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Is Subcutaneous Local Anesthesia in Shoulder Magnetic Resonance Arthrography Necessary?
Koivikko, M.P., et al. - Magnetic resonance arthrography is a well-established diagnostic method in degenerative and traumatic disorders of the shoulder. Some radiologists prefer to apply a local anesthetic to the skin prior to performing the joint puncture. However, no information regarding the efficacy of local anesthetics exists...Conclusion: Routine use of local anesthesia of the skin in arthrography injection is unnecessary [more...]

Acta Radiologica, 08/31/07

Ultrasound Guidance for Puncture and Injection in the Radiocarpal Joint
Lohman, M., et al. - Conclusion: Ultrasound guidance of the contrast injection in radiocarpal MR arthrograms is a cost-effective and safe alternative to fluoroscopically guided procedures. Furthermore, the use of ultrasound guidance provides clues about possible fluid collections within the joint [more...]

Acta Radiologica, 08/31/07

Intra- and Interobserver Reproducibility of Vertebral Endplate Signal (Modic) Changes in the Lumbar Spine: The Nordic Modic Consensus Group Classification
Jensen, T.S., et al. - Conclusion: In this study, we found convincing reproducibility of a detailed evaluation protocol of vertebral endplate signal changes, the "Nordic Modic Classification." The authors recommend that the evaluation protocol should be used in future studies investigating vertebral endplate signal changes [more...]

Acta Radiologica, 08/31/07

Malignant chest wall neoplasms of bone and cartilage: a pictorial review of CT and MR findings
Sullivan, P.O., et al. - Malignant tumours of the chest wall are uncommon. The purpose of this pictorial essay is to describe the CT and MRI findings of malignant neoplasms affecting the bony skeleton of the chest wall and the costal cartilages. The most common primary malignant neoplasms involving the bony skeleton of the chest wall are chondrosarcoma, osteosarcoma and Ewing's sarcoma/primitive neuroectodermal tumour [more...]

British Journal of Radiology, 08/31/07

Intraoperative Stability Testing of Lateral-Entry Pin Fixation of Pediatric Supracondylar Humeral Fractures
Zenios, M., et al. - The aims of this study were (1) to ascertain prospectively whether rotational instability can be determined intraoperatively and (2) to quantify the incidence of rotational instability after lateral-entry wire fixation in type-3 supracondylar humeral fractures in children according to Wilkins modification of Gartland classification...Conclusion: supracondylar fractures that are rotationally stable intraoperatively after wire fixation are unlikely to displace postoperatively. Only a small proportion (26%) of these fractures were rotationally stable with 2 lateral-entry wires [more...]

Journal of Pediatric Orthopaedics , 08/31/07

Manganese-enhanced magnetic resonance microscopy of mineralization
Chesnick, I.E., et al. - Paramagnetic manganese (II) can be employed as a calcium surrogate to sensitize magnetic resonance microscopy (MRM) to the processing of calcium during bone formation. At high doses, osteoblasts can take up sufficient quantities of manganese, resulting in marked changes in water proton T1, T2 and magnetization transfer ratio values compared to those for untreated cells. Accordingly, inductively coupled plasma mass spectrometry (ICP-MS) results confirm that the manganese content of treated cell pellets was 10-fold higher than that for untreated cell pellets [more...]

Magnetic Resonance Imaging , 08/30/07

MR imaging of the posterolateral corner of the knee
Bolog, N., et al. - The posterolateral corner (PLC) is a complex functional unit, consisting of several structures, which is responsible for posterolateral stabilization. The PLC is not consistently defined in the literature. However, most descriptions include the popliteal tendon (PT), the lateral collateral ligament (LCL), the popliteofibular ligament (PFL) and the posterolateral capsule, which is reinforced by the arcuate ligament (AL) and the fabellofibular ligament (FFL) [more...]

Skeletal Radiology, 08/30/07

Radiographic measures of thoracic kyphosis in osteoporosis: Cobb and vertebral centroid angles
Briggs, A., et al. - Several measures can quantify thoracic kyphosis from radiographs, yet their suitability for people with osteoporosis remains uncertain. The aim of this study was to examine the validity and reliability of the vertebral centroid and Cobb angles in people with osteoporosis.Lateral radiographs of the thoracic spine were captured in 31 elderly women with osteoporosis. Thoracic kyphosis was measured globally (T1-T12) and regionally (T4-T9) using Cobb and vertebral centroid angles [more...]

Skeletal Radiology, 08/30/07

A primary leiomyosarcoma of bone containing pseudoepithelial plexiform elements
Rigopoulou, A., et al. - A rare but distinctive variant of smooth muscle tumours that occurs almost exclusively in the uterus is characterised by the presence of plexiform tumourlets, which are composed of clumps and cords of tumour cells that form a discrete pseudoepithelial component. We report on a case of a primary leiomyosarcoma of the proximal humerus, which, in addition to characteristic histological and immunophenotypic features of leiomyosarcoma, contained plexiform tumourlets [more...]

Skeletal Radiology, 08/30/07

Anomalies of the long head of the biceps brachii tendon: clinical significance, MR arthrographic findings, and arthroscopic correlation in two patients
Gaskin, C., et al. - Two patients with clinically relevant anomalies of the long head of the biceps brachii tendon (LHBT) are presented with MR arthrography and surgical correlation. Such variations in the LHBT can mimic tears of the tendon itself or the adjacent superior labrum both on MR arthrography and at surgery. MR arthrographic features are recognizable and allow for correct prospective diagnosis, possibly averting unnecessary surgery [more...]

Skeletal Radiology, 08/30/07

Posterior dislocation of the long head of biceps tendon: case report and review of the literature
Mullaney, P., et al. - Posterior or lateral dislocation of the long head of biceps is a rare complication of shoulder dislocation that can result in inability to relocate the humerus. The diagnosis should be suspected when certain radiographic features are present at the initial presentation. Other imaging modalities can aid diagnosis when clinical management is unsuccessful or protracted [more...]

