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Skeletal Radiology

F Joseph Simeone, Joel P Harvey, Andrew J Yee, Elizabeth K O'Donnell, Noopur S Raje, Martin Torriani, Miriam A Bredella
OBJECTIVE: To determine the value of low-dose whole-body CT (WBCT) in the management of patients with multiple myeloma (MM) and precursor states. MATERIALS AND METHODS: The study group comprised 116 patients (mean age: 68 ± 11 years, 48% women) who underwent WBCT for the work-up or surveillance of MM or MM precursor disease. WBCTs were reviewed for the presence of MM-related bone disease and incidental findings requiring therapy. The medical records, results from bone marrow aspirations and biopsies and follow-up imaging studies were reviewed to assess the influence of WBCT on patient management...
September 14, 2018: Skeletal Radiology
Stefano Bianchi, Laure Droz, Thomas Le Corroller, Marino Delmi
We present the cases of four patients (two men and two women, mean age of 48.5 years) with surgically confirmed partial anterior tarsal syndrome, diagnosed by ultrasound. All patients reported pain in the dorsal aspect of the forefoot radiating to the first intermetatarsal space. Ultrasound showed compression of the medial branch of the deep fibular nerve by the extensor hallucis brevis tendon at the level of the Lisfranc joint, associated with a hypoechoic neuroma. The ultrasound allowed a correct diagnosis to be obtained, which was not evident from clinical examination or by standard radiographs (four patients) or MRI (three patients)...
September 13, 2018: Skeletal Radiology
Stijn A Bos, Corey M Gill, Edgar L Martinez-Salazar, Martin Torriani, Miriam A Bredella
OBJECTIVE: To determine the role of brown adipose tissue (BAT) in cancer activity. MATERIALS AND METHODS: The study group comprised 142 patients (121 female, 21 male; mean age, 49 ± 16 years) who underwent F18-FDG PET/CT (PET/CT) for staging or surveillance of cancer and who were BAT-positive on PET/CT. BAT volume by PET/CT, abdominal (visceral and subcutaneous) fat and paraspinous muscle cross-sectional areas (CSA) were assessed. Groups with and without active cancer on PET/CT were compared using a two-sided paired t test...
September 13, 2018: Skeletal Radiology
Hatim Alabsi, Thomas Goetz, Darra T Murphy
Aneurysms of the distal radial artery at the level of the wrist are rare. Most reported cases are posttraumatic, either from iatrogenic arterial puncture for radial arterial access or from a penetrating injury. Other causes include infection and connective tissue disorders. Early diagnosis is important to avoid the potential complications of thrombus formation, distal digital ischemia, and rupture. Evaluation of the radial artery is typically performed using non-invasive modalities like ultrasonography, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA)...
September 13, 2018: Skeletal Radiology
Jina Park, Yoon-Hee Choi, Jee Won Chai, Seung Woo Cha, Joo Hee Lim, Chris Hyunchul Jo, Dong Hyun Kim
OBJECTIVE: To evaluate the usefulness of anterior capsular abnormality, thickening, and abnormal signal intensity on MRI for the diagnosis of adhesive capsulitis of the shoulder. MATERIALS AND METHODS: This retrospective study included 29 patients with adhesive capsulitis and 20 controls. Clinical criteria with significant restricted passive motion was used for the diagnosis of adhesive capsulitis. The anterior capsular thickness and signal intensity were evaluated on the thickest portion of anterior glenohumeral joint capsule, located deep to the subscapularis muscle...
September 11, 2018: Skeletal Radiology
F Joseph Simeone, Arvin Kheterpal, Connie Y Chang, William E Palmer, Miriam A Bredella, Ambrose J Huang, Martin Torriani
OBJECTIVE: To describe an ultrasound guided injection technique for diagnosing and treating posteromedial knee friction syndrome, which occurs between the sartorius/gracilis tendons and medial femoral condyle (MFC). MATERIALS AND METHODS: Our study was IRB-approved and HIPAA-compliant. We identified patients via a retrospective review of medical records and MRI with posteromedial knee pain and isolated edema between MFC and sartorius/gracilis tendons and no evidence for meniscal tear, ruptured Baker's cyst or degenerative joint disease...
