Musculoskeletal Articles

Metatarsalgia: An ultrasound perspective
Gregg., et al. - Research on metatarsophalangeal joint instability and the plantar plate was conducted from May 2002 to May 2006. Along with plantar plate tears, we found a range of pathologies. This is a pictorial review of our experience [more...]

Australasian Radiology, 10/31/07

Discography: can pain in a morphologically normal disc be due to an adjacent abnormal disc?
Derincek, A., et al. - Symptomatic patients who had Magnetic Resonance Imaging findings of degenerative disc disease and who failed conservative treatment were identified. As a preoperative test, these patients underwent discography. The patients, who experienced pain with injection into a morphologically normal disc adjacent to a morphologically abnormal disc, were included in the study. These patients subsequently had repeat discograms, during which the adjacent abnormal disc was first anesthetized with 2% lidocaine and the discogram was repeated at the adjacent normal level [more...]

Archives of Orthopaedic and Trauma Surgery, 10/31/07

Imaging of painful solitary lesions of the sacrum
Peh., et al. - In patients with sacral pain, the painful symptoms may be caused by a variety of bony and soft tissue lesions. Benign lesions include giant cell tumour, neurogenic tumour, insufficiency fracture, infection and giant bone island. Malignant lesions include primary bone tumours, Ewing sarcoma, plasmacytoma, lymphoma and chordoma. Soft tissue tumours adjacent to or involving the sacrum may cause painful symptoms [more...]

Australasian Radiology, 10/30/07

Usefulness of muscle denervation as an MRI sign of peripheral nerve pathology
Lisle., et al. - Peripheral nerve disorders may be classified into compressive or entrapment neuropathies and non-compressive neuropathies. Muscle denervation recognized on MRI may be a useful sign in the diagnosis of peripheral nerve disorders. Acute or subacute denervation results in prolonged T2 relaxation time, producing increased signal in skeletal muscle on short tau inversion-recovery and fat-suppressed T2-weighted images [more...]

Australasian Radiology, 10/30/07

CT-guided interventions in orthopedics
Huch, K., et al. - In this study we present our experience with CT-guided interventions for musculoskeletal diseases. Technical details, advantages and disadvantages and the accuracy of the method are described...Conclusion: CT-guidance can substantially support diagnostic and therapeutic procedures in bone and soft tissues, especially if located in deep areas of the body, which are difficult to reach using open approaches [more...]

Archives of Orthopaedic and Trauma Surgery, 10/29/07

Classification of hyperspectral medical tongue images for tongue diagnosis
Zhi, L., et al. - Human tongue is one of the important organs of the body, which carries abound of information of the health status. The images of the human tongue that are used in computerized tongue diagnosis of traditional Chinese medicine (TCM) are all RGB color images captured with color CCD cameras currently. However, this conversional method impedes the accurate analysis on the subjects of tongue surface because of the influence of illumination and tongue pose [more...]

Computerized Medical Imaging and Graphics , 10/29/07

A 3D visualization tool for the design and customization of spinal braces
Fortin, D., et al. - A new tool was developed and validated on an X-ray dummy to allow personalized design and adjustment of spinal braces. The 3D visualization of the external trunk surface registered with the underlying 3D bone structures permits the clinicians to select pressure areas on the trunk surface for proper positioning of correcting pads inside the brace according to the patient's specific trunk deformities [more...]

Computerized Medical Imaging and Graphics , 10/29/07

Synovial knee affected in multiple hemangiomatosis
Perez, A.Z., et al. - Synovial hemangioma is a vascular lesion of joint cavities. It is a rare cause of pain and spontaneous hemarthrosis in the paediatric age group. It is often seen as an internal derangement of the knee. We present the case of a 37-year-old woman with a history of recurrent effusions of this joint. The MRI showed a soft tissue mass affecting the Hoffa?s fat pad and the synovial surrounding the patella. Other hemangiomas were detected in other sides of the body. Through arthroscopy, we eliminated all the pathological tissue of the knee. The patient remains asymptomatic after 1 year [more...]

Archives of Orthopaedic and Trauma Surgery, 10/29/07

Imaging findings of radiation-induced sarcoma of the head and neck
Makimoto, Y., et al. - We set out to retrospectively review the clinical and imaging features of patients with post-radiation sarcoma, especially in the head and neck region. We reviewed the records of 4194 patients with carcinoma of the head and neck region who had a history of radiation. They had undergone CT and/or MRI. Medical records were reviewed for the primary diagnosis, radiation history and latency period to the development of sarcoma. The patients included four men and two women with a mean age of 64.5 years [more...]