Skeletal Radiology, 08/30/07

MRI in long-term evaluation of reconstructed hind-feet of land?mine trauma patients
Sanal, H.T., et al. - The purpose of this study was to assess the flap reconstructed hind feet of patients with MRI who were traumatized by land–mine...Conclusion: In reconstructed hind feet by myocutaneus flaps done for land–mine traumas, MRI presents useful information by displaying detailed anatomy of the flaps, bones, joints, soft tissues and associated complications [more...]

European Journal of Radiology, 08/30/07

Reliability of tarsal bone segmentation and its contribution to MR kinematic analysis methods
Wolf, P., et al. - The purpose of this study was to determine the reliability of tarsal bone segmentation based on magnetic resonance (MR) imaging using commercially available software. All tarsal bones of five subjects were segmented five times each by two operators. Volumes and second moments of volume were calculated and used to determine the intra- as well as interoperator reproducibility [more...]

Computerized Medical Imaging and Graphics , 08/30/07

Absent cervical spine pedicle: report of a case in a mediaeval skeleton
Mays, S., et al. - This paper presents a first dry-bone study of the anatomy of an absent cervical spine pedicle and briefly reviews the literature involving this anomaly. The case study is of the absence of the right cervical spine pedicle at C6 in a mediaeval skeleton from England. Key features of the anomaly, including, in addition to the absent pedicle, dysplasia of the ipsilateral transverse process, dorsal displacement of the articular pillar, and reversal of the ipsilateral facet articulation with the supra-adjacent vertebra, are illustrated [more...]

Skeletal Radiology, 08/30/07

Intramyocellular lipid quantification: comparison between 3.0- and 1.5-T 1H-MRS
Torriani, M., et al. - This study aimed to prospectively compare measurement precision of calf intramyocellular lipid (IMCL) quantification at 3.0 and 1.5 T using 1H magnetic resonance spectroscopy (1H-MRS)...Conclusion: Using current technology, 1H-MRS for IMCL at 3.0 T did not improve measurement precision, as compared with 1.5 T [more...]

Magnetic Resonance Imaging , 08/30/07

MRI evaluation and measurement of the normal odontoid peg position
Cronin, C.G., et al. - To measure the normal distances (and range) from the tip of the odontoid peg to the different reference skull baselines (Chamberlain's, McGregor's, and McRae's line) using magnetic resonance imaging (MRI)...We retrospectively evaluated midline sagittal MRI brain images of 200 adults chosen randomly...Conclusion: Based on the current population, these results provide the mean and range of normal distances from the odontoid peg to the most frequently used skull baselines using MRI [more...]

Clinical Radiology, 08/29/07

Stress-related bone injuries with emphasis on MRI
Datir, A.P., et al. - Stress-related bone injuries are common in professional athletes and in military personnel. However, in an increasingly health conscious society undertaking more, and often unsupervised, exercise regimes, these injuries may increase. Early diagnosis is of paramount importance to detect the signs of stress reaction, allow healing, and prevent progression to frank fracture. This review illustrates the classical magnetic resonance imaging (MRI) features of stress injury and fracture with emphasis on its role in the diagnosis and follow-up, as well as its limitations [more...]

Clinical Radiology, 08/29/07

Computerized segmentation and diagnostics of whole-body bone scintigrams
Sajn, L., et al. - Bone scintigraphy or whole-body bone scan is one of the most common diagnostic procedures in nuclear medicine. Since expert physicians evaluate images manually some automated procedure for pathology detection is desired. A robust knowledge based methodology for segmenting body scans into the main skeletal regions is presented [more...]

Computerized Medical Imaging and Graphics , 08/29/07

Correlation of plain radiographic indices of the hip with quantitative bone mineral density
Sah, A., et al. - Radiographic parameters of the hip can be useful as an indication of bone mineral density at the femoral neck. Measurements available from routine hip radiographs were correlated with DXA values. Although radiographs are not a test for osteoporosis, measurements of cortical thickness provide information useful for referral for osteoporosis assessment.Plain hip radiographs are widely used for evaluation of hip pathology in osteoarthritis [more...]

Osteoporosis International, 08/29/07

Access to Osteoporosis Treatment is Critically Linked to Access to Dual-Energy X-ray Absorptiometry Testing
Cadarette, S., et al. - To determine if inequities in access to osteoporosis investigation [dual-energy x-ray absorptiometry (DXA) testing] and treatment (bisphosphonate, calcitonin, and/or raloxifene) exist among older women in a region with universal health care coverage...Conclusions: Significant inequities in access to fracture prevention exist in a region with universal health care coverage. Improved access to DXA and better communication to patients of both their DXA results and the benefits of treatment has the potential to reduce the burden of osteoporosis [more...]

Medical Care, 08/29/07

Difference Between 2 Measurement Methods of Version Angles of the Acetabular Component
Arai, N., et al. - We evaluated the relationship and the difference between measurements of version angles (VAs) of the acetabular components in total hip arthroplasty taken using 2 different methods. One VA was measured on an anteroposterior radiograph of the hip joint (VAP) and the other on a cross-table lateral radiograph (VCL) in 97 hips after surgery (clinical data) and 6 sawbone pelvic models (model data). There was a positive correlation between VAP and VCL for both data [more...]

Journal of Arthroplasty, 08/28/07

Effect of age and gender on the number and distribution of sites in Paget's disease of bone
Haddaway, M.J., et al. - Paget's disease of bone (PDB) is reportedly declining in prevalence and severity, with increasing numbers of monostotic cases. Some accounts suggest that these findings are more evident in women, and that monostotic disease is unexpectedly frequent at certain sites. We have studied whether birth date or gender is associated with the number of sites affected and with the distribution of sites in monostotic disease and, by reviewing 100 follow-up 99Tcm methylene diphosphonate (MDP) scans, whether additional sites appear after initial diagnosis [more...]

British Journal of Radiology, 08/28/07

Sonographically Guided Percutaneous Needle Lavage in Calcific Tendinitis of the Shoulder: Short- and Long-Term Results
del Cura, J.L., et al. - The purpose of our study was to evaluate the short- and long-term effectiveness of sonographically guided percutaneous needle aspiration and lavage in calcific tendinitis of the shoulder and to study the progress of calcifications and symptoms in the first year after treatment...Conclusion: Percutaneous needle aspiration and lavage is effective in the short term and in the long term in calcific tendinitis of the shoulder, with results similar to or better than those published for other techniques, and it is only slightly invasive and painful. Progress after treatment may include a transitory period of recurrence of the pain [more...]

