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Seminars in Musculoskeletal Radiology

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https://www.readbyqxmd.com/read/27842432/radiation-exposure-in-bone-densitometry
#1
G Solomou, John Damilakis
This article provides an overview of the literature regarding the magnitude of radiation exposure associated with the current radiologic methods used in patients with suspected osteoporosis. The use of X-ray-based techniques for the detection and monitoring of osteoporosis has increased over the last few decades. Dual-energy X-ray absorptiometry is the most common method, used worldwide for the assessment of osteoporosis, and it may be applied at several skeletal sites. Quantitative computed tomography comprises an alternative validated technique, increasingly used for skeleton assessment...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842431/vertebroplasty-and-kyphoplasty-in-vertebral-osteoporotic-fractures
#2
Francisco Aparisi
Vertebroplasty and kyphoplasty are minimally invasive treatments and indispensable tools in the treatment of osteoporotic compression fractures. This method of treatment is performed using fluoroscopy or a scanner control an access via the pedicle or the posterolateral angle of the vertebral body. Vertebroplasty requires a smaller caliber needle than kyphoplasty, so it is technically easier. Vertebroplasty uses high-pressure injection, whereas in kyphoplasty the injection is held at low pressure, which together with the effect of compression on the bone that the balloon produces reduces the risk and rate of cement leakage...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842430/atypical-fractures-following-bisphosphonate-therapy
#3
Rati N Patel, Anwar Ashraf, Murali Sundaram
Bisphosphonates have been widely used in the treatment of osteoporosis with well-documented long-term efficacy and safety, particularly in postmenopausal patients. But over the past decade, low-energy atypical subtrochanteric and proximal diaphyseal femoral fractures have emerged as an unexpected complication of prolonged bisphosphonate use. To the radiologist unfamiliar with this entity, the findings may be subtle and often missed, potentially evolving from an early incomplete fracture to a displaced complete fracture with a delay in diagnosis...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842429/metabolic-bone-disease-in-patients-with-malabsorption
#4
Catherine M Phan, Giuseppe Guglielmi
Chronic inflammation and malabsorption in gastrointestinal disease can cause bone metabolism alterations and bone mineral loss in children and adults. Gastrointestinal disease is often forgotten as a cause of osteoporosis, osteopenia, or osteomalacia. The etiology of pathologic bone alterations in gastrointestinal disease is multifactorial. Bone alterations were thought to result simply from intestinal malabsorption, but a more complex interaction between cytokines and local/systemic factors influencing bone formation and resorption is envisaged...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842428/renal-failure-a-modern-semiology-for-an-old-disease
#5
Michelangelo Nasuto, Vittorio Pansini, Bernard Cortet, Giuseppe Guglielmi, Anne Cotten
Chronic kidney disease (CKD) is a complex systemic disease that induces mineral metabolic dysfunction leading to bone fragility and tissue calcifications. Bone abnormalities in CKD can include increased bone turnover and resorption due to secondary hyperparathyroidism, decreased bone turnover and bone formation, defective bone mineralization, or a mixed pattern of these abnormalities. Other features of musculoskeletal involvement include synovial, tendon, and ligament thickening due to β2-microglobulin amyloidosis, soft tissue masses, or axial and peripheral arthropathies...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842427/distinguishing-benign-and-malignant-vertebral-fractures-using-ct-and-mri
#6
Benedikt J Schwaiger, Alexandra S Gersing, Thomas Baum, Christian R Krestan, Jan S Kirschke
The differential diagnosis between benign and malignant vertebral fractures is a common challenge in clinical practice, especially because osteoporotic fractures become more frequent within the aging population and many malignant diseases spread to the bone first, impacting bone integrity. This article reviews the morphological features and computed tomography (CT) and magnetic resonance imaging (MRI) imaging findings that help differentiate between benign and malignant fractures. Newer techniques such as MR-based diffusion-weighted imaging, dynamic contrast-enhanced MR, and chemical-shift imaging as well as hybrid techniques such as positron emission tomography-CT are also discussed briefly...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842426/nonspinal-fragility-fractures
#7
Maria Pilar Aparisi Gómez
This article focuses on nonspinal fragility or insufficiency fractures. Fragility fractures occur when normal levels of energy are applied to weakened bone, and they normally represent spontaneous fractures or traumatic fractures from minimal energy trauma that would not normally result in fracture in healthy people. This is the case in osteoporosis, where there is reduction of bone mass as well as loss of normal trabecular architecture leading to changes in structural characteristics that compromise biomechanics...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842425/vertebral-fracture-identification
#8
Alberto Bazzocchi, Giuseppe Guglielmi
When bone becomes frail due to metabolic disorders, one or more vertebral fractures (VFs) may occur. A vertebral body fracture after minor trauma is a hallmark of osteoporosis. VFs represent a target in clinical practice and are often an endpoint in clinical trials. The health care and economic burden of VFs is huge, and they also significantly increase mortality and morbidity, as well as impairing function and quality of life. VFs are frequently clinically silent, thus imaging plays a role not only after symptoms appear but also in screening...
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27842424/metabolic-bone-diseases-an-updated-view-part-two
#9
Giuseppe Guglielmi, Michelangelo Nasuto
No abstract text is available yet for this article.