September 11, 2018: Skeletal Radiology
Joel P Harvey, David I Suster, Kevin A Raskin, G Petur Nielsen, Miriam A Bredella
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms composed of perivascular epithelioid cells that are immunoreactive for both melanocytic and myogenic markers. Recently, a fibroma-like PEComa associated with tuberous sclerosis complex (TSC) has been identified. We describe the first intra-articular case of a fibroma-like PEComa in a 44-year-old man who presented with a hypointense intra-articular knee mass, which was mistaken for tenosynovial giant cell tumor, diffuse type. This case report demonstrates that fibroma-like PEComa should be included in the extended differential diagnosis of intra-articular soft tissue masses...
September 11, 2018: Skeletal Radiology
Marina Carotti, Fausto Salaffi, Marco Di Carlo, Francesco Sessa, Andrea Giovagnoni
OBJECTIVE: To assess the involvement of the atlantoaxial joint in patients with early rheumatoid arthritis (ERA) and to elucidate the risk profile for the individual patient. MATERIALS AND METHODS: Consecutive ERA patients (disease duration < 12 months) were included in our study. A cervical spine magnetic resonance imaging (MRI) and X-rays (cervical spine, hands, wrists, and feet) were performed in all patients. The MRI features were correlated with clinical, radiological, and biochemical variables...
September 11, 2018: Skeletal Radiology
Varun Puvanesarajah, Laura M Fayad, Sandesh S Rao, Edward F McCarthy, Carol D Morris
A 70-year-old man with a history of bladder and colon cancer presented with an enlarging mass in his right lower extremity. Forty years before presentation, he had injured his right lower extremity in a motor vehicle accident. Imaging findings indicated suspected sarcoma, which led to biopsy. Biopsy and further surgical exploration revealed the presence of a surgical sponge and surrounding local inflammatory reaction. No neoplasm was found, and the sponge and involved tissues were removed. Gossypiboma is exceedingly rare in the extremities...
September 10, 2018: Skeletal Radiology
Derik L Davis, Thomas Kesler, Mohit N Gilotra, Ranyah Almardawi, Syed A Hasan, Rao P Gullapalli, Jiachen Zhuo
BACKGROUND: Quantification of rotator cuff intramuscular fatty infiltration is important for clinical decision-making in patients with rotator cuff tear. The semi-quantitative Goutallier classification system is the most commonly used method, but has limited reliability. Therefore, we sought to test a freely available fuzzy C-means segmentation software program for reliability of the quantification of shoulder intramuscular fatty infiltration on T1-weighted MR images and for correlation with fat fraction by six-point Dixon MRI...
September 10, 2018: Skeletal Radiology
Takeshi Fukuda, Mingqian Huang, Anuradha Janardhanan, Mark E Schweitzer, Chuan Huang
OBJECTIVE: To evaluate the correlation between bone marrow cellularity (BMC) and metabolic activity in healthy subjects and to see whether yellow marrow is indeed metabolically quiescent. Because metabolic activity can be assumed to reflect vascularity, we assessed the relationship between regional metabolic activity and geographic frequency of metastases as noted in the literature. MATERIALS AND METHODS: Two hundred and twenty locations (ten in each side of the pelvis and proximal femur) were evaluated in 11 consecutive healthy volunteers with simultaneous PET/MR...
September 7, 2018: Skeletal Radiology
Fauniel Rowland, Catherine Call, Bilal Mujtaba, Behrang Amini, Wei-Lien Wang
Leiomyomas are benign tumors of smooth muscle cells. Leiomyomas of somatic soft tissue are a specific class of leiomyoma believed to arise from the smooth muscle cells found in the walls of blood vessels and represent less than 4% of benign, somatic soft tissue tumors. Of the somatic soft tissue tumors, approximately one-third will become calcified. We report an intramuscular, calcified leiomyoma arising from the left deltoid of a 47-year-old Caucasian male. To the best of the authors' knowledge, this is the first reported case of a calcified, intramuscular leiomyoma of the deltoid...
September 5, 2018: Skeletal Radiology
M Blasi, J De la Fuente, A Pérez-Bellmunt, O Zabalza, S Martínez, O Casasayas, M Miguel-Pérez
OBJECTIVE: To establish a high-resolution US technique that enables a systematic morphometric examination of the three components that form the distal biceps brachii tendinous complex; the internal bicipital aponeurosis, the distal biceps brachii tendon and the external bicipital aponeurosis (also known as lacertus fibrosus). MATERIALS AND METHODS: Fifty cryopreserved cadaver body donor elbows were dissected to obtain morphometric reference values and to establish reliable landmarks for the US examination...
September 5, 2018: Skeletal Radiology
Torsten Diekhoff, Michael Scheel, Sandra Hermann, Jürgen Mews, Bernd Hamm, Kay Geert A Hermann
The name of Kay Geert A. Hermann is incorrectly captured in the original article and is now corrected in this paper.
