May 31, 2006

The appropriate use of radiography in clinical practice: a report of two cases of biomechanical versus malignant spine pain
BMC Musculoskeletal Disorders
Conclusions: In these two cases, the prudent use of diagnostic plain film radiography did not significantly alter the appropriate long-term management of patients with neuromusculoskeletal signs and symptoms. The judicious use of magnetic resonance imaging was an effective procedure when investigating recalcitrant neuromusculoskeletal pain in these two patients...

Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury
Journal of Shoulder and Elbow Surgery
A comparison of the overall clinical results in both groups showed no statistically significant differences. The acromioclavicular joint was anatomically reduced in only half of the surgical patients. Those shoulders treated surgically showed a significantly higher incidence of osteoarthritis and coracoclavicular ligament ossification. Differences in clavicular deformity or osteolysis were not significant...

Radiographic Findings of Osteoarthritis versus Arthroscopic Findings of Articular Cartilage Degeneration in the Tibiofemoral Joint
Radiology
Conclusion: Marginal osteophytes were the most sensitive radiographic feature for the detection of osteoarthritis of the tibiofemoral joint. Joint space narrowing, subchondral sclerosis, and subchondral cysts were less sensitive radiographic features of osteoarthritis and rarely occurred in the absence of associated osteophyte formation...

May 25, 2006

Heel bone densitometry: device specific thresholds for the assessment of osteoporosis
British Journal of Radiology
A diagnosis of osteoporosis is facilitated by bone mineral density (BMD) measurement of the lumbar spine and hip using dual energy X-ray absorptiometry (DXA), interpreted in accordance with criteria published by the World Health Organization (WHO). The use of peripheral DXA is growing in primary care and guidance on its use has recently been published by the National Osteoporosis Society (NOS), recommending a triage approach using thresholds specific to each type of peripheral device...

The Ability of the Lauge-Hansen Classification to Predict Ligament Injury and Mechanism in Ankle Fractures: An MRI Study
Journal of Orthopaedic Trauma
Conclusions: These results demonstrate that the Lauge-Hansen classification system may have some limitations as a predictor of the mechanism of injury and the presence of soft-tissue damage associated with ankle fractures. The identification of a novel pattern of ankle fracture also illustrates how the system fails to describe all possible fracture patterns...

Relationship Between Bone Marrow Edema and Development of Symptoms in Patients With Osteonecrosis of the Femoral Head
American Journal of Roentgenology
Bone marrow edema strongly correlated with necrotic volume and was the most significant risk factor for worsening of hip pain. A large necrotic volume of 30% or more may be the second useful indicator for predicting future worsening of hip pain...

Reliability Analysis of 16-MDCT in Preoperative Evaluation of Total Knee Arthroplasty and Comparison With Intraoperative Measurements
American Journal of Roentgenology
Femoral sizing on a CT workstation had excellent or almost perfect correlation with intraoperative measurements. Therefore, reliable preoperative planning for total knee arthroplasty may be done with 16-MDCT and an advanced workstation...

May 22, 2006

Atypical manifestations of multiple myeloma: Radiological appearance
European Journal of Radiology
Diagnostic procedures performed on patients with multiple myeloma typically reveal lytic bone lesions, osteopenia or osteoporosis, bone marrow infiltration by plasma cells as well as overproduction of immunoglobulin or light chains in the serum or urine. Skeletal manifestations are extremely variable and the unusual forms have been described extensively...

Combined Labeled Leukocyte and Technetium 99m Sulfur Colloid Bone Marrow Imaging for Diagnosing Musculoskeletal Infection
Radiographics
The use of labeled leukocyte (white blood cell [WBC]) studies in the diagnosis of osteomyelitis can be problematic. A combined study consisting of WBC imaging and complementary bone marrow imaging performed with technetium 99m (99mTc) sulfur colloid is approximately 90% accurate and is especially useful for diagnosing osteomyelitis in situations involving altered marrow distribution...

