lumbar spinal vertebrae can be measured noninvasively with CT. We tested the hypothesis that larger axial rotations are found in motion segments with disks that test positive for concordant pain, which is considered by some investigators to be a reasonable, accurate predictor of spinal instability...

Lipofibromatous Hamartoma of the Upper Extremity: A Review of the Radiologic Findings for 15 Patients
American Journal of Roentgenology
Although there are pathognomonic features that characterize lipofibromatous hamartoma on MRI, the range of appearances is broad. Sonography appears to show equally characteristic features and may be a useful tool for assessing this condition...

Direct Arthrography of the Pisotriquetral Joint
American Journal of Roentgenology
The purpose of this study was to describe and evaluate a simple and safe procedure for direct arthrography of and steroid injection into the pisotriquetral joint...Direct pisotriquetral arthrography using a medial approach is an effective and easy-to-perform technique for injection of steroids ...



March 14, 2006

MRI for Differentiating Ganglion and Synovitis in the Chronic Painful Wrist
American Journal of Roentgenology
MRI is accurate in preoperatively distinguishing between ganglion and synovitis in the setting of chronic dorsal wrist pain. Four main criteria were useful: margin, shape, internal structure, and enhancement after administration of contrast material, with shape and internal structure being most helpful...


Spinal Infections: Diagnostic Tests and Imaging Studies
Clinical Orthopedics and Related Research
Computed tomography provides structural details in the bone and intervertebral disc but magnetic resonance imaging is a superior imaging test for diagnosing infections earlier and more accurately. In many patients, percutaneous or open biopsy is required to make the definitive diagnosis of discitis or osteomyelitis and the organism responsible for the infection. Early and accurate diagnosis of spinal infections will lead to less invasive treatment for the patient...

Subchondral bone micro-architectural alterations in osteoarthritis: a synchrotron micro-computed tomography study
Osteoarthritis and Cartilage
Conclusion: Subchondral bone changes were mainly observed in advanced OA, when cartilage has been deleted and preserved in adjacent area. These data suggest that subchondral bone changes would be rather secondary to the cartilage deterioration than a primitive mechanism of OA. Nevertheless, longitudinal data could bring more accurate conclusions...


March 13, 2006

Pseudoaneurysm of the medial inferior genicular artery following anterior cruciate ligament reconstruction with hamstring tendon autograft
The Knee
Vascular injuries associated with arthroscopic surgery of the knee are uncommon. Pseudoaneurysm of the medial inferior genicular artery after hamstring tendon ACL reconstruction has not been reported yet. Diagnosis can be obtained clinically if continuous filling of the drain, hard and painful swelling of the lower leg, pulsatile swelling or mass in the region of the affected joint, are present. Definitive confirmation of the diagnosis can be achieved by sonography and angiography...
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March 10, 2006

Screening for low bone mass with quantitative ultrasonography in a community without dual-energy X-ray absorptiometry: population-based survey
BMC Musculoskeletal Disorders
Dual-energy x-ray absorptiometry (DXA) is the criterion standard to identify low bone mineral density (BMD), but access to axial DXA may be limited or cost prohibitive...Conclusion: Age-related decreases in calcaneal ultrasonometry, which reflected the prevalence of low bone mass, were more obvious in women than in men...



March 9, 2006

The Bristol Hip View: a new hypothetical radiographic projection for femoral neck fractures
British Journal of Radiology
This experimental study is to evaluate a modified radiographic view of the femoral neck in the assessment of femoral fractures. A dry femur and pelvis was set up in a rig to simulate the positioning of a routine anteroposterior (AP) pelvis X-ray view. Films were exposed to create a routine AP pelvis, AP hip and two views with external tube angulation of 15� and 30�. Observers were asked to evaluate the films using a visual analogue score on two separate occasions...