British Journal of Radiology, 10/26/07

Retrospective evaluation of radiotherapy in plantar fasciitis
Miszczyk, L., et al. - Plantar fasciitis is a common painful syndrome that is usually treated by irradiation with a fraction dose (fd) of 1 Gy up to a total dose (TD) of 6 Gy according to clinical experience. By analysing our experiences with numerous former patients, we have attempted to find the relationship between dose and effect [more...]

British Journal of Radiology, 10/26/07

Achilles Tendon After Percutaneous Surgical Repair: Serial MRI Observation of Uncomplicated Healing
Fujikawa, A., et al. - The purpose of this study was to prospectively explore the MRI features of normal healing of the expected residual tendon gap in the Achilles tendon after percutaneous surgical repair...Conclusion: The time course of the MR findings in the ruptured Achilles tendon after percutaneous surgical repair appears to reflect regular healing [more...]

American Journal of Roentgenology, 10/25/07

Reliability of knee extension and flexion measurements using the Con-Trex isokinetic dynamometer
Maffiuletti, N.A., et al. - The aim of this study was to evaluate the reliability of isokinetic and isometric assessments of the knee extensor and the flexor muscle function using the Con-Trex isokinetic dynamometer. Thirty healthy subjects (15 males, 15 females) were tested and retested 7 days later for maximal strength (isokinetic peak torque, work, power and angle of peak torque as well as isometric maximal voluntary contraction torque and rate of torque development) and fatigue (per cent loss and linear slope of torque and work across a series of 20 contractions) [more...]

Clinical Physiology and Functional Imaging, 10/25/07

Closed rupture of the extensor digitorum longus tendon: A case report and biomechanical analysis of rupture mechanism
Hattori, K., et al. - Closed subcutaneous rupture of the extensor digitorum longus tendon (EDL) has been rarely documented. We present a case report of a patient with closed subcutaneous rupture of EDL. To identify the site of tendon rupture, three-dimensional computed tomography (3D-CT) was performed. The 3D-CT (volume rendering) images indicated tendon rupture of EDL on the dorsal region of the left foot. To identify the mechanisms of EDL rupture we also performed a biomechanical study using three cadavers [more...]

The Foot, 10/25/07

Delayed Epiphyseal Closure in a Patient With [beta]-Thalassemia Major Complicated by Hypogonadotrophic Hypogonadism
Nguyen, Q.H., et al. - A 25-year-old man was referred for a bone scan to assess sacral pain on a background of [beta]-thalassemia major complicated by severe anemia. He required repeated blood transfusions resulting in iron overload, which was treated with long-term iron chelation therapy. This case illustrates the potential skeletal manifestations of thalassemia and its treatment as demonstrated on bone scintigraphy, which include alterations in skeletal development and maturation, particularly delayed epiphyseal closure as well as complications of severe osteoporosis [more...]

Clinical Nuclear Medicine , 10/25/07

Submandibular Gland Carcinoma With Unusual Widespread Bone Marrow Metastases Detected by Tc-99m MDP Bone Scan and FDG PET
Ko, H-L., et al. - We report a case of a 33-year-old woman with undifferentiated submandibular gland carcinoma, status post excision and external radiotherapy. Three years after radiotherapy, primary tumor control was considered to be satisfactory, but she complained of upper back pain. A Tc-99m MDP whole body bone scan was done and exhibited diffuse uptake in the axial skeleton and relatively decreased tracer uptake in the extremities. Positron emission tomography demonstrated increased F-18 FDG uptake over the whole spine and pelvis [more...]

Clinical Nuclear Medicine , 10/25/07

Axial Compression Frame for MRI of Thoracolumbar Spine
Choy, D.S.J., et al. - Our objective was to present a method of performing thoracolumbar MRI with intervertebral disk pressure at 150 kPa without the patient being seated...Conclusion: Spine MRI with compression is more physiologic and will produce a higher yield than standard supine MRI [more...]

American Journal of Roentgenology, 10/24/07

Rotator Cuff Impingement: Correlation Between Findings on MRI and Outcome After Fluoroscopically Guided Subacromial Bursography and Steroid Injection
Hambly, N., et al. - The purpose of this study was to describe the use of fluoroscopically guided subacromial bursography in the management of rotator cuff impingement and to correlate clinical outcome with preprocedural MRI findings...Conclusion: Imaging-guided subacromial steroid injection may be of benefit in the short-term management of clinically and MRI-proven subacromial impingement, with 83% of 69 patients reporting symptom relief at 6-month follow-up evaluation. Patients with shorter duration of symptoms and minor-grade MRI findings have improved outcome [more...]