Ultrasonography for rheumatologists: the development of specific competency based educational outcomes
Annals of Rheumatic Diseases
Conclusions: This is the first study to developing a competency model for the education of rheumatologists in MSK US based on the evidence of international experts. A specific set of learning outcomes has been defined, which will facilitate future informed education and practice development and provide a blueprint for a structured rheumatology MSK US curriculum and assessment process...

A Comparison Between Clinical Assessment and Magnetic Resonance Imaging of Acute Hamstring Injuries
American Journal of Sports Medicine
Physicians evaluating hamstring strains in professional football players are increasingly turning to magnetic resonance imaging to support the clinical diagnosis and management of the injury...Conclusion: This study shows that magnetic resonance imaging is not required for estimating the duration of rehabilitation of an acute minor or moderate hamstring injury in professional football players...

Tumoral Calcinosis: Pearls, Polemics, and Alternative Possibilities
Radiographics
There are many conditions with similar appearances, including the calcinosis of chronic renal failure, calcinosis universalis, calcinosis circumscripta, calcific tendonitis, synovial osteochondromatosis, synovial sarcoma, osteosarcoma, myositis ossificans, tophaceous gout, and calcific myonecrosis. The radiologist plays a critical role in avoiding unnecessary invasive procedures and in guiding the selection of appropriate tests that can result in a conclusive diagnosis of tumoral calcinosis...
CME   

Treatment of Musculoskeletal Vascular Anomalies
Seminars in Musculoskeletal Radiology
The treatment of musculoskeletal vascular anomalies can be accomplished by means of challenging image-guided interventional techniques. Most patients benefit clinically from these procedures. Careful planning, appropriate training, and adequate patient care during and after the procedure are important to achieve optimal results and to minimize procedure-related risks...

Magnetic Resonance-Guided Musculoskeletal Interventional Radiology
Seminars in Musculoskeletal Radiology
As an imaging modality, magnetic resonance (MR) guidance has great potential to direct diagnostic and therapeutic procedures performed in the musculoskeletal region and influence patient management. MR-guided interventional procedures involving bone, soft tissue, intervertebral discs, and joints are safe and sufficiently effective for use in clinical practice...

Prospective 7 year follow up imaging study comparing radiography, ultrasonography, and magnetic resonance imaging in rheumatoid arthritis finger joints
Annals of Rheumatic Diseases
Conclusion: After 7 years, an increase of bone erosions was detected by all imaging modalities. In contrast, clinical improvement and regression of synovitis were seen only with US and MRI. More than one third of erosions previously detected by MRI were seen by CR 7 years later...

Low grade radiographic sacroiliitis as prognostic factor in patients with undifferentiated spondyloarthritis fulfilling diagnostic criteria for ankylosing spondylitis throughout follow up
Annals of Rheumatic Diseases
Conclusions: Low grade radiographic sacroiliitis is a prognostic factor for ankylosing spondylitis in patients originally classified as having undifferentiated SpA. Low grade radiographic sacroiliitis should be regarded as indicative of early ankylosing spondylitis in patients with undifferentiated SpA...

May 17, 2006

Bone Augmentation: Past, Present, and Future
Seminars in Musculoskeletal Radiology
Painful skeletal and vertebral conditions caused by degeneration, fractures, infection, and neoplasm are common and associated with high morbidity and mortality. Since the introduction of modern orthopedic surgery these conditions have been treated with a multitude of techniques...

Percutaneous Minimally Invasive Therapies in the Treatment of Bone Tumors: Thermal Ablation
Seminars in Musculoskeletal Radiology
Many percutaneous image-guided ablative techniques have been utilized in the treatment of bone cancers. These techniques are fast becoming a focus in the treatment of patients with both benign and malignant forms of bone cancer...

High signal in knee osteophytes is not associated with knee pain
Osteoarthritis and Cartilage
Our understanding of the local source of pain in osteoarthritis (OA) remains unclear...Conclusion: High-signal osteophytes detected on MRI are not associated with the presence of pain, pain severity or the self-reported location of pain...