American Journal of Roentgenology, 08/27/07

MRI Follow-Up of Posttraumatic Bone Bruises of the Knee in General Practice
Boks, S.S., et al. - Our purpose was to study the natural course of bone bruises in posttraumatic knees and to describe possible determinants of this course...Conclusion: Median healing time of bone bruises is 42.1 weeks. Prognosis is particularly influenced by the presence of osteoarthritis. Age, type of bone bruise, and number of bruises also have prognostic value [more...]

American Journal of Roentgenology, 08/27/07

Selective Atrophy of the Abductor Digiti Quinti: An MRI Study
Recht, M.P., et al. - Entrapment of the first branch of the lateral plantar nerve is a well-recognized but diagnostically elusive cause of heel pain...Conclusion: Selective fatty atrophy of the ADQ is not a rare finding on MR examination of the foot and ankle, being seen in 6.3% of all studies and in 7.5% of all studies in females. The clinical relevance of selective ADQ atrophy seen on MRI is uncertain [more...]

American Journal of Roentgenology, 08/27/07

Disentangling manual muscle testing and Applied Kinesiology: critique and reinterpretation of a literature review
Haas, H., et al. - Cuthbert and Goodheart recently published a narrative review on the reliability and validity of manual muscle testing (MMT)in the Journal. The authors should be recognized for their effort to synthesize this vast body of literature. However, the review contains critical errors in the search methods, inclusion criteria, quality assessment, validity definitions, study interpretation, literature synthesis, generalizability of study findings, and conclusion formulation that merit a reconsideration of the authors findings [more...]

BMC Musculoskeletal Disorders, 08/27/07

Difference Between the Epicondylar and Cylindrical Axis of the Knee
Eckhoff, D., et al. - Locating the true flexion-extension axis of the knee can play an important role in component placement in a total knee arthroplasty, especially using contemporary computer-assisted surgical navigation. We determined if the commonly used transepicondylar axis is an accurate and reproducible substitute for the flexion-extension axis. Twenty-three fresh-frozen cadaveric distal femurs with intact soft tissue were imaged with computed tomography and reconstructed in three-dimensional virtual space [more...]

Clinical Orthopedics and Related Research, 08/27/07

Introduction of a novel magnetic resonance imaging tenosynovitis score for rheumatoid arthritis: reliability in a multireader longitudinal study
Haavardsholm, E.A., et al. - Conclusions: The introduced tenosynovitis scoring system demonstrates a high degree of multireader reliability, is feasible, and may be used as an adjuvant to the existing OMERACT RAMRIS score, allowing improved quantification of inflammatory soft tissue changes in patients with rheumatoid arthritis [more...]

Annals of Rheumatic Diseases, 08/27/07

Microvascular responses following digital thermal hyperaemia and iontophoresis measured by laser Doppler imaging in idiopathic inflammatory myopathy
Gunawardena, H., et al. - To measure microvascular function using laser Doppler imaging following digital hyperaemia and iontophoresis of vasoactive substances in patients with idiopathic inflammatory myopathy (IIM)...Conclusion: This is the first study to evaluate microvascular responses using LDI in patients with IIM. We have demonstrated that patients with DM have abnormal endothelial dependent mediated vasodilation and the same abnormality is present in patients with PM [more...]

Rheumatology, 08/27/07

MRI and Biologic Behavior of Desmoid Tumors in Children
McCarville, M.B., et al. - The outcome of desmoid tumor in children cannot be reliably predicted on the basis of histologic findings...Conclusion: MRI has limited value in prediction of the postoperative presence of residual or recurrent desmoid tumor in children. It is useful, however, for detecting disease and monitoring postoperative adjuvant therapy [more...]

American Journal of Roentgenology, 08/27/07

MRI of the Distal Biceps Femoris Muscle: Normal Anatomy, Variants, and Association with Common Peroneal Entrapment Neuropathy
Vieira, R.L.R., et al. - The objectives of our study were to describe the previously unreported normal MR anatomy of the distal biceps femoris muscle and its relationship with the common peroneal nerve and to present a case in which previously unreported MR evidence of an anatomic variation in the distal biceps femoris muscle was associated with common peroneal entrapment neuropathy...Conclusion: Variations in the posterior and distal extents of the biceps femoris muscle can produce a tunnel in which the common peroneal nerve travels. We also described a case of common peroneal neuropathy secondary to tunnel formation [more...]

American Journal of Roentgenology, 08/27/07

Abduction and External Rotation in Shoulder Impingement: An Open MR Study on Healthy Volunteers?Initial Experience
Gold, G.E., et al. - To prospectively evaluate rotator cuff contact with the glenoid in healthy volunteers placed in the unloaded and loaded abduction and external rotation (ABER) positions in an open magnetic resonance (MR) imager...Conclusion: The unloaded and loaded ABER positions resulted in contact of the supraspinatus and infraspinatus with the glenoid in all volunteers. Distances between the rotator cuff insertion sites and the glenoid decreased in the loaded ABER position [more...]

Radiology, 08/27/07

Diffusion Weighted Imaging in Osteoradiology
Herneth, A., et al. - Diffusion weighted imaging gained attention as an imaging modality, which provides information on the microstructure of a tissue, which can be used for tissue characterization. This is of importance in patients where other diagnostic tools provide equivocal or unspecific information. In addition quantitative diffusion measurements provide objective parameters for unbiased comparison of treatment response, which is mandatory for therapy monitoring. Technical restriction limited the use of Diffusion Weighted Imaging to the brain [more...]

Topics in Magnetic Resonance Imaging, 08/24/07

Magnetic Resonance Imaging of Appendicular Musculoskeletal Infection
Lalam, R., et al. - Appendicular skeletal infection includes osseous and extraosseous infections. Skeletal infection needs early diagnosis and appropriate management to prevent long-term morbidity. Magnetic resonance imaging is the best imaging modality to diagnose skeletal infection early in most circumstances. This article describes the role of magnetic resonance imaging in relation to the other available imaging modalities in the diagnosis of skeletal infection [more...]