American Journal of Roentgenology, 10/24/07

Estimation of thigh muscle cross-sectional area by dual-energy X-ray absorptiometry in frail elderly patients
Hansen, R.D., et al. - Conclusions: Assessment of sarcopenia by DXA midthigh slice is a potential low-radiation, accessible alternative to CT scanning of older patients. The errors inherent in this technique indicate, however, that it should be applied to groups of patients rather than to individuals or to evaluate the response to interventions [more...]

American Journal of Clinical Nutrition, 10/24/07

Simultaneous traumatic pseudoaneurysm and thrombosis of the popliteal artery after anterior cruciate ligament reconstruction
Janssen, R.P.A., et al. - Conclusion: Awareness of possible arterial complications after ACL reconstruction is essential for early diagnosis. Clinical symptoms of pain in the popliteal fossa and sensory deficits in lower leg and foot should prompt the physician to analyze possible injuries of the popliteal artery. The differential diagnosis should include compartment syndrome and deep venous thrombosis. Doppler examination as well as intact pedal arterial pulses are unreliable in diagnosing arterial lesions after ACL reconstruction. Contrast-, CT- or MRI-angiography are the diagnostic tools of choice [more...]

Injury Extra, 10/24/07 Free Full Text

Cutaneous Malignant Melanoma Showing Extraosseous Accumulation of Tc-99m MDP in a Metastatic Inguinal Lymph Node on Bone Scintigraphy
Ak, I., et al. - We report a case of cutaneous malignant melanoma that showed extraosseous accumulation of Tc-99m MDP in a metastatic lymph node. The patient was a 61-year-old man with histopathologically proven cutaneous malignant melanoma in his left foot. Bone scintigraphy demonstrated extraosseous Tc-99m MDP accumulation in a left inguinal lymph node as a hyperactive focus. The histopathological diagnosis was lymphatic infiltration of malignant melanoma to the left inguinal lymph node. There have been a few cases showing abnormal extraosseous accumulation of Tc-99m MDP in malignant melanoma lesions in soft tissue [more...]

Clinical Nuclear Medicine , 10/24/07

MRI Quantitative Morphologic Analysis of Patellofemoral Region: Lack of Correlation with Chondromalacia Patellae at Surgery
Endo, Y., et al. - In numerous studies, the morphologic features of the patellofemoral joint have been analyzed on radiographs...Conclusion: The results of our study with MRI confirmed many previous radiographic findings. Although we did not find correlation between the presence of chondromalacia patellae and the patellofemoral indexes we analyzed, it is possible that the results of further investigations incorporating different grades of chondromalacia and different locations along the patellar articular surface may lead to further insight regarding the morphologic risk factors for chondromalacia patellae [more...]

American Journal of Roentgenology, 10/24/07

MRI of Quadratus Femoris Muscle Tear: Another Cause of Hip Pain
O'Brien, S.D., et al. - Conclusion: MRI is an important tool in assisting clinicians to make a correct diagnosis for the patient who presents with hip pain. Although quadratus femoris muscle tear is an uncommon injury, radiologists should be aware of this entity to assist with making a diagnosis that is usually unsuspected clinically [more...]

American Journal of Roentgenology, 10/23/07

IDEAL Imaging of the Musculoskeletal System: Robust Water?Fat Separation for Uniform Fat Suppression, Marrow Evaluation, and Cartilage Imaging
Gerdes, C.M., et al. - Conclusion: The IDEAL technique provides uniform fat saturation even in complex magnetic environments and simultaneously produces in-phase and opposed-phase images that may be useful for characterization of osseous lesions. The IDEAL water–fat separation method is highly versatile and has been successfully combined with T1-weighted, T2-weighted, steady-state free precession, and spoiled gradient-recalled echo techniques to produce high-quality MR images in clinically acceptable scanning times [more...]

American Journal of Roentgenology, 10/23/07

Communicating Foramen Between the Tendon Sheaths of the Extensor Carpi Radialis Brevis and Extensor Pollicis Longus Muscles: Imaging of Cadavers and Patients
Cvitanic, O.A., et al. - The purpose of this study was to examine the anatomic features and imaging appearance of the intersection of the extensor pollicis longus (EPL) tendon with the extensor carpi radialis brevis (ECRB) and longus (ECRL) tendons in cadavers and patients...Conclusions: A normal foramen exists between the sheaths of the EPL and ECRB tendons where they intersect in the wrist. Such foramina allow synovial fluid to communicate between the tendon sheaths and probably account for the high prevalence of tenosynovitis in more than one tendon on clinical MRI studies [more...]