September 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741546/bisphosphonate-and-medication-related-osteonecrosis-of-the-jaw-a-review
#10
Thomas Mücke, Christian R Krestan, David A Mitchell, Jan S Kirschke, Arno Wutzl
For patients with malignant disease taking bisphosphonates and denosumab, the incidence of medication-related osteonecrosis of the jaw (MRONJ) is up to 15% in contrast to 0.01% in patients with osteoporosis. Clinical presentation of MRONJ extends from asymptomatic exposure of bone in 94% of patients to severe cases of mandibular fractures in a minority of 4.5%. The strongest risk factors for MRONJ are invasive dental procedures and dental infections. Advances in imaging provide more preoperation information compared with panoramic radiograph...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741545/diabetes-and-bone
#11
Ursula Heilmeier, Janina M Patsch
Skeletal fragility has been recognized as an important feature of diabetes mellitus type 1 (T1D) and type 2 (T2D). While patients with DM1 typically display low bone mineral density (BMD) and concomitant increases in fracture risk, T2D bone disease is more complex and less understood. Although BMD is often normal or even slightly elevated, the risk of fragility fractures is disproportionally high. Alterations in bone quality (i.e., bone microstructure and matrix properties) have been reported by independent groups of researchers...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741544/paget-disease-of-bone
#12
Radhesh Krishna Lalam, Victor N Cassar-Pullicino, Naomi Winn
Paget disease (PD) is a common disease of bone associated with abnormal bone turnover that in turn is due to an imbalance between osteoclastic and osteoblastic activity. There is good evidence that PD is reducing in incidence, prevalence, and severity. The disease is most often asymptomatic and is usually detected incidentally on imaging examinations performed for other reasons. The features of PD are relatively specific on radiographs and computed tomography. However, the appearances on magnetic resonance imaging are subtle and nonspecific, although it has become the initial imaging choice for several clinical indications including back pain, neurologic dysfunction, and knee pain...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741543/skeletal-manifestations-of-osteogenesis-imperfecta
#13
Anastasia N Fotiadou, Michele Calleja, Rikin Hargunani, Richard Keen
The skeletal manifestations of osteogenesis imperfecta are investigated. The antenatal and postnatal diagnosis of the disease is briefly mentioned and the characteristic appearances of bone deformities are analyzed in detail. The distinctive bony manifestations of osteogenesis imperfecta are illustrated using typical examples. Finally, we comment on the differential diagnosis.
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741542/bone-quality-beyond-bone-mineral-density
#14
Thomas M Link, Ursula Heilmeier
Both bone mass and quality are responsible for bone strength. Whereas bone mass is measured with bone mineral density, quantification of bone quality is more complex and involves bone architecture, texture, and mechanical parameters. Over the last decade, significant progress has been made in developing technologies to measure bone quality. These include novel low-cost modalities such as trabecular bone score measured on dual-energy X-ray absorptiometry images and quantitative ultrasound as well as more advanced imaging modalities such as multidetector computed tomography, magnetic resonance imaging, and high-resolution peripheral quantitative computed tomography...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741541/bone-densitometry-in-children
#15
Judith E Adams
Maximizing peak bone mass in childhood is relevant to optimizing bone health in later life, so the study of the skeleton in children in health and disease is important. Dual-energy X-ray absorptiometry (DXA) is the most widely used clinical tool for the assessment of bone status in children. Technological developments in DXA enable vertebral fracture assessment at much lower ionizing radiation doses than spinal radiographs. Quantitative computed tomography remains predominantly a research tool but has some advantages over DXA in not being size dependent...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741540/adult-dual-energy-x-ray-absorptiometry-in-clinical-practice-how-i-report-it
#16
Carmelo Messina, Luca Maria Sconfienza, Michele Bandirali, Giuseppe Guglielmi, Fabio Massimo Ulivieri
Several imaging methods for the diagnosis and management of osteoporosis exist. Dual-energy X-ray absorptiometry (DXA) is the most widely available and commonly used for measuring bone mineral density (BMD). Central DXA has several advantages: It has very good reproducibility, administers a negligible radiation dose to the patient, and BMD values obtained by DXA relate to fracture risk. Nevertheless, DXA has some technical limitations that should be recognized by those physicians who interpret and report this examination...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741539/radiology-of-osteoporosis-old-and-new-findings
#17
Yiru Lorna Fan, Wilfred C G Peh
Osteoporosis, a systemic metabolic disease of bone, is characterized by low bone mass and altered trabecular pattern, leading to increased risk of fractures. It increases in prevalence with age, especially in postmenopausal women, and can have other secondary causes. Radiologic evaluation of osteoporosis has historically used conventional radiography, which demonstrates cortical thinning, increased radiolucency, and altered trabecular patterns, and also aids in assessing vertebral fractures. Many indexes have been devised, such as the Saville index for the degree of radiolucency, and the Genant grading system for vertebral fractures...
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27741538/metabolic-bone-diseases-an-updated-view-part-one
#18
Giuseppe Guglielmi, Michelangelo Nasuto
No abstract text is available yet for this article.
July 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27336456/the-hallucal-sesamoid-complex-normal-anatomy-imaging-and-pathology
#19
Ramya Srinivasan
The first metatarsophalangeal joint and hallucal-sesamoid complex are critical structures in weightbearing and susceptible to several pathologies including turf toe, sesamoiditis, degenerative or inflammatory arthritides, infection, and avascular necrosis. This review article summarizes the complex anatomy of the region, covers common pathologies while clarifying terms such as turf toe and sesamoiditis, reviews imaging techniques, and discusses management.
April 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27336455/ultrasound-guided-interventions-in-the-midfoot-and-forefoot
#20
O Kenechi Nwawka, Yoshimi Endo
Pathologic conditions in the midfoot and forefoot may be diagnosed and treated using image-guided intervention. Image-guided techniques to treat arthrosis, tendinopathy, nerve disorders, and other miscellaneous midfoot and forefoot conditions are described, with a focus on sonographic guidance.
April 2016: Seminars in Musculoskeletal Radiology
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