Musculoskeletal Imaging Pictorial Essay
|
|
- Wilfred Todd
- 6 years ago
- Views:
Transcription
1 Kiss et al. Dialysis- Related Amyloidosis Revisited Musculoskeletal Imaging Pictorial Essay Emilia Kiss 1 Gèrald Keusch 2 Marco Zanetti 3 Tarzis Jung 1 Albin Schwarz 2 Michael Schocke 4 Werner Jaschke 4 Benedikt V. Czermak 4 Kiss E, Keusch G, Zanetti M, et al. DOI: /AJR Received August 19, 2004; accepted after revision December 22, Department of Radiology, Waid Hospital, Zürich, Switzerland Department of Nephrology, Waid Hospital, Zürich, Switzerland Department of Radiology, Balgrist University Hospital, Zürich, Switzerland Department of Radiology, Medical University Innsbruck, Anichstrasse 35, Innsbruck Tyrol, Austria Address correspondence to B. V. Czermak. AJR 2005; 185: X/05/ American Roentgen Ray Society Dialysis-Related Amyloidosis Revisited OBJECTIVE. Dialysis-related amyloidosis occurs secondarily to the deposition of β 2 -microglobulin. Dialysis-related amyloidosis predominantly involves the osteoarticular system and is clinically manifested by erosive and destructive osteoarthropathies, destructive spondyloarthropathy, and carpal tunnel syndrome. This article illustrates the radiographic, sonographic, CT, and MRI findings of dialysis-related amyloid arthropathies. CONCLUSION. Dialysis-related amyloidosis is characterized by various imaging appearances. In evaluating amyloidosis, MRI provides considerably more information than that obtained from conventional radiographic, CT, and sonographic studies. ialysis-related amyloidosis is a D unique type of amyloidosis affecting patients undergoing long-term hemodialysis. It occurs secondarily to the deposition of β 2 -microglobulin and is responsible for significant morbidity with potential mortality. The mechanism of amyloid fibril formation from β 2 -microglobulin is still unknown. The pathogenesis and pathophysiology are probably multifactorial and have been associated with the duration of renal failure, patient s current age, patient s age at initiation of hemodialysis, duration of hemodialysis, Fig year-old woman on hemodialysis for 10 years for analgesic nephropathy with biopsy-proven dialysisrelated amyloidosis. Axial radiograph of left hip shows well-defined cystic lesion (arrow) with sclerotic rim in area of left femoral neck. Femoral lesions arise in subcapital region, usually commencing at superolateral aspect