American Journal of Roentgenology, 10/23/07

Anatomy of the Urethral Supporting Ligaments Defined by Dissection, Histology, and MRI of Female Cadavers and MRI of Healthy Nulliparous Women
Sayed, R.F.E., et al. - Conclusion: Our results present evidence that may help resolve previous controversies regarding the MR appearance of the ventral urethral ligaments and that better define the course of the ligament dorsal to the urethra, the suburethral ligament. We hope that this detailed anatomic information about the structures involved in continence may lead eventually to improvements in the treatments for women with stress urinary incontinence [more...]

American Journal of Roentgenology, 10/23/07

Finger tendon disease in untreated early rheumatoid arthritis: A comparison of ultrasound and magnetic resonance imaging
Wakefield, R.J., et al. - Conclusion: This is the first study to compare US and MRI for the detection of tenosynovitis in the fingers of patients with early untreated RA. Tenosynovitis was found to be common using both modalities, with MRI being more sensitive. A negative US scan does not exclude inflammation and an MRI should be considered. Further work is recommended to standardize definitions and image acquisition for both US and MRI images [more...]

Arthritis Care and Research , 10/23/07

Magnetic resonance imaging of skeletal muscle
Koltzenburg, M., et al. - Magnetic resonance imaging supplements investigations for the differential diagnosis of neuromuscular diseases. An advantage over routine neurophysiological or histopathological methods is that they are operator-independent, non-invasive and painless. Magnetic resonance imaging also has the advantage of providing a lasting detailed topographical picture of regional variations and allows robust measurements of muscle volume and various functional parameters [more...]

Current Opinion in Neurology, 10/22/07

Biomarkers predict radiographic progression in early rheumatoid arthritis and perform well compared with traditional markers
Young-Min, S., et al. - Conclusion: These results indicate that biochemical markers are useful predictors of radiographic progression in RA and that serum MMP-3 levels decrease significantly with MTX therapy. Multivariate models that include MMP-3 and CTX-II perform better than existing traditional markers in predicting radiographic outcome in RA [more...]

Arthritis & Rheumatism, 10/22/07

CT-guided sacroplasty for the treatment of sacral insufficiency fractures
Silver, D.A.T., et al. - The paper by Heron and colleagues describes the treatment of sacral insufficiency fractures using computed tomography (CT)-guided sacroplasty. The authors describe a relatively new use for percutaneous cement augmentation for treating symptomatic sacral insufficiency fractures. Current literature is growing on this technique but is dominated by case reports, as has been the case for vertebroplasty to date, with relatively few prospective studies. In the recent meta-analysis of published literature between 1983 and 2004 by Hadjipavlou et al., there were only eight identified prospective studies, which were non-randomized [more...]

Clinical Radiology, 10/19/07

MRI of overuse injury in elite athletes
Koh, E.S., et al. - Conclusion: Overuse injuries are common in athletes of all levels, particularly elite athletes. MRI is the optimal technique for imaging overuse injuries because of its sensitivity to early injury and wide field of view, which may assist in the diagnosis of other overuse injuries or alternative pathology. Post-gadolinium imaging may be particularly helpful in identifying early inflammatory changes in this group of patients. Careful review of each functional anatomical unit and awareness of the associated pathologies may assist diagnosis of injuries related to overuse in elite athletes, as well as sportsmen and women of all levels [more...]

Clinical Radiology, 10/19/07

Hand bone densitometry: a more sensitive standard for the assessment of early bone damage in rheumatoid arthritis
Haugeberg, G., et al. - To examine the role of hand dual-energy x ray absorptiometry (DEXA) compared with radiography in the assessment of bone involvement in patients with early rheumatoid arthritis (RA) who have active disease...Conclusion: The study results indicate that hand DEXA is a more sensitive tool than radiology (radiographic joint-damage scores), for measuring disease-related bone damage in early RA [more...]

Annals of Rheumatic Diseases, 10/18/07

Inguinal pain with limping: Iliopectineal bursitis as first sign of polymyalgia rheumatica
Weber, M., et al. - An 83-year-old man presented with pain in his right groin, limping, and the ultrasound findings of an iliopectineal bursitis as the first sign of polymyalgia rheumatica. The systemic disease of polymyalgia rheumatica may begin with local signs caused by peripheral musculoskeletal inflammation. Ultrasound or magnetic resonance imaging (MRI) is appropriate in order to decide on early oral prednisolone [more...]

