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Skeletal Radiology

Ramon Balius, Carles Pedret, Iñigo Iriarte, Rubén Sáiz, Luis Cerezal
The ultrasound examination of hamstrings inspires respect due to the connective complexity of their structures, particularly for sonographers who are not used to this kind of study. Therefore, it is important to know the specific ultrasound reference points that facilitate the location of the hamstring structures, dividing them into four areas of interest: (a) tendinous origin of the hamstring, (b) the proximal half, (c) distal and medial half, and (d) distal and lateral half. The origin of the hamstrings is found at the level of the ischial tuberosity...
April 17, 2019: Skeletal Radiology
Ceylan Colak, Scott E Kilpatrick, Nathan W Mesko, Carl S Winalski
Myxofibrosarcoma is a malignant fibroblastic soft tissue neoplasm containing a variable amount of myxoid stroma that commonly presents as a slow-growing mass in elderly patients. The neoplasm may be superficial or deep to the muscle fascia and characteristically has an infiltrative growth pattern with a dominant or multinodular mass. We describe an unusual case of high-grade myxofibrosarcoma of the wrist and forearm that infiltrated the muscles, tendons, and wrist joint, causing bone erosions. The tumor was mistakenly diagnosed as synovitis and a chronic, erosive, inflammatory process...
April 15, 2019: Skeletal Radiology
A Ross Sussmann
Variations of the anatomy of the hamstring muscle complex are uncommon. In particular, absence of some or all of the hamstring muscles is rarely described in the literature. This report presents a case of absent semimembranosus musculature detected incidentally on knee magnetic resonance imaging (MRI), then found to be bilateral on MRI of both thighs performed shortly thereafter. Imaging also demonstrated atypical morphologies of the semitendinosus and biceps femoris muscles in both thighs.
April 15, 2019: Skeletal Radiology
Lara Barnsley, Les Barnsley
OBJECTIVE: The aim of this study was to compare the diagnostic accuracy of nuclear imaging modalities in the detection of aseptic loosening of total knee arthroplasty (TKA). MATERIALS AND METHODS: MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews were searched from database inception to December 2018 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies compared the results of a single imaging modality against an appropriate reference standard of prosthetic TKA loosening, with sufficient information to determine either sensitivity and/or specificity...
April 12, 2019: Skeletal Radiology
Ulas Akgun, Umut Canbek, Nevres Hurriyet Aydogan
OBJECTIVE: The aim of this study was to evaluate the sensitivity and specificity of radiographs in identifying incomplete atypical femoral fractures and to determine interobserver and intra-observer reliability. MATERIALS AND METHODS: Anterior-posterior and lateral radiographs of 10 femurs with incomplete atypical femoral fractures confirmed using bone scintigraphy and magnetic resonance imaging, and 40 femurs without incomplete atypical femoral fractures confirmed using bone scintigraphy, were reviewed by 4 orthopedic surgeons and 4 radiology specialists...
April 10, 2019: Skeletal Radiology
Eduardo Baptista, Eduardo A Malavolta, Mauro E C Gracitelli, Daniel Alvarenga, Marcelo Bordalo-Rodrigues, Arnaldo A Ferreira Neto, Nestor de Barros
OBJECTIVE: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) for detection of instability and tears of the proximal long head of biceps tendon (LHBT). To assess intraobserver and interobserver agreement. MATERIALS AND METHODS: We performed a retrospective analysis of prospectively collected data of 100 consecutive shoulders who underwent non-contrast 1.5-T MRI prior to arthroscopic surgery due to rotator cuff injury. Images were independently analyzed by two musculoskeletal radiologists...
April 2, 2019: Skeletal Radiology
E McLoughlin, A Iqbal, A Patel, S L James, Rajesh Botchu
OBJECTIVE: We describe a novel and safe needle-holding method that we have termed the 'dual steristrip technique'. This technique can be used to stabilize the bone biopsy needle without the need for the radiologist's hand to be in close proximity to the X-ray beam during CT-guided intervention. MATERIALS AND METHODS: The dual steristrip technique uses steristrips to stabilize the bone biopsy needle and allows for accurate assessment of needle position and trajectory...
