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Seminars in Musculoskeletal Radiology

Iwona Sudoł-Szopińska, Lennart Jans, Anne Grethe Jurik, Robert Hemke, Iris Eshed, Nathalie Boutry
No abstract text is available yet for this article.
September 2018: Seminars in Musculoskeletal Radiology
Naomi Winn, Radhesh Lalam
Limb salvage is a key goal of tumor management around the knee, with surgical, medical, and radiologic treatment options. Primary bone and soft tissue sarcomas are optimally treated in specialist tertiary centers; however, metastatic disease is encountered in all aspects of radiologic practice, with overlap in the management strategies. Both specialist and generalist radiologists therefore need to be familiar with the expected normal appearances following these therapies and be able to recognize potential complications...
September 2018: Seminars in Musculoskeletal Radiology
Mihra S Taljanovic, Lana H Gimber, Imran M Omar, Andrea S Klauser, Michael D Miller, Jason R Wild, Tyson S Chadaz
Postoperative infections of the knee are uncommon but may occur with joint arthroplasties, fracture fixation, or after arthroscopic procedures. The ultimate diagnosis is made by joint aspiration or tissue sampling. Joint aspiration and tissue sampling can be performed under imaging guidance or intraoperatively. Imaging is an important adjunct to clinical and laboratory findings and should start with radiographs. Cross-sectional imaging including magnetic resonance (MR) imaging, computed tomography (CT), nuclear studies, and ultrasound (US) are frequently used if the diagnosis is in doubt and to evaluate the extent of disease...
September 2018: Seminars in Musculoskeletal Radiology
Hatice Tuba Sanal, Christian Krestan, Mark Schurz
Related to fractures of and around the knee, inappropriate technical factors related to the surgery, severe comminution of the fracture, early overly arduous rehabilitation of the patient, and patient-related noncompliances may have the potential for the risk of inadequate fixation and other complications. Loss of fixation, malunion/nonunion, infection, arthritis, arthrofibrosis, and symptomatic hardware are among postsurgical complications that may necessitate further reconstructive techniques. In this review, complications that may be encountered in the postsurgical period of fractures involving the patella, supracondylar femur, and tibial plateau are described...
September 2018: Seminars in Musculoskeletal Radiology
Iman Khodarahmi, Elliot K Fishman, Jan Fritz
Advances in surgical techniques, orthopaedic implant design, and higher demands for improved functionality of the aging population have resulted in a high prevalence of patients with metallic implants about the knee. Total knee arthroplasty, knee-replacing tumor prostheses, and osteosynthesis implants create various imaging artifacts and pose special challenges for the imaging evaluation with computed tomography (CT) and magnetic resonance imaging (MRI). CT artifacts can be effectively mitigated with metal artifact reduction reconstruction algorithms, dual-energy data acquisition with virtual monoenergetic extrapolation, and three-dimensional postprocessing techniques, such as volume and cinematic rendering...
September 2018: Seminars in Musculoskeletal Radiology
Ioan N Gemescu, Marc-André Weber, Christoph Rehnitz, Wolfram Mittelmeier, John A Carrino, Kolja M Thierfelder
Total knee arthroplasty (TKA) has significant medical and economic implications. The correct placement of the femoral and tibial components is vital to ensure a functional knee and also low failure and revision surgery rates. This article provides the most relevant information regarding knee endoprosthesis from a radiologic point of view. Basic information on the recommended alignment of the femoral and tibial components in TKA and how to measure them are discussed. We then present the most important axial plane rotational references for the femoral and the tibial components...
September 2018: Seminars in Musculoskeletal Radiology
Jeremiah R Long, David A Rubin
The extensor mechanism of the knee plays an important role in many movements of the lower extremity. Although its main function is to extend the knee, it also stabilizes the patellofemoral joint and resists passive flexion of the knee when landing from jumping. Pathologic conditions of the extensor mechanism can be acute or chronic, and they can negatively affect daily activities. Fortunately, many surgical treatments are available aimed at restoring function to the injured extensor mechanism. Understanding the surgical techniques and common complications of these procedures enables the radiologist to recognize expected and unexpected postoperative imaging appearances...
September 2018: Seminars in Musculoskeletal Radiology
Ali Naraghi, Dawn H Pearce, Daniel B Whelan, Jaskarndip Chahal
Posterolateral corner (PLC) injuries of the knee are often sustained in combination with anterior or posterior cruciate ligament injuries. A variety of surgical techniques including acute repair, nonanatomical reconstructions, and anatomical reconstructions have been used to treat grade III PLC injuries. Scant literature is available on postoperative imaging of the PLC. This article reviews the more commonly used surgical techniques and the postoperative imaging assessment of the PLC of the knee.
September 2018: Seminars in Musculoskeletal Radiology
Andrew C Cordle, Don D Williams, Carol L Andrews
Meniscal surgery is commonplace. Patients who have had prior surgery may return for additional imaging for continued or new pain, limited range of motion, or interval injury. Accurate interpretation of postoperative imaging requires a clear understanding of the normal meniscal anatomy and biomechanics. Surgical goals and current surgical techniques impact the imaging appearance. These techniques are reviewed in the context of the various meniscal tear patterns. Multiple imaging modalities may be used in patient assessment with magnetic resonance (MR) imaging providing key information regarding the integrity of the meniscal repair...
September 2018: Seminars in Musculoskeletal Radiology
Ramya Srinivasan, Jennifer Wan, Christina R Allen, Lynne S Steinbach
Anterior cruciate ligament (ACL) tears are common injuries that if left untreated can result in chronic instability, cartilage damage, meniscal tears, and ligamentous injuries, eventually leading to early osteoarthritis. ACL reconstruction surgeries are therefore increasingly being performed. Despite the fact that most patients achieve excellent postoperative results, patients can present with recurrent instability and pain. These patients often undergo imaging with radiographs, magnetic resonance imaging, and/or computed tomography...