Quantitative assessment of hip osteoarthritis based on image texture analysis
British Journal of Radiology
A non-invasive method was developed to investigate the potential capacity of digital image texture analysis in evaluating the severity of hip osteoarthritis (OA) and in monitoring its progression. 19 textural features evaluating patterns of pixel intensity fluctuations were extracted from 64 images of radiographic hip joint spaces (HJS), corresponding to 32 patients with verified unilateral or bilateral OA...

Radiology of Shoulder Prostheses
Seminars in Musculoskeletal Radiology
This article is chiefly limited to the routine radiographic evaluation of shoulder arthroplasties and guidelines to their interpretation. Other imaging modalities for the evaluation of joint replacements are discussed elsewhere in this issue. The basic types of shoulder reconstructions and some of the shoulder replacement designs in previous and current use at The New York Orthopedic Hospital at Columbia Presbyterian Medical Center are illustrated, along with the indications and contraindications of the various types of reconstructions...

Imaging of Hip Arthroplasty
Seminars in Musculoskeletal Radiology
Radiography is the mainstay of the imaging evaluation of the prosthetic hip, but arthrography, aspiration, scintigraphy, sonography, computed tomography, and magnetic resonance imaging all have roles in the evaluation of the painful prosthesis. This article reviews the appearance of normal hip arthroplasty as well as the appearances of potential complications...

Small Joint Arthroplasty
Seminars in Musculoskeletal Radiology
There is little published on the radiology of small joint arthroplasty when compared with the commonly performed hip or knee replacement. The types of joint replacement, their clinical efficacy, and the expected radiographic appearances are reviewed for each of these upper and lower extremity joints. Potential complications and their radiographic appearances are presented...

Radiographic Signs of Osseointegration in Porous-coated Acetabular Components
Clinical Orthopedics and Related Research
There currently is no direct method to radiographically determine osseointegration of an uncemented, porous-coated acetabular component. We defined five radiographic signs for detecting acetabular osseointegration: (1) absence of radiolucent lines; (2) presence of a superolateral buttress; (3) medial stress-shielding; (4) radial trabeculae; and (5) an inferomedial buttress...

Fatigue Bone Injuries Causing Anterior Lower Leg Pain
Clinical Orthopedics and Related Research
Shin splints, or stress-related anterior lower leg pain, seem to arise from numerous causes, including stress fractures. We retrospectively reviewed 154 consecutive military patients who had magnetic resonance imaging during a 5-year period for stress-related anterior lower leg pain...

Computer-assisted Total Knee Arthroplasty Using Patient-specific Templating
Clinical Orthopedics and Related Research
Computer-assisted analyses of six random computed tomography scans showed mean errors for alignment and bone resection within 1.7[degrees] and 0.8 mm (maximum, 2.3[degrees] and 1.2 mm, respectively). Patient-specific templates are a practical alternative to conventional instrumentations, but additional clinical validation is required before clinical use...

Imaging of Total Knee Arthroplasty
Seminars in Musculoskeletal Radiology
Painful total knee arthroplasty (TKA) represents a diagnostic challenge for the clinician and radiologist, as there is a wide variety of potential etiologies, with a broad range of clinical presentations, and the abnormalities on imaging studies are often subtle, absent, or nonspecific. Imaging findings of normal TKA are reviewed, in addition to a variety of complications such as loosening, infection, instability, osteolysis, heterotopic ossification, extensor mechanism disruption, and fracture...



March 8, 2006

Cavovarus Foot Deformity With Multiple Tarsal Coalitions: Functional and Three-Dimensional Preoperative Assessment
The Journal of Foot and Ankle Surgery
In rare instances, tarsal coalition leads to cavovarus foot deformity, although the pathologic mechanism leading to this deformity is not clear...Three-dimensional computed tomography reconstruction and gait analysis appeared to be helpful additional parameters to understanding the pathomechanics of this complex foot deformity and for preoperative planning of triple arthrodesis...