Joint, Bone, Spine, 10/17/07

Spontaneous Flexor Tendon Rupture of the Flexor Digitorum Profundus Secondary to an Anatomic Variant
Masaki, F., et al. - We report a case of the flexor digitorum profundus tendon rupture of the little finger, which was predisposed by an anatomic variation of the tendon. Intraoperative findings and magnetic resonance imaging of the opposite hand suggested that the flexor digitorum profundus tendons of the ring and the little finger bifurcated. The patient had tendon reconstruction and regained function [more...]

Journal of Hand Surgery, 10/17/07

CT-guided sacroplasty for the treatment of sacral insufficiency fractures
Heron, J., et al. - To describe the clinical presentation, procedure and outcome in patients treated with computed tomography (CT)-guided sacroplasty as a treatment for sacral insufficiency fractures...Conclusion: CT-guided sacroplasty represents an alternative treatment for sacral insufficiency fractures that are resistant to conservative treatment. The symptomatic relief the procedure produces seems to be excellent both in this small series and in described cases in the literature [more...]

Clinical Radiology, 10/17/07

Does extremity-MRI improve erosion detection in severely damaged joints? A study of long-standing rheumatoid arthritis using three imaging modalities
Freeston, J.E., et al. - Long-standing rheumatoid arthritis produces unique challenges when assessing damage due to joint deformity. The use of extremity magnetic resonance imaging (eMRI) offers the possibility of improved disease assessment because of greater patient tolerability...Conclusions: In severely damaged rheumatoid arthritis joints, sensitivity of erosion detection was markedly higher for eMRI-RV than radiography, using high field MRI as the reference. eMRI-RV was, however, less sensitive than high field MRI [more...]

Annals of Rheumatic Diseases, 10/17/07

Visual search behaviour in skeletal radiographs
Leong, J.J.H., et al. - Conclusions: Expert search behaviour exhibited higher accuracy and consistency whilst using less time fixating on fracture sites. This strategy conforms to the discovery and reflective phases of the global–focal model, where the reflective search may be implicated in the cross-referencing and conspicuity of the target, as well as the level of decision-making process involved. The effect of specialization appears to change the search strategy more than the effect of the length of training [more...]

Clinical Radiology, 10/16/07

Uptake characteristics of fluorodeoxyglucose (FDG) in deep fibromatosis and abdominal desmoids
Basu, S., et al. - In this preliminary report, we explore the uptake pattern of fluorodeoxyglucose (FDG) in fibromatosis and hypothesize the potential clinical role of FDG-positron emission tomography (PET) in the management of this benign but locally aggressive heterogeneous group of soft-tissue tumours. Five patients were studied (two men and three women, age range 23–35 years), among whom were three cases of deep musculoskeletal fibromatosis, one of abdominal fibromatosis (abdominal desmoid) associated with familial adenomatous polyposis (Gardner's syndrome) and one case of both deep musculoskeletal fibromatosis and abdominal desmoid [more...]

British Journal of Radiology, 10/16/07

The Reproducibility of Radiographic Measurement of Lateral Meniscus Horn Position
Wilmes, P., et al. - The objective of our investigation was to evaluate whether it is possible to locate and reproduce the tibial insertion areas of the anterior and posterior horns of the lateral meniscus on preoperative radiographs...Conclusions: Anterior and posterior lateral meniscus horn insertions can be determined on radiographs with a high precision and reproducibility [more...]

Arthroscopy, 10/16/07

Decompression of idiopathic symptomatic epidural lipomatosis of the lumbar spine
Min, W.-K., et al. - Epidural lipomatosis has been implicated as a cause or contributor of symptomatic lumbar spinal stenosis. Symptomatic spinal epidural lipomatosis (SEL) of the lumbar spine is a rare disease, often associated with steroid overload. Idiopathic lipomatosis is even much less frequent. Signs and symptoms depend upon the level and degree of nerve root compression. Diagnosis is best based on MRI [more...]

Joint, Bone, Spine, 10/16/07

Multislice Computed Tomography for Evaluating Acetabular Defects in Revision THA
Eduardo, G.-C., et al. - Acetabular bone defects influence acetabular revision surgery, but plain radiographs provide limited information about the osteolytic lesions. Multislice computed tomography may show the volume and location of osteolytic cavities in patients with failed cups more accurately than plain radiographs. We asked whether multislice computed tomography with metal artifact minimization could calculate the volume and location of pelvic osteolysis associated with a failed cup [more...]