Magnetic Resonance Imaging to Evaluate Osteolysis Around Total Knee Arthroplasty
Journal of Arthroplasty
Wear-induced osteolysis remains a common problem after total knee arthroplasty and may be particularly difficult to detect clinically or radiographically around the femoral component. We describe the use of magnetic resonance imaging to identify particulate-induced osteolysis around the distal femur and proximal tibia in 2 patients with total knee arthroplasties...

Value of Fat Suppressed Proton Density Weighted Turbo Spin Echo Sequences in Detecting Meniscal Lesions: Comparison with Arthroscopy
Acta Radiologica
To evaluate fat suppressed (FS) proton density weighted (PDw) turbo spin echo (TSE) magnetic resonance imaging (MRI) compared to arthroscopy in the detection of meniscal lesions...

Percutaneous Balloon Kyphoplasty in the Treatment of Pathological Vertebral Body Fracture and Deformity in Multiple Myeloma: A One Year Follow up
Acta Radiologica
Conclusion: Balloon kyphoplasty is an effective minimally invasive procedure for stabilizing pathological vertebral fractures caused by multiple myeloma and leading to a statistically significant reduction of pain status. Balloon kyphoplasty stabilizes the vertebral body height, but is only partially able to prevent further kyphotic deformities...

Associations among preoperative MRI features and functional status following arthroscopic partial meniscectomy
Osteoarthritis and Cartilage
Conclusions: Preoperative MRI findings of cartilage damage have independent prognostic value in predicting the functional outcome of APM. This study was limited by a cross-sectional design with retrospective recall of preoperative functional status. Thus, the findings need to be confirmed in prospective investigations...

May 15, 2006

Anterior Horn Tears of the Lateral Meniscus in Soccer Players
Arthroscopy
Conclusions: These data show that the McMurray test and joint-line tenderness had a low diagnostic value in diagnosing anterior horn tears of the lateral meniscus. MRI, however, had a high diagnostic value. Common arthroscopic findings included multiple longitudinal tears within the white zone of the anterior horn...

Can CT determine the site of traumatic osteochondral defects in the paediatric knee?
Injury
Currently the ability of pre-operative CT imaging to determine the origin of traumatic osteochondral lesions (OCL) in the knee in children is yet to be established. The surgical approach to the knee will to some extent be determined by the origin of the lesion...

May 11, 2006

Imaging Modalities in the Outcome Assessment of Knee Osteoarthritis
Current Rheumatology Reviews
Knee radiography is the current "gold standard" for assessing the severity of knee osteoarthritis (OA) in clinical and research settings...This review discusses the issues related to joint imaging using radiographs and MRI in the outcome assessment of knee OA...

Radiographic Measurements of Patients With Juvenile Hallux Valgus Compared With Age-Matched Controls: A Cohort Investigation
The Journal of Foot and Ankle Surgery
The purpose of this study was to investigate radiographic measurements in a cohort of patients with juvenile hallux valgus (with a hallux valgus angle > 15�) using standardized weightbearing x-rays compared with an age-matched control group...This study showed that a positive metatarsal protrusion distance is a significant component of juvenile hallux valgus...
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Radiographic Measurement Techniques for Sacral Fractures Consensus Statement of the Spine Trauma Study Group
Spine
Members of the Spine Trauma Study Group evaluated various imaging methods and compiled standardized approaches to making radiographic measurements for the assessment of sacral fractures...Conclusions: With adoption of these radiographic guidelines, future studies will have a uniform method in which to describe sacral injuries and therefore allow study of the efficacy of various recommended treatment protocols...

Epidemiology of Vertebral Fractures: Implications for Vertebral Augmentation
Academic Radiology
To put vertebral augmentation (eg, vertebroplasty) into perspective, the etiology and outcomes of vertebral fractures are reviewed. There is considerable debate about which criteria should be used to define a vertebral fracture because there is no consistent relation between symptoms and the degree of vertebral deformity...