Topics in Magnetic Resonance Imaging, 08/24/07

Arthroscopy and Endoscopy of the Foot and Ankle: Indications for New Techniques
Lui, T.H., et al. - The scope of arthroscopy and endoscopy of the foot and ankle is expanding. New techniques are emerging to deal with diverse ankle pathology. Some of the conditions that can be dealt with arthroscopically are as follows: hallux valgus deformity, lesser toe deformity, first metatarsophalangeal instability, cock-up deformity of the big toe, peroneal tendon instability, lateral ankle and subtalar instability, hindfoot deformity or arthrosis, first metatarsocuneiform hypermobility, Lisfranc joint arthrosis, various stages of posterior tibial tendon insufficiency, foot and ankle arthrofibrosis, late complications after calcaneal fracture, acute and chronic Achilles tendon rupture, insertional Achilles tendinopathy, entrapment of the first branch of the lateral plantar nerve, Freiberg?s infarction, flexor digitorum longus tenosynovitis, flexor hallucis longus pathology, calcaneonavicular coalition or ?too-long? anterior process of the calcaneus, and ganglions [more...]

Arthroscopy, 08/24/07

Growth in early life predicts bone strength in late adulthood: The Hertfordshire Cohort Study
Oliver, H., et al. - Infant growth is a determinant of adult bone mass, and poor childhood growth is a risk factor for adult hip fracture. Peripheral quantitative computed tomography (pQCT) allows non-invasive assessment of bone strength. We utilised this technology to examine relationships between growth in early life and bone strength.We studied 313 men and 318 women born in Hertfordshire between 1931 and 1939 who were still resident there in adult life, for whom detailed early life records were available. [more...]

Bone , 08/24/07

Molecular Imaging: Integration of Molecular Imaging into the Musculoskeletal Imaging Practice
Biswal, S., et al. - Chronic musculoskeletal diseases such as arthritis, malignancy, and chronic injury and/or inflammation, all of which may produce chronic musculoskeletal pain, often pose challenges for current clinical imaging methods. The ability to distinguish an acute flare from chronic changes in rheumatoid arthritis, to survey early articular cartilage breakdown, to distinguish sarcomatous recurrence from posttherapeutic inflammation, and to directly identify generators of chronic pain are a few examples of current diagnostic limitations. There is hope that a growing field known as molecular imaging will provide solutions to these diagnostic puzzles [more...]

Radiology, 08/23/07

Radiopharmaceutical therapy of bone metastases with 89SrCl2, 186Re-HEDP and 153Sm-EDTMP: a dosimetric study using Monte Carlo simulation
Strigari, L., et al. - The aim of the paper is to calculate the dose to bone surface and bone volume using a Monte Carlo particle transport model and to give quantitative arguments for activity prescription.This study simulates the dose delivery process to skeletal metastases by bone surface- and bone volume-seeking radiopharmaceuticals. Dose distributions for three radiopharmaceuticals, 186Re-HEDP, 153Sm-EDTMP and 89SrCl2, frequently used for pain palliation therapies, were calculated using the EGSnrc Monte Carlo code [more...]

European Journal of Nuclear Medicine & Molecular Imaging, 08/23/07

Injuries associated with calcaneal fractures?An MRI assessment
Wansbrough, G., et al. - Twenty one consecutive isolated calcaneal fractures (mean age 46; range 19–75) were treated by open reduction and internal fixation. In 19 patients, MRI scans were undertaken at (mean) 7.5 weeks to assess the technical aspects of reduction and fixation, and identify associated soft tissue and tarsal injuries. Clinical outcome was assessed with a validated scoring system, and compared with the demonstrable injuries.Assessment of the intra-articular fracture reduction and screw position was obscured in a proportion of cases and for this reason MRI is not the technique of choice for to assessing the post-operative reduction [more...]

Foot and Ankle Surgery, 08/23/07

Para-articular Osteochondroma of the Knee
Rizzello, G., et al. - We report a case of para-articular chondroma located in the infrapatellar fat pad of the knee of a 42-year-old woman with a history of anterior knee pain and restricted range of motion. On clinical examination, a solid palpable mass in the infrapatellar region was detected. Radiography and computed tomography of the knee revealed the presence of 3 different ?popcorn?-like gross calcifications within Hoffa?s fat pad. Magnetic resonance imaging showed areas of signal intensity in Hoffa?s fat pad that were consistent with calcific nodules surrounded by chondral tissue [more...]

Arthroscopy, 08/23/07

Raman imaging of two orthogonal planes within cortical bone
Kazanci, M., et al. - The lamellar bone's strength is mainly affected by the organization of its mineralized collagen fibers and material composition. In the present study, Raman microspectroscopic and imaging analyses were employed to study a normal human femoral midshaft bone cube-like specimen with a spatial resolution of 1–2 m. Identical bone lamellae in both longitudinal and transverse directions were analyzed, which allowed us to separate out orientation and composition dependent Raman lines, depending on the polarization directions [more...]

Bone , 08/23/07

Post-exercise abdominal, subcutaneous adipose tissue lipolysis in fasting subjects is inhibited by infusion of the somatostatin analogue octreotide
Enevoldsen, L., et al. - To determine whether blockade of the exercise-induced increase in growth hormone (GH) secretion may affect the regional lipolytic rate in the post-exercise recovery period, the aim of the present experiments was to study the effect of infusion of the somatostatin analogue octreotide on the s.c., abdominal adipose tissue metabolism, before, during and after exercise in healthy, fasting, young male subjects [more...]

Clinical Physiology and Functional Imaging, 08/23/07

Estimating Head Circumference from Pediatric Imaging Studies An Improved Method
Vorperian, H.K., et al. - Head circumference (HC) is an important developmental measure used both clinically and in research. This paper advances a method to estimate HC from imaging studies when a direct HC-tape measurement cannot be secured. Unlike former approaches, the model takes into account the fact that growth is nonlinear, and that HC growth rates are sexually dimorphic [more...]