Clinical Orthopedics and Related Research, 10/15/07

Multiple vertebral osteonecrosis
Javier, R.-M., et al. - Vertebral osteonecrosis classically presents with an intravertebral vacuum cleft phenomenon or a fluid-filled cleft on MR images. These clefts are usually found in older patients presenting with more severe fractures, more significant collapse and instability. Therefore, although considered for a long time as pathognomonic for vertebral osteonecrosis, vertebral clefts are now considered to represent fracture non-union [more...]

Joint, Bone, Spine, 10/12/07

Pulmonary Cement Embolism: A Complication of Percutaneous Vertebroplasty
Duran, C., et al. - To determine the frequency of pulmonary cement embolism after percutaneous vertebroplasty...Conclusion: An incidence of pulmonary cement embolism of 6.8% during PV was found. Close clinical follow-up, postprocedural chest radiographs, and chest CT scans, if necessary, are important for the detection of pulmonary cement embolism at an early stage [more...]

Acta Radiologica, 10/11/07

Diagnostic Efficacy in Knee MRI Comparing Conventional Technique and Multiplanar Reconstruction with One-Millimeter FSE PDW Images
Yoon, Y.C., et al. - To compare the performance of a 1-mm-thickness fast spin-echo (FSE) proton-density-weighted (PDW) MR imaging technique with multiplanar reconstruction (MPR) in diagnosing tears of the menisci and cruciate ligaments with that of conventional MR imaging...Conclusion: 1-mm-slice-thickness FSE PDW imaging with MPR showed comparable performance in diagnosing tears of the cruciate ligaments and menisci to conventional sequences but the scan time was much shorter. Therefore, this technique (method B) might improve the throughput of a 3T MR imaging system [more...]

Acta Radiologica, 10/11/07

Surgical outcome of thoracic myelopathy secondary to ossification of ligamentum flavum
Park, B.-C., et al. - Conclusion: OLF is a rare cause of thoracic myelopathy. The frequency appears to have been rarely reported in South Korean subjects. CT with sagittal reconstructions and MRI are helpful for diagnosis and spinal cord involvement. When neurologic symptoms develop, decompressive laminectomy should be done immediately and the surgical outcome is generally good if hyperintense intramedullary signal changes of spinal cord have not yet developed [more...]

Joint, Bone, Spine, 10/10/07

The Utility of Dynamic Flexion-Extension Radiographs in the Initial Evaluation of the Degenerative Lumbar Spine
Hammouri, Q.M., et al. - To assess the utility of lateral dynamic flexion-extension radiographs in the initial evaluation of the degenerative lumbar spine...Conclusion: In the population studied, dynamic radiographs did not significantly alter the initial course of clinical management beyond standing AP and lateral lumbar images [more...]

Spine, 10/10/07

Dynamic Magnetic Resonance Imaging of the Cervical Spine Using the NeuroSwing System
Schlamann, M., et al. - Routine MR examinations of the cervical spine might be insufficient in the diagnosis of a stenotic problem of the spinal canal, especially when symptoms only occur in a specific position...Conclusion: Real-time dynamic examination of the cervical spine might be a useful supplement to the conventional static examination and may allow a more precise allocation of symptoms in some patients [more...]

Spine, 10/09/07

Navigation Reduces the Learning Curve in Resurfacing Total Hip Arthroplasty
Cobb, J.P., et al. - Hip resurfacing is a novel technique with a substantial learning curve resulting in poor outcomes for many patients. We asked whether navigation would influence this learning curve and accuracy of implantation. Twenty medical students earning their degree in surgical technology participated in a randomized trial. We provided instruction about the surgical technique, including the use of conventional instrumentation, the use of a computed tomography-based planner for hip resurfacing, and a navigation system [more...]

Clinical Orthopedics and Related Research, 10/08/07

Asymmetric Atrophy of Multifidus Muscle in Patients With Unilateral Lumbosacral Radiculopathy
Hyun, J.K., et al. - To evaluate quantitatively the asymmetry of multifidus muscles in unilateral lumbosacral radiculopathy with disc herniation (herniated intervertebral disc; HIVD) by using magnetic resonance imaging (MRI)...Conclusion: Asymmetry of the multifidus muscles as seen in MRI was a useful finding to assess patients who had unilateral lumbosacral radiculopathy with HIVD. This may reflect the denervation of multifidus muscles in lumbosacral radiculopathy [more...]

Spine, 10/08/07

Spinal Cord Morphology and Dynamics During Cervical Laminoplasty: Evaluation With Intraoperative Sonography
Mihara, H., et al. - Conclusion: Intraoperative sonography during laminoplasty appears to be very useful for evaluating spinal cord decompression status. Our original classification system based on restoration patterns of the space ventral to the spinal cord is considered to be practical for predicting neurologic improvement in cervical compressive myelopathy [more...]