March 7, 2006

Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination
Arthritis Research & Therapy
With MRI as the reference method, ultrasonography had higher sensitivity and accuracy in detecting signs of inflammation and destruction in RA finger joints than did clinical and radiographic examinations, without loss of specificity. This study shows that ultrasonography has the potential to improve assessment of patients with RA...



March 6, 2006

The implications of 18F-FDG PET for the diagnosis of endoprosthetic loosening and infection in hip and knee arthroplasty
BMC Musculoskeletal Disorders
Conclusion: 18F-Fluoro-deoxyglucose positron emission tomography (18F-FDG-PET) allows reliable prediction of peri-prosthetic septical inflammatory tissue reactions. Because of the high sensitivity of this method, a negative PET result in the setting of a diagnostically unclear situation eliminates the need for revision surgery...


Radiographic features of lumbar disc degeneration and bone mineral density in men and women
Annals of Rheumatic Diseases
Conclusions: Radiographic features of lumbar disc degeneration are associated with an increase in BMD at the spine. Osteophytes and end plate sclerosis, but not disc space narrowing, are associated with an increase in BMD at the hip...

Comparing a Supine Radiologic Versus Standing Clinical Measurement of Kyphosis in Older Women: The Fracture Intervention Trial
To determine whether a supine radiologic measure of kyphosis in older women is a reasonable estimate of clinical kyphosis determined in the standing position, and to investigate a computerized assessment of the Cobb angle...Conclusions: There is reasonable agreement between a supine radiologic and standing clinical measurement of kyphosis in older women...


March 3, 2006

Subchondral Bone Marrow Edema in Patients with Degeneration of the Articular Cartilage of the Knee Joint
To retrospectively determine at magnetic resonance (MR) imaging the prevalence of subchondral bone marrow edema beneath arthroscopically proved articular cartilage defects...Conclusion: Higher grades of articular cartilage defects are associated with higher prevalence and greater depth and cross-sectional area of subchondral bone marrow edema...

Association between Extrinsic and Intrinsic Carpal Ligament Injuries at MR Arthrography and Carpal Instability at Radiography: Initial Observations
Conclusion: The presence or absence of carpal instability on radiographs depends on the association between intrinsic and extrinsic ligament tears-even partial ones-rather than on the presence of intrinsic ligament tears alone, even when the tears are complete...


March 2, 2006

Do we need radiographs to diagnose osteoarthritis?
Best Practice & Research: Clinical Rheumatology
The usefulness of plain radiography in the diagnosis of osteoarthritis is reviewed. While plain radiography is frequently used to define osteoarthritis in research and is traditionally discussed as a diagnostic modality in clinical practice, recent magnetic resonance imaging studies suggest that plain radiography has limited ability to detect osteoarthritic features at an early stage of disease such as might be encountered in general practice...


Which radiographic techniques should we use for research and clinical practice?
Best Practice & Research: Clinical Rheumatology
Based upon published data, the different methods of imaging the knee joint are evaluated with respect to the radiographic procedure and anatomical structures recorded in: (1) images from radiographs of the tibiofemoral joint that have been obtained from the non-weight-bearing and weight-bearing extended knee views and the standardized knee flexion positions using fluoroscopy (semi-flexed and Lyon Schuss views) and non-fluoroscopic methods (MTP and fixed flexion); and (2) images from radiographs of the patellofemoral joint obtained from the lateral and the different axial views of the joint...

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March 1, 2006

Preservation of thoracic spine microarchitecture by alendronate: Comparison of histology and microCT
The effect of bisphosphonates on trabecular microarchitecture may contribute to the reduced risk of vertebral fracture with treatment independent of the bone volume...Reduced vertebral fracture risk with alendronate may be due to a combination of factors including the increased bone volume, reduced turnover and greater mineralization reported by others. Added to this is now suggested the preservation of several aspects of vertebral cancellous architecture, with microscopy the most sensitive method of analysis...