Evidence on the Effectiveness and Cost-effectiveness of Vertebroplasty A review of Policy Makers� Responses
Academic Radiology
This review paper tracks the growth in the evidence supporting the use of percutaneous vertebroplasty for painful osteoporotic vertebral compression fractures. The rapidly increasing numbers of publications in the literature between 1994 and 2004 are documented...

Use of digital x ray radiogrammetry in the assessment of joint damage in rheumatoid arthritis
Annals of Rheumatic Diseases
To compare digital x ray radiogrammetry (DXR) with manual radiography for assessing bone loss in RA and examine the relationship of the scores obtained with other disease indices...Conclusion: DXR measurements are more precise than Sharp scores; both are related to long term disease activity in RA. DXR is simple to use, does not require intensive training, and may identify subjects not responding to standard treatment...

May 8, 2006

Risk factors for progression of tibiofemoral osteoarthritis: an analysis based on fluoroscopically standardised knee radiography
Annals of Rheumatic Diseases
Conclusions: Progression of both joint space narrowing and osteophyte growth are predicted by the severity of the respective radiographic features of osteoarthritis at baseline and by the presence of patellofemoral osteoarthritis. In addition, knee stiffness is a risk factor for progressive osteophyte growth...

May 5, 2006

Tarsal Shape, Size, and Articulating Surface Morphology in Adolescent Surgically Treated Clubfoot and Their Contralateral Normal Foot
Journal of Pediatric Orthopaedics
Despite the inability of radiographic measurements to quantify the 3-dimensional (3D) shape and size of the hindfoot bones affected by the clubfoot pathology, radiographs continue to be used to evaluate treatment efficacy...These data offer an objective standard that will advance the knowledge of the clubfoot pathology and aid treatment efficacy evaluation...

The Other Hip in Unilateral Hip Dysplasia
Clinical Orthopedics and Related Research
There was an inverse relationship between reduced anterior support developmental dysplasia in which plain radiographs suggested unilateral dysplastic abnormality only, computed tomography scans revealed both hips to be abnormal. The data suggest that patients referred with seemingly unilateral developmental dysplasia also are at risk of having contralateral dysplastic malformation...

Shoulder Impingement: Objective 3D Shape Analysis of Acromial Morphologic Features
Radiology
Conclusion: Three-dimensional modeling yields objective data about the acromial undersurface. On the basis of this method, osseous impingement by the acromion is not a primary cause of shoulder impingement syndrome or rotator cuff tears...

Double echo steady state magnetic resonance imaging of knee articular cartilage at 3 Tesla: a pilot study for the Osteoarthritis Initiative
Annals of Rheumatic Diseases
Conclusions: DESSwe permits accurate and precise analysis of cartilage morphology in the femorotibial joint at 3 T. Further studies are needed to examine the accuracy of DESSwe in the femoropatellar joint and its ability to characterise sensitivity to longitudinal changes in cartilage morphology...

May 3, 2006

Computed Tomography Assessment of the Accuracy of In Vivo Placement of Artificial Discs in the Lumbar Spine Including Radiographic and Clinical Consequences
Spine
Conclusions: Current prosthetic disc implantation methods, with minimally invasive access techniques, are relatively accurate. Although there can be deviation of the prosthesis from ideal placement, no repercussions were attributable...

May 2, 2006

Spontaneous regression of herniated lumbar intervertebral disc
APLAR Journal of Rheumatology
Conclusion: The regression of the disc correlated with clinical improvement and was illustrated in follow-up magnetic resonance imaging. The exact mechanism underlying this condition is still unclear. As in our case, extruded lumbar intervertebral disc herniations may spontaneously regress and non-surgical conservative treatments may be appropriate

May 1, 2006

Computerized Tomographic Measurement of the Cervical Pedicles Diameter in a Malaysian Population and the Feasibility for Transpedicular Fixation
Spine
Conclusion: Transpedicular screw fixation for the cervical spine must not be attempted in the Malaysian population before the exact pedicle diameters are known.Therefore, preoperative CT evaluation is a must before transpedicular fixation is performed, especially in female patients...