Academic Radiology, 08/22/07

Fourier transform infrared and Raman microspectroscopy and microscopic imaging of bone
Gourion-Arsiquaud, S., et al. - Interest is growing in the use of vibrational spectroscopic imaging (infrared and Raman) as a tool to observe changes in bone properties. These techniques allow simultaneous analysis of the properties of individual components of bone, as well as their interactions. They also provide spatial information that is essential for the analysis of heterogeneous tissue. These techniques may make it possible to determine the changes in bone that result in fragility and to assist with evaluation of potential therapies [more...]

Current Opinion in Orthopedics, 08/22/07

Unexpected finding of elevated glucose uptake in fibrous dysplasia mimicking malignancy: contradicting metabolism and morphology in combined PET/CT
Stegger, L., et al. - Fibrous dysplasia is a common benign disorder of bone in which fibro-osseous tissue replaces bone spongiosa. Lesions have a typical appearance on computed tomography (CT) images and regularly show a markedly increased uptake in bone scintigraphy using 99mTc-labelled methylene diphosphonate (99mTc-MDP) as radiotracer. The glucose avidity of these lesions depicted by positron emission tomography (PET) using the radiolabelled glucose derivative 18F-fluoro-2-deoxy-glucose (FDG) is less well known since FDG-PET does not have a role in the assessment of this disease [more...]

European Radiology, 08/22/07

Suppression of heart rate variability after supramaximal exertion
Niewiadomski, W., et al. - Wingate test is short anaerobic exercise, performed with maximal power, whereas aerobic exercise at 85% maximal heart rate (HRmax) may be performed for long period. Sustained HR elevations and changes in autonomic activity indices have been observed after latter kind of exercise. Several studies reported reduction in mean interval between consecutive R peaks in ECG (RRI) 1 h after Wingate test; however, underlying changes in autonomic activity remain elusive [more...]

Clinical Physiology and Functional Imaging, 08/22/07

Significantly Improved Lumbar Arthroplasty Placement Using Image Guidance: Technical Note
Marshman, L., et al. - To compare the accuracy of lumbar total disc arthroplasty placement using an image-guidance system (IGS) with conventional fluoroscopy...Conclusion: This is the first clinical study to demonstrate significantly improved accuracy of lumbar total disc arthroplasty placement on CT using IGS compared with conventional fluoroscopy. IGS should be considered for routine use with lumbar total disc arthroplasty insertion [more...]

Spine, 08/22/07

Central fatigue of the first dorsal interosseous muscle during low-force and high-force sustained submaximal contractions
Eichelberger, T., et al. - The aim of this study was to compare the extent of central fatigue in the first dorsal interosseous (FDI) muscle of healthy adults in low, moderate and high-force submaximal contractions. Nine healthy adults completed four experimental sessions where index finger abduction force was recorded during voluntary contractions and in response to brief trains (five pulses at 100 Hz) of electrical stimulation. The ability to maximally activate FDI under volition, or voluntary activation, and its change with sustained activity (central fatigue) was assessed using the twitch interpolation technique [more...]

Clinical Physiology and Functional Imaging, 08/21/07

The Role of Post-Reduction Radiographs After Shoulder Dislocation
Kahn, J.H., et al. - We sought to determine whether post-reduction radiographs add clinically important information to what is seen on pre-reduction X-rays in Emergency Department (ED) patients with anterior shoulder dislocations. In this prospective, observational study, clinicians recorded preliminary pre-reduction and post-reduction X-ray readings on patients with shoulder dislocations [more...]

Journal of Emergency Medicine, 08/21/07

Venous thromboembolism in acute spinal cord injury patients
Shyam, S., et al. - Conclusions : There is a much lower incidence (10%) of DVT and PE following spinal cord injury (SCI) in India than what is reported from the western countries. Higher age group and quadriplegia were the only factors which could be correlated. Deep vein thrombosis extending proximal to the knee was significant. In the absence of autopsy and other screening tests like D-dimer test or 125I fibrogen uptake study, the true incidence of venous thromboembolism remains uncertain. Noninvasive screening of all patients for the detection of deep vein thrombosis in SCI patients is strongly recommended [more...]

Indian Journal of Orthopaedics, 08/20/07

Muscle metaboreflex contribution to resting limb haemodynamic control is preserved in older subjects
Roseguini, B., et al. - Ageing is associated with tonic elevations in basal sympathetic vasoconstrictor outflow to skeletal muscle and a parallel decline in vascular function. The purpose of this study was to test the hypothesis that older individuals exhibit attenuated calf vascular resistance (CVR) responses to muscle metaboreflex activation in comparison with young subjects...Conclusion: older subjects have similar BP and calf haemodynamic responses to static handgrip exercise and selective action of the muscle metaboreflex when compared with young subjects, compatible with preserved muscle metaboreflex contribution to resting limb haemodynamic control with ageing in humans [more...]

Clinical Physiology and Functional Imaging, 08/20/07

Validation of a radiographic damage index in chronic gout
Dalbeth, N., et al. - To identify a valid method to measure radiographic damage in patients with chronic gout...Conclusion: A modified Sharp/van der Heijde system accurately and reliably represents radiographic joint damage in chronic gout [more...]

Arthritis Care and Research , 08/17/07

Single-Site vs Multisite Bone Density Measurement for Fracture Prediction
Leslie, W.D., et al. - Bone density measurement with dual-energy x-ray absorptiometry is widely used for fracture risk assessment. Discordance between measurement sites is common, but it is unclear how this affects fracture prediction...Conclusions: Proximal femur bone density measurements consistently outperformed lumbar spine measurements for global fracture prediction. In this cohort, the total hip was the best site for overall fracture assessment [more...]

Archives of Internal Medicine, 08/16/07

Magnetic Resonance Imaging of Spinal Infection
Tins, B.J., et al. - This article reviews the pathophysiology of spinal infection and its relevance for imaging. Magnetic resonance imaging (MRI) is the modality with by far the best sensitivity and specificity for spinal infection. The imaging appearances of spinal infection in MRI are outlined, and imaging techniques are discussed. The problems of clinical diagnosis are outlined. There is some emphasis on the MRI differentiation of pyogenic and nonpyogenic infection and on the differential diagnosis of spinal infection centered on the imaging presentation [more...]