March 30, 2019: Skeletal Radiology
Nicholas G Rhodes, Benjamin M Howe, Matthew A Frick, Steven L Moran
Ulnar nerve compression at the elbow, specifically the cubital tunnel, is the second most common upper extremity compression neuropathy. Many patients presenting with compression symptoms will subsequently undergo surgical intervention. We review the open surgical treatment of cubital tunnel syndrome and review the expected postoperative imaging appearance of those treatments on magnetic resonance imaging (MR), including: simple or in situ decompression, medial epicondylectomy, and anterior transposition, including subcutaneous, intramuscular, and submuscular variants...
March 28, 2019: Skeletal Radiology
Antoine Moraux, Stefano Bianchi, François Tassery, Thomas Le Corroller
OBJECTIVE: The purpose of this study was to evaluate whether ultrasound allows precise assessment of a focal defect at the lateral patellar retinaculum (LPR) and to determine its anatomical significance. MATERIALS AND METHODS: This work was initially undertaken in four cadaveric specimens and followed by high-resolution ultrasound study in 48 healthy adult volunteers (96 knees) by two musculoskeletal radiologists. Dimension and location of the LPR defect and its relations to adjacent anatomical structures were analyzed...
March 26, 2019: Skeletal Radiology
Alexander Favril, Filip Vanhoenacker, Yannick Goubau, Tjeerd Jager
We report three cases of camptodactyly in adolescent patients, presenting with a passive flexion deformity of the fifth finger. Ultrasound findings include aberrant lumbrical insertion and decreased lumbrical size, confirmed with magnetic resonance imaging, and aberrant dynamics. Surgery confirmed these findings in one patient. To the best of our knowledge, these imaging findings have not been reported previously.
March 25, 2019: Skeletal Radiology
Hillary W Garner, Benjamin K Wilke, Karen Fritchie, Joseph M Bestic
Epithelioid schwannoma is an uncommon benign peripheral nerve sheath tumor, with distinct morphological and pathological features. To our knowledge, the imaging features of epithelioid schwannoma have not been described. In this case report, we describe the imaging findings of a pathologically proven case of epithelioid schwannoma presenting as a slowly growing painless mass near the ankle. The MR imaging signs commonly associated with conventional schwannoma were absent. On correlative radiographs, there were intra-tumoral calcifications...
March 22, 2019: Skeletal Radiology
WanYin Lim, Asif Saifuddin
There is a large variety of conditions that can result in 'bone marrow edema' or 'bone marrow lesions' (BML) in the wrist on magnetic resonance imaging (MRI). The combination of clinical history and the distribution of the BML can serve as a valuable clue to a specific diagnosis. This article illustrates the different patterns of BML in the wrist to serve as a useful guide when reviewing wrist MRI studies. Imaging artefacts will also be briefly covered.
March 22, 2019: Skeletal Radiology
Kevin Pham, Nisreen S Ezuddin, Juan Pretell-Mazzini, Ty K Subhawong
OBJECTIVE: To review histologic diagnoses of soft-tissue masses (STMs) ≤ 2 cm with indeterminate imaging features encountered in musculoskeletal oncology clinic at a tertiary referral center. MATERIALS AND METHODS: This was an IRB-approved retrospective review of patients with STMs ≤ 2 cm, referred to our tertiary care orthopedic oncology clinic over 4.75 consecutive years. Maximum diameter was based on imaging measurement by a fellowship-trained musculoskeletal radiologist...
March 22, 2019: Skeletal Radiology
Elizabeth S Levin, Benjamin Plotkin, Benjamin D Levine, Kambiz Motamedi, Lyndsey Burton, Leanne L Seeger
OBJECTIVE: To determine the clinical significance of T2 signal hyperintensity in the proximal patellar tendon seen on MRI of the knee. MATERIALS AND METHODS: MRIs of 100 patients who underwent MRI of the knee between 1 May 2018 and 15 July 2018 were retrospectively evaluated. All examinations were performed on 3-Tesla MRI scanners with a dedicated knee coil and in accordance with our institution's standard knee MRI protocol. The presence of increased T2 signal was assessed on both sagittal and axial T2-weighted fat-saturated images...