September 2018: Seminars in Musculoskeletal Radiology
Felix Wuennemann, Christoph Rehnitz, Marc-André Weber
Focal chondral or osteochondral lesions of the knee are common lesions involving either the cartilage layers or the cartilage layers and the subchondral bone. Despite their heterogeneous clinical presentation, they are important risk factors for the premature development of osteoarthritis. Therefore, early detection of osteochondral lesions and focal cartilage defects is crucial. In symptomatic (osteo-)chondral lesions, numerous therapeutic strategies, ranging from conservative treatment to surgical procedures such as marrow stimulation, osteochondral autograft transplantation, or autologous chondrocyte implantation are available...
September 2018: Seminars in Musculoskeletal Radiology
Marc-André Weber, Donna G Blankenbaker
No abstract text is available yet for this article.
September 2018: Seminars in Musculoskeletal Radiology
Nathan Dettori, Hema Choudur, Avneesh Chhabra
High-resolution ultrasound serves as a fast, accessible, reliable, and radiation-free tool for anatomical and dynamic evaluation of various peripheral nerves. It can be used not only to identify and diagnose peripheral nerve and perineural pathology accurately but also to guide various nerve and perineural interventions. We describe the normal and pathologic appearances of peripheral nerves, the pathologies commonly affecting the individual peripheral nerves, and the current ultrasound-guided peripheral nerve interventions and techniques...
July 2018: Seminars in Musculoskeletal Radiology
Basavaraj Chari, Eugene McNally
Peripheral nerve entrapment of the ankle and foot is relatively uncommon and often underdiagnosed because electrophysiologic studies may not contribute to the diagnosis. Anatomy of the peripheral nerves is variable and complex, and along with a comprehensive physical examination, a thorough understanding of the applied anatomy is essential. Several studies have helped identify specific areas in which nerves are commonly compressed. Identified secondary causes of nerve compression include previous trauma, osteophytes, ganglion cysts, edema, accessory muscles, tenosynovitis, vascular lesions, and a primary nerve tumor...
July 2018: Seminars in Musculoskeletal Radiology
Andrea S Klauser, Tommaso Buzzegoli, Mihra S Taljanovic, Sylvia Strobl, Stefan Rauch, James Teh, Julia Wanschitz, Wolfgang Löscher, Carlo Martinoli
Nerve entrapment syndromes of the upper extremity are associated with structural abnormalities or by an intrinsic abnormality of the nerve. Nerve entrapment syndromes generally have a typical clinical presentation, and findings on physical examination and in conjunction with electrodiagnostic studies imaging is used to evaluate the cause, severity, and etiology of the entrapment. With the development of high-frequency linear array transducers (12-24 MHz), ultrasound (US) is incomparable in terms of spatial resolution to depict morphological aspects and changes in nerves...
July 2018: Seminars in Musculoskeletal Radiology
Gustav Andreisek, Nicolae V Bolog
This article provides a review of magnetic resonance neurography (MRN) and how to get started. It explains step by step how to establish MRN at an institution: how to set up MRN protocols, how to train technicians, what a report needs to contain, and how relevant findings should be communicated to the referring physician. Advanced imaging techniques such as diffusion tensor imaging are only briefly discussed at the end of the article because most of those techniques are difficult for beginners and are still not considered standard in the clinical routine...
July 2018: Seminars in Musculoskeletal Radiology
James F Griffith
Examination of the brachial plexus with ultrasound is efficient because it allows many parts of the brachial plexus as well as the surrounding soft tissues to be assessed with high spatial resolution. The key to performing good ultrasound of the brachial plexus is being familiar with the anatomy and the common variants. That makes it possible to concentrate solely on the ultrasound appearances free of simultaneously wondering about the anatomy. Ultrasound of the brachial plexus is particularly good for assessing nerve sheath tumor, perineural fibrosis, metastases, some inflammatory neuropathies, neuralgic amyotrophy, and posttraumatic sequalae...
July 2018: Seminars in Musculoskeletal Radiology
Leon Lenchik, Robert D Boutin
As populations continue to age worldwide, the impact of sarcopenia on public health will continue to grow. The clinically relevant and increasingly common diagnosis of sarcopenia is at the confluence of three tectonic shifts in medicine: opportunistic imaging, precision medicine, and machine learning. This review focuses on the state-of-the-art imaging of sarcopenia and provides context for such imaging by discussing the epidemiology, pathophysiology, consequences, and future directions in the field of sarcopenia...
July 2018: Seminars in Musculoskeletal Radiology
Marc-André Weber, Marcel Wolf, Mike P Wattjes
The role of muscle imaging in the diagnosis of inherited and acquired muscle diseases has gained clinical relevance. In particular, magnetic resonance imaging (MRI) is increasingly being used for diagnostic purposes, especially with its capability of whole-body musculature assessment. The assessment and quantification of muscle involvement in muscle diseases can be of diagnostic value by identifying a certain involvement pattern and thus narrowing the differential diagnosis and supporting the clinical diagnosis...
July 2018: Seminars in Musculoskeletal Radiology
Yoshimi Endo, Theodore T Miller
Imaging plays an important role in the evaluation of patients presenting with possible myositis, with magnetic resonance imaging the most appropriate modality but ultrasound also playing a complementary role. This article reviews the imaging appearance of the inflammatory myopathies, other forms of myositis, and mimickers of myositis, with a discussion of distinguishing features for each entity. The fascia and disease processes that preferentially involve the fascia are also reviewed.
July 2018: Seminars in Musculoskeletal Radiology
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