Topics in Magnetic Resonance Imaging, 08/15/07

MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome
Kong, A., et al. - Greater trochanteric pain syndrome is commonly due to gluteus minimus or medius injury rather than trochanteric bursitis. Gluteal tendinopathy most frequently occurs in late-middle aged females. In this pictorial review the pertinent MRI and US anatomy of the gluteal tendon insertions on the greater trochanter and the adjacent bursae are reviewed. The direct (peritendinitis, tendinosis, partial and complete tear) and indirect (bursal fluid, bony changes and fatty atrophy) MRI signs of gluteal tendon injury are illustrated. The key sonographic findings of gluteal tendinopathy are also discussed [more...]

European Radiology, 08/14/07

Shoulder: What the Orthopaedic Doctor Needs to Know
Vanderbeck, J., et al. - Diagnosing shoulder pathology accurately requires both clinical expertise and the ability to interpret and correlate radiographic studies. Variational anatomy of the shoulder combined with the complexity of physical examination makes this difficult. Physical examination of the shoulder often leaves the surgeon with more than one working diagnosis. Imaging studies of the shoulder are more valuable if used to confirm a working diagnosis as opposed to reading the study in a vacuum [more...]

Seminars in Musculoskeletal Radiology, 08/14/07

Role of Magnetic Resonance Imaging in Musculoskeletal Trauma
Ahn, J.M., et al. - This review discusses the role and applications of MR imaging for musculoskeletal trauma. It covers traumatic conditions of the musculoskeletal system, including hemarthrosis, lipohemarthrosis, stress fracture, occult fractures, cartilage injuries, the muscle and tendon trauma, avulsion injuries, extensor mechanism injuries, and traumatic conditions of joints [more...]

Topics in Magnetic Resonance Imaging, 08/13/07

The Role of Magnetic Resonance Imaging in the Early Diagnosis of Rheumatoid Arthritis
Ashikyan, O., et al. - Rheumatoid arthritis (RA) is a common disease that affects 1% of the population. With the advent of disease-modifying therapies, it became particularly important to detect RA as early as possible. In this article, we discuss the role of magnetic resonance imaging (MRI) in the imaging of early RA. Imaging of soft tissues manifestations, which precede the development of osseous erosions, is discussed. We also review the role of MRI in establishing correct diagnosis in cases of arthritis, which do not demonstrate classical clinical presentation. The role of MRI in the follow-up of RA is addressed [more...]

Topics in Magnetic Resonance Imaging, 08/13/07

Cartilage lesions of the glenohumeral joint: diagnostic effectiveness of multidetector spiral CT arthrography and comparison with arthroscopy
Lecouvet, F., et al. - This study assessed the diagnostic effectiveness of multidetector spiral CT arthrography (MDCTa) in detecting hyaline cartilage abnormalities of the shoulder joint, with correlation to arthroscopy...Conclusion: MDCTa is accurate for the study of cartilage surface in the entire shoulder joint. This technique may beneficially impact patient's management by means of selecting the proper treatment approach [more...]

European Radiology, 08/13/07

Imaging of giant cell tumor of bone
Shaligram, P., et al. - Giant cell tumor (GCT) of bone is a benign but locally aggressive and destructive lesion generally occurring in skeletally mature individuals...This review demonstrates a spectrum of these features and describes the imaging characteristics of GCT in conventional radiographs, computerized tomography scans, magnetic resonance imaging, bone scans, positron emission tomography scans and angiography [more...]

Indian Journal of Orthopaedics, 08/13/07

Phalangeal quantitative ultrasound measurements in former pre-term children aged 9?11 years
Halaba, Z.P., et al. - There were no significant differences in values of Ad-SoS, weight and height between patients and controls irrespective of birth weight or prematurity. In conclusion, phalangeal ultrasound measurements performed in prematurely born infants show that at the age of 9–11 years their bone status does not differ from children born at term [more...]

British Journal of Radiology, 08/13/07

Pediatric skeletal trauma - Plain film to MRI
Hussain, H.M., et al. - The unique features of children?s growing skeletons create challenges in imaging pediatric skeletal trauma and can lead to characteristic injuries and fractures. Some cases require only plain film evaluation, while others need additional imaging modalities, most often CT and magnetic resonance imaging (MRI). The authors review types of pediatric skeletal trauma, the relevant findings on plain film, CT, and MRI, and the advantages of CT and MRI in this setting [more...]

Applied Radiology, 08/10/07 Free Full Text   Registration Required   

Can low-dose computed tomographic scan of the spine replace conventional radiography? An evaluation based on imaging myelomas, bone metastases, and fractures from osteoporosis
Chassang, M., et al. - We evaluated and compared the radiological images of the spine of 111 patients affected by myeloma, bone metastases, and fractures secondary to osteoporosis demonstrated in low-dose computed tomographic (CT) scans and those demonstrated in conventional radiographic studies [more...]

Clinical Imaging, 08/10/07

Increased Uptake in a Vertebral Bone Island Seen Only on SPECT
Achong, D.M., et al. - Skeletal scintigraphy may be performed to evaluate a suspected bone island. In general, a bone island does not demonstrate increased uptake on bone scan. A case of increased uptake in a lumbar vertebral body bone island seen on SPECT, but not conventional planar imaging, is presented [more...]

Clinical Nuclear Medicine , 08/10/07

Imaging of knee osteoarthritis: data beyond the beauty
Eckstein, F., et al. - The semi-quantitative and quantitative tools for analysis of articular structure are now available and permit comprehensive analysis of morphological and compositional tissue changes in osteoarthritis. These changes will need to be related to clinical outcomes (e.g. how a patient feels or functions) with current epidemiological studies, such as the Osteoarthritis Initiatives, providing the opportunity for clinical validation of these imaging biomarkers [more...]

Current Opinion in Rheumatology, 08/10/07

Preoperative templating of femoral components on plain X-rays: Rotational evaluation with synthetic X-rays on ORTHODOC
Hananouchi, T., et al. - Preoperative femoral templating for total hip arthroplasty (THA) has been performed by antero-posterior radiographs of both hips which should be taken with the femur rotated internally to reduce the effect of femoral anteversion...We suggest that when templating femoral stem, this criterion "the TLT is less than 5 mm" reduces some risks by inappropriate rotated radiograph [more...]