March 21, 2019: Skeletal Radiology
Brodwen McBain, Ebonie Rio, Jill Cook, Rafal Grabinski, Sean Docking
OBJECTIVES: To collate and synthesise the literature to provide estimates of the diagnostic accuracy of imaging modalities, and summarise the reported imaging findings associated with de Quervain's syndrome. MATERIALS AND METHODS: A systematic search was performed in seven databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PROSPERO, Web of Science, and ProQuest Dissertations & Theses Global). Two reviewers independently performed screening, data extraction and quality assessment using a modified Quality Assessment of Diagnostic Accuracy Studies-2...
March 19, 2019: Skeletal Radiology
Patrick K O'Callaghan, Kyle Freeman, Leah C Davis, Robert F Murphy
A 9-year-old boy sustained an ulnohumeral dislocation with a medial epicondyle fracture and experienced incomplete post-traumatic median nerve palsy in addition to post-traumatic stiffness following closed reduction and cast immobilization. When his motor palsy and stiffness did not improve, MRI and ultrasound were obtained, which demonstrated entrapment of the median nerve in an osseous tunnel at the fracture site, compatible with type 2 median nerve entrapment. Subsequently, the patient underwent surgery to mobilize the medial epicondyle and free the median nerve, resulting in improved range of motion, near complete restoration of motor function, and complete restoration of sensory function in the median nerve distribution within 6 months of surgery...
March 13, 2019: Skeletal Radiology
Junzi Shi, Joerg Ermann, Barbara N Weissman, Stacy E Smith, Jacob C Mandell
Retro-odontoid pseudotumor, or mass-like retro-odontoid soft tissue thickening, is an uncommon but important imaging finding that may be associated with rheumatoid arthritis, crystal deposition diseases, as well as non-inflammatory conditions such as cervical degenerative changes and mechanical alterations. Retro-odontoid pseudotumor is commonly associated with atlantoaxial microinstability or subluxation. MRI and CT have an important role in the detection and diagnosis of retro-odontoid pseudotumor. However, due to a wide range of imaging characteristics and ambiguous etiology, it is a frequently misunderstood entity...
March 13, 2019: Skeletal Radiology
Chien-Hung Lin, Kun-Yu Wu, Clement Kuen-Huang Chen, Chien-Feng Li, Tsyh-Jyi Hsieh
Intraosseous myoepithelial carcinoma is an extremely rare type of bone tumor that most often presents in the long tubular bones, but also occurs in small tubular bones and the axial skeleton. We report the radiographic images and complete magnetic resonance (MR) features of a 44-year-old male with right knee pain of 7 months' duration. The radiographic findings and convention MR images indicated a giant cell tumor of the bone. The dynamic contrast-enhanced images showed a patent with the early wash-in and early wash-out usually noted in a giant cell tumor of the bone...
March 13, 2019: Skeletal Radiology
Takashi Takahashi, David Polly, Christopher T Martin
OBJECTIVE: Full-spine radiographs are frequently ordered by spinal deformity surgeons to assess spinal imbalance. The radiologist interpretation of these films varies amongst providers. Detailed numeric measurements of the deformity are time-consuming. In this study, we hoped to better define current practice patterns for interpretation of spinal deformity films amongst musculoskeletal radiologists in North America. MATERIALS AND METHODS: An anonymous online survey was conducted amongst Society of Skeletal Radiology members...
March 12, 2019: Skeletal Radiology
Graeme Thompson, Andrew Van Den Heever
Coracoid stress fractures are a rare sports injury but present a management challenge, with the focus on optimising return-to-play, whilst minimising complications. Potential contributing mechanisms for the injury are briefly discussed and a novel approach to accurate fracture fixation under CT guidance is described. The ability of radiologists to orient themselves in 3D with a volume dataset on a workstation provides an image-guided option for percutaneous fixation that minimises risk of complications.
March 11, 2019: Skeletal Radiology
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