Spine, 10/08/07

Adductor-Related Groin Pain in Competitive Athletes
Schilders, E., et al. - Conclusions: A single entheseal pubic cleft injection can be expected to afford at least one year of relief of adductor-related groin pain in a competitive athlete with normal findings on a magnetic resonance imaging scan; however, it should be employed only as a diagnostic test or short-term treatment for a competitive athlete with evidence of enthesopathy on magnetic resonance imaging [more...]

Journal of Bone and Joint Surgery, 10/08/07

Reliability of Histopathologic and Radiologic Grading of Cartilaginous Neoplasms in Long Bones
Jones, K.B., et al. - Conclusions: This study demonstrates low reliability for the grading of cartilaginous lesions in long bones, even among specialized and experienced pathologists and radiologists. This included low reliability both in differentiating benign from malignant lesions and in differentiating high-grade from low-grade malignant lesions, both of which are critical to the safe treatment of these neoplasms. This may explain in part the wide variation in outcomes reported for chondrosarcomas treated in different medical centers [more...]

Journal of Bone and Joint Surgery, 10/08/07

A pediatric case of pyomyositis presenting with septic pulmonary emboli
Yuksel, H., et al. - Pyomyositis is a suppurative infection of skeletal muscle most commonly caused by Staphylococcus aureus. It is mainly encountered in children and immunocompromised. Eight year old previously healthy girl presented with confusion, fever and swelling of the right knee two days after a trauma. Abdominal ultrasonography and computerized tomography taken upon development of hematemesis revealed no pathology in the abdomen, but potential bleeding sites in lung sections [more...]

Joint, Bone, Spine, 10/05/07

Positioning of the wrist for scaphoid radiography
Toth, F., et al. - The purpose of this cadaver study was to determine the ideal position of the wrist for scaphoid radiography...Conclusion: We concluded that our four views are sufficient for proper radiographic evaluation of the scaphoid [more...]

European Journal of Radiology, 10/05/07

Superior Bennett Lesion: A Bone Fragment at the Posterosuperior Glenoid Rim in 5 Athletes
Nakagawa, S., et al. - In throwing athletes, a Bennett lesion is a bony spur that usually forms at the posteroinferior glenoid rim and sometimes becomes painful. We encountered superior Bennett lesions in the shoulders of 5 athletes, which were detected at the posterosuperior glenoid rim as a separate bone fragment. In all 5 athletes this lesion appeared to be the main cause of shoulder pain during throwing or overhead activity. The lesions were easily visualized on plain radiographs (axial view, scapular Y view, and 45° craniocaudal view) or computed tomography scans [more...]

Arthroscopy, 10/04/07

What Is the Relationship of Low Back Pain to Signs of Abnormal Skeletal Metabolism Detected by Bone Scans?
Breuer, B., et al. - In approximately 80–85% of patients with chronic nonspecific low back pain (NSLBP), a precise pathoanatomical diagnosis cannot be identified. Mechanisms of bone nociception may contribute to NSLBP...Conclusion: Further studies should be conducted on possible mechanisms relating bone nociception to chronic NSLBP in individuals who are 65 years or younger [more...]

Pain Medicine, 10/04/07

Faecal incontinence as presentation of an ependymomas of the spinal cord
Jeyarajah, S., et al. - Conclusions: Suspicion for non-colonic causes for faecal incontinence should arise when there is absence of other etiologic factors. Establishment of the diagnosis of spinal tumours is with neurological examination and MRI spine [more...]

BMC Musculoskeletal Disorders, 10/03/07

Assessing the Range of Cervical Rotation in Patients With Rheumatoid Arthritis After Atlantoaxial Screw Fixation Using Axial CT
Sugimoto, Y., et al. - To assess range of cervical rotation possible after atlantoaxial fixation in rheumatoid arthritis (RA) patients using axial CT...Conclusion. All 19 patients with RA and atlantoaxial instability in our study had relief of pain and a significant decrease in the C1-T1 rotation angle after atlantoaxial fixation. Subaxial rotation did not change from before to after the operation [more...]

Spine, 10/03/07

Radiographic geometric measures of the hip joint and abductor muscle function in patients after total hip replacement
Amaro, A.J., et al. - The aim of this study was to evaluate the correlation between radiographic geometric measurements (abductor lever arm and abductor muscle length) and abductor muscle function in osteoarthritic hip joint patients after surgery. Thirteen patients (11 males and 2 females, aged 55 to 74 years old) were evaluated at least 6 months after unilateral total hip replacement due to primary coxarthrosis. The length of the abductor muscles and their lever arm were measured on standardized antero-posterior hip radiographs taken in supine position; the product of these two values, namely the dysfunction index (DI), was considered an estimate for the hip abductor torque [more...]