Archives of Orthopaedic and Trauma Surgery, 08/10/07

Knee MR Images: What the Orthopaedic Surgeon Needs to Know
Khoury, L., et al. - Ideally, the orthopaedic surgeon works together with the radiologist in order to understand and contextualize the data obtained from a knee magnetic resonance imaging study. In this article we review the information most useful to the practice of orthopaedic surgery obtained from these MRI scans, including sections on ligaments, menisci, articular cartilage, limb alignment, bone, and surrounding soft tissues [more...]

Seminars in Musculoskeletal Radiology, 08/09/07

MRI in acute spinal trauma
Hollingshead, M.C., et al. - With its ability to directly evaluate all of the soft tissues of the spine, MRI plays a critical role in the evaluation of the trauma patient with ligamentous injury and possible instability. This article discusses the use of MRI in acute spinal trauma. The recognition of soft tissue injuries impacts patient management, aids in surgical planning, and influences patient outcome [more...]

Applied Radiology, 08/08/07 Free Full Text   Registration Required   

The Mechanics Behind the Image: Foot and Ankle Pathology Associated with Gastrocnemius Contracture
Bowers, A.L., et al. - Here we describe the underlying biomechanical abnormalities and radiographic findings in these pathological conditions of the foot and ankle associated with gastroequinus contracture. An awareness and understanding of the pathomechanics should enable the radiologist to better appreciate the form and function associated with the image [more...]

Seminars in Musculoskeletal Radiology, 08/08/07

The Significance of Increased Fluid Signal on Magnetic Resonance Imaging in Lumbar Facets in Relationship to Degenerative Spondylolisthesis
Chaput, C., et al. - Conclusion: Large (>1.5 mm) facet effusions are highly predictive of degenerative spondylolisthesis at L4-L5 in the absence of measurable anterolisthesis on supine MRI. A clinically measurable facet effusion (>=1 mm) suggests the need for SLFE films to diagnose degenerative spondylolisthesis that can be missed with supine positioning on MRI [more...]

Spine, 08/08/07

Large series vindicates early MRI for the diagnosis of wrist pain following trauma
Sinha, R., et al. - Injuries to and around the wrist are of common occurrence. However, disability following these injuries both in the short and long term is common. Early accurate diagnosis is of paramount importance and in those who have no obvious injury, advice regarding mobilization is necessary. In this context, we put early MRI to the test to assess if there were advantages of early scanning. All patients who attended Casualty following a wrist injury and had normal plain films but a high index of clinical suspicion for an underlying injury underwent a MRI scan [more...]

Injury Extra, 08/08/07 Free Full Text   

Diagnostic Features of Fibrodysplasia (Myositis) Ossificans Progressiva on Bone Scan
Tulchinsky, M., et al. - Fibrodysplasia ossificans progressiva (FOP) is a rare, autosomal dominant disorder of connective tissue that leads to progressive, disabling heterotopic ossification in characteristic anatomic patterns. It is accompanied by pathognomonic congenital malformation of the great toes (or thumbs)-microdactyly...The case presented here is aimed at increasing familiarity with those typical diagnostic features, especially on bone scintigraphy [more...]

Clinical Nuclear Medicine , 08/08/07

Hip pain in adults: MR imaging appearance of common causes
Mengiardi, B., et al. - To determine the exact origin of hip pain can be challenging. Symptoms apparently originating from the hip may arise from the pelvis, the sacroiliac joint, the lumbar spine, periarticular structures such as muscles and bursae, or from unexpected sites such as the abdominal wall, the genitourinary tract, or the retroperitoneal space. This article reviews the differential diagnosis of hip pain arising from the hip and surrounding structures and the role of different imaging methods with emphasis on magnetic resonance imaging where most recent advances have occurred [more...]

European Radiology, 08/07/07

Intraobserver and Interobserver Reliability of Two Ultrasound Measures of Humeral Head Position in Infants with Neonatal Brachial Plexus Palsy
Vathana, T., et al. - Conclusions: Ultrasonographic examination of the shoulder in infants to assess for the position of the humeral head with respect to the scapula showed high intraobserver reproducibility and interobserver reliability. It is recommended as a reliable technique for evaluating shoulder position in infants with neonatal brachial plexus palsy [more...]

Journal of Bone and Joint Surgery, 08/07/07

A cross sectional study of requests for knee radiographs from primary care
Bedson, J., et al. - Conclusions: The features of radiographic OA are commonly reported in those patients over 40 whom GPs send for x ray. If OA is clinically suspected, radiologists appear to be more likely to report its presence. Further research into alternative models of referral and reporting might identify a more appropriate imaging policy in knee disorders for primary care [more...]

BMC Musculoskeletal Disorders, 08/07/07

Cross-Sectional Imaging of Internal Derangement of the Wrist with Arthroscopic Correlation
Khoury, V., et al. - Wrist arthroscopy has become an indispensable tool for the surgeon treating internal derangement of the wrist. The role of arthroscopy in both the diagnosis and treatment of intrinsic ligaments and triangular fibrocartilage complex (TFCC) pathology is well established...This article focuses on the role of cross-sectional imaging and arthroscopy in the evaluation and management of wrist internal derangement, namely of intrinsic ligaments and TFCC pathology [more...]

Seminars in Musculoskeletal Radiology, 08/07/07

MRI features of a primary thoracic epidural melanoma: a case report
Unal, B., et al. - We present the magnetic resonance imaging (MRI) findings on a patient with a primary thoracic extradural spinal malignant melanoma. MRI showed a well-defined T1-hyperintense mass that was mostly of low signal on T2-weighted images. Surgery confirmed the presence of a well-encapsulated black-colored lesion which proved to be a melanoma [more...]

Clinical Imaging, 08/07/07

Pediatric Elbow Trauma: An Orthopaedic Perspective on the Importance of Radiographic Interpretation
Jacoby, S.M., et al. - Radiographic interpretation of pediatric elbow trauma presents a daunting task for both the radiologist and treating orthopaedic surgeon. Proper radiographic diagnosis and appropriate intervention requires a thorough understanding and appreciation of developmental anatomy. As the pediatric elbow matures, it transitions from multiple cartilaginous anlagen through a predictable pattern of ossification and fusion [more...]