September 5, 2018: Skeletal Radiology
Mohammad Samim, Nima Eftekhary, Jonathan M Vigdorchik, Ameer Elbuluk, Roy Davidovitch, Thomas Youm, Soterios Gyftopoulos
OBJECTIVE: To determine if hip 3D-MR imaging can be used to accurately demonstrate femoral and acetabular morphology in the evaluation of patients with femoroacetabular impingement. MATERIALS AND METHODS: We performed a retrospective review at our institution of 17 consecutive patients (19 hips) with suspected femoroacetabular impingement who had both 3D-CT and 3D-MRI performed of the same hip. Two fellowship-trained musculoskeletal radiologists reviewed the imaging for the presence and location of cam deformity, anterior-inferior iliac spine variant, lateral center-edge angle, and neck-shaft angle...
September 4, 2018: Skeletal Radiology
Malwina Kaniewska, Matthias Schenkel, Karim Eid, Tobias Bühler, Rahel A Kubik-Huch, Suzanne E Anderson
OBJECTIVE: To evaluate the quality of the iliopsoas muscle complex after pertrochanteric femoral fracture, using MRI; to propose an anatomy-based evaluation of the iliopsoas muscle complex; and to determine the inter-reader reliability of two classifications of fatty muscle degeneration. MATERIALS AND METHODS: We included adult patients with a displaced lesser trochanter following pertrochanteric femoral fracture. Muscle quality was evaluated using the Goutallier and Slabaugh classifications at three levels (L4/L5, L5/S1, and the anterior inferior iliac spine)...
September 3, 2018: Skeletal Radiology
Aishwarya Gulati, Vibhor Wadhwa, Oganes Ashikyan, Luis Cerezal, Avneesh Chhabra
Distal radioulnar joint (DRUJ) dysfunction is a common cause of ulnar sided wrist pain. Physical examination yields only subtle clues towards the underlying etiology. Thus, imaging is commonly obtained towards an improved characterization of DRUJ pathology, especially multimodality imaging, which is frequently resorted to arrive at an accurate diagnosis. With increasing use of advanced MRI and CT techniques, DRUJ imaging has become an important part of a musculoskeletal radiologist's practice. This article discusses the normal anatomy and biomechanics of the DRUJ, illustrates common clinical abnormalities, and provides a comprehensive overview of the imaging evaluation with an insight into the role of advanced cross-sectional modalities in this domain...
September 1, 2018: Skeletal Radiology
Elaina Zabak, Hythem Omar, Ethan Boothe, Lulu Tenorio, Jeffrey Guild, Suhny Abbara, Avneesh Chhabra
OBJECTIVE: To analyze the impact of pelvic computed tomography (CT) technique optimization on estimated dose and subjective and objective image quality. MATERIALS AND METHODS: An institutional review board (IRB)-approved retrospective records review was performed with waived informed consent. Five CT scanners (various manufacturers/models) were standardized to match the lowest dose profile on campus via subjective assessment of clinical images by experienced musculoskeletal radiologists...
August 28, 2018: Skeletal Radiology
Wilson C Lai, Armin Arshi, Dean Wang, Leanne L Seeger, Kambiz Motamedi, Benjamin D Levine, Sharon L Hame
OBJECTIVE: Our study aimed to determine the duration of pain relief from intraarticular hip corticosteroid injections and identify patient predictive factors on injection response. We also sought to determine the subsequent rate of hip surgery and whether severity of hip osteoarthritis or injection response correlated with the decision to undergo surgery. MATERIALS AND METHODS: All intraarticular hip steroid injections performed for osteoarthritis under fluoroscopic guidance at a single institution between January 2010 to December 2012 were retrospectively reviewed...
August 28, 2018: Skeletal Radiology
Pei Ing Ngam, James Thomas Hallinan, David Soon Yiew Sia
Luxatio erecta humeri (LEH), also known as inferior shoulder dislocation, is uncommon, comprising about 0.5% of all cases of shoulder dislocation. Synchronous bilateral LEH is exceedingly rare and, to our knowledge, there are no descriptions of axillary nerve injury on magnetic resonance imaging (MRI) following LEH. We present a case of traumatic bilateral LEH in a 59-year-old woman who fell from a fast-moving mobility scooter and sustained direct axial loading forces on the fully abducted shoulders. Both shoulders were successfully reduced using the traction-countertraction technique in the emergency department...
August 27, 2018: Skeletal Radiology
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