European Journal of Orthopaedic Surgery & Traumatology, 10/03/07

Intra-Extradural Plexiform Schwannoma of the Cervical Spine
Sakaura, H., et al. - To describe the clinical and radiographic features of an extremely rare case with intra-extradural plexiform schwannoma of the cervical spine...Conclusion: To the best of our knowledge, this is the first reported case of intra-extradural plexiform schwannoma. Careful magnetic resonance imaging might be helpful in suggesting this rare plexiform schwannoma before surgery [more...]

Spine, 10/02/07

The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study
Libicher, M., et al. - This study investigated the prevalence of the intravertebral vacuum phenomenon (IVP) and osteonecroses in vertebral compression fractures (VCFs). We therefore performed an histological analysis of biopsies obtained from VCFs prior to balloon kyphoplasty. Computed tomography (CT) scans were reviewed regarding the presence of an IVP (i.e. cleft sign, Kümmell disease). We reviewed the data of 266 consecutive patients treated by balloon kyphoplasty in 501 procedures from 2002 to 2004 [more...]

European Radiology, 10/02/07

Magnetic Resonance Imaging-Guided Percutaneous Biopsy of Musculoskeletal Lesions
Carrino, J.A., et al. - Conclusions: Magnetic resonance imaging-guided percutaneous biopsies of musculoskeletal lesions for which other imaging modalities might be inadequate have a good diagnostic performance overall. The performance can be very good for bone lesions, moderate for extra-articular soft-tissue lesions, and fair for intra-articular soft-tissue lesions [more...]

Journal of Bone and Joint Surgery, 10/02/07

S100 Proteins Calprotectin and S100A12 Are Related to Radiographic Changes Rather Than Disease Activity in Psoriatic Arthritis with Low Disease Activity
Madland, T.M., et al. - Conclusion: Calprotectin and S100A12 do not perform better than traditional biomarkers of disease activity in PsA, but were associated with presence of peripheral radiographic features in this cross-sectional study. The patients' low level of disease activity may have led to underestimation of the associations between any biomarker and disease measures [more...]

Journal of Rheumatology, 10/02/07

Quantitative Vertebral Fracture Detection on DXA Images Using Shape and Appearance Models
Roberts, M., et al. - Conclusion: The appearance and shape parameters of statistical models could provide more powerful quantitative classifiers of osteoporotic vertebral fracture, particularly mild fractures. False positive rates can be substantially reduced at high sensitivity by using an appearance-based classifier, because this can better distinguish between mild fractures and some kinds of non-fracture shape deformities [more...]

Academic Radiology, 10/01/07

Acute Spontaneous Spinal Subdural Hematoma Presenting as Paraplegia: A Rare Case
Kyriakides, A.E., et al. - Conclusion: Spinal subdural hematoma (SSDH) is uncommon and can be caused by abnormalities of coagulation, blood dyscrasias, or trauma, underlying neoplasm, and arteriovenous malformation. SSDH is very rare in the absence of these underlying conditions. It occurs most commonly in the thoracic spine and presents with sudden back pain radiating to the arms, legs or trunk, varying degrees of motor, sensory, and autonomic disturbances [more...]

Spine, 10/01/07

Local Metastases Along the Tract of Needle: A Rare Complication of Vertebroplasty in Treating Spinal Metastases
Chen, Y.J., et al. - Conclusion: To our knowledge, local metastasis after vertebroplasty in treating spinal metastases has not been reported in the literature. However, this may be a potential complication of vertebroplasty in treating spinal metastases as improvement in cancer treatments occurs with subsequent longer survival times [more...]

Spine, 10/01/07

Immuno-histological assessment of the synovial tissue in small joints in rheumatoid arthritis: validation of a minimally invasive ultrasound-guided synovial biopsy procedure
Scire, C.A., et al. - The aim of this study was to perform an immuno-histological assessment of the synovial tissue from involved small joints in rheumatoid arthritis (RA) and to explore the reliability of a mini-invasive ultrasound (US)-guided technique of small joints synovial biopsy for the histopathological assessment. Synovial tissue collected during arthrotomic surgery of small joints in 9 patients served as gold standard for the validation of the histological assessment. Small hand joint synovial biopsies from additional 9 patients with erosive RA were obtained by a mini-invasive US-guided procedure, performed percutaneously by portal and rigid forceps technique [more...]

Arthritis Research & Therapy, 10/01/07