Seminars in Musculoskeletal Radiology, 08/06/07

The Radiology of Antibiotic-Impregnated Cement
Heffernan E.J., et al. - Conclusion: Although the radiologic appearances of antibiotic-impregnated polymethyl methacrylate (PMMA) and regular PMMA are identical, peculiarities in the position and morphology of antibiotic-impregnated cement, as illustrated in this review, usually enable the radiologist to differentiate between the two. Its presence indicates one of two things: Either infection was present at the time the PMMA cement was inserted, or there was a high potential for the development of local sepsis, such as in cases of an open fracture [more...]

American Journal of Roentgenology, 08/06/07

The Clinical Utility of Computed Tomography Compared to Conventional Radiography in Diagnosing Sacroiliitis. A Retrospective Study on 910 Patients and Literature Review
Geijer, M., et al. - Ankylosing spondylitis (AS) is a progressive, debilitating disease with complex symptoms, unclear etiology and pathogenesis, and difficult diagnosis...Conclusion: Our results indicate that the clinical utility of radiography for evaluation of sacroiliitis is limited. The high rate of inaccurate results should motivate the use of sectional imaging for its superior performance [more...]

Journal of Rheumatology, 08/06/07

Ultrasonographic findings of painful shoulders and correlation between physical examination and ultrasonographic rotator cuff tear
Kim, H.A., et al. - The most frequent US finding was effusion in the long head of the biceps tendon. Among the rotator cuff tendons, supraspinatus was the most frequently involved. Physical examination had low sensitivity and specificity for the detection of tendon tear. US examination leads to an anatomical diagnosis of shoulder pain in many patients. Whether the US examination of the painful shoulder improves its treatment should be investigated [more...]

Modern Rheumatology, 08/06/07

MRI of the Foot for Suspected Osteomyelitis: Improving Radiology Reports for Orthopaedic Surgeons
Liu, P.T., et al. - In this article we review the literature on MRI of pedal osteomyelitis, focusing on how radiologists can be most helpful to the orthopaedic surgeon if they review the pretest probability of disease, examine for secondary signs as well as primary signs of osteomyelitis, and grade their degree of suspicion when reporting these cases [more...]

Seminars in Musculoskeletal Radiology, 08/03/07

Usefulness of Temporal Subtraction Images for Identification of Interval Changes in Successive Whole-Body Bone Scans: JAFROC Analysis of Radiologists' Performance
Shiraishi, J., et al. - We evaluated the usefulness of temporal subtraction images obtained from two successive whole-body bone scans, in terms of improvement in radiologists'? diagnostic accuracy in detecting interval changes and of a reduction in reading time, by use of a jackknife free-response receiver operating characteristic (JAFROC) analysis method...Conclusions: Temporal subtraction imaging for successive whole-body bone scans has the potential greatly to assist radiologists by increasing both their accuracy and productivity [more...]

Academic Radiology, 08/03/07

Isolated lesion of the infraspinatus at the myotendinous junction: a new lesion
Tavernier, T.H., et al. - Conclusion: This isolated lesion of the infraspinatus at the myotendinous junction has not been previously described. It is recognized by its characteristic MRI appearance and is not generally seen on CT arthrograms, as there is no communication with the joint. Its natural history appears to be of a progression from edema to fatty degeneration with or without myotendinous retraction and scarring. Its etiology has not yet been clearly established [more...]

Clinical Imaging, 08/02/07

Musculoskeletal Neoplasia: Helping the Orthopaedic Surgeon Establish the Diagnosis
Parsons, T.W., et al. - The radiologist plays a key role as part of the diagnostic team, including providing crucial support for biopsy and staging. This article discusses a systematic approach in the evaluation and staging of musculoskeletal neoplasia from the perspective of supporting the orthopaedic surgeon [more...]

Seminars in Musculoskeletal Radiology, 08/02/07

The Reliability and Diagnostic Value of Radiographic Criteria in Sagittal Spine Deformities: Comparison of the Vertebral Wedge Ratio to the Segmental Cobb Angle
Tayyab, N.A., et al. - Conclusion. The segmental CA exhibited a higher degree of reliability than the vertebral WR. The apex vertebral WR exhibited the greatest amount of wedging in the Scheuermann's patients; whereas in the other groups it remained largely consistent with the adjacent vertebral WRs. An apex vertebral WR <=0.80 and/or a segmental CA of >=20[degrees] are highly associated with the clinical diagnosis of Scheuermann's kyphosis. If the segmental CA cannot be ascertained, the apex vertebral WR is a relatively strong reliable alternative, primarily with regards to Scheuermann's kyphosis [more...]

Spine, 08/02/07

Progression of Acetabular Periprosthetic Osteolytic Lesions Measured with Computed Tomography
Howie, D.W., et al. - Conclusions: There is considerable variation in the rates of progression of the size of osteolytic lesions around stable acetabular components. Lesion size and the progression of lesion size are generally related to polyethylene wear rates, higher patient activity levels, and larger-diameter femoral heads. Osteolytic lesions measuring >10 cm3 in volume are associated with a high rate of progression [more...]

Journal of Bone and Joint Surgery, 08/02/07

Magnetic Resonance Imaging of the Long Head of the Biceps Tendon: Benefit of Coplanar Image
Lin, A., et al. - Conclusion: Advantages included imaging of the intra-articular biceps tendon with least partial-volume effects, definition of SLAP lesions and the tendinous origin at the supraglenoid tubercle, depiction of intra-articular bicipital ruptures, and increased sensitivity and specificity for intra-articular lesions [more...]

Journal of Computer Assisted Tomography, 08/01/07

Traumatic Retroperitoneal Hematoma Illustrated on Tc-99m Methylene Diphosphonate Bone Scintigraphy in a Patient Presenting With a Fall
Van Nguyen, H., et al. - Retroperitoneal haematoma is rarely described in the context of bone scintigraphy, as it is usually an incidental discovery on bone scan carried out for another purpose. We report a case of a right retroperitoneal haematoma detected on Tc-99m-methylene diphosphonate bone scintigraphy taken in an elderly patient presenting with a mechanical fall and a right acetabular fracture [more...]

Clinical Nuclear Medicine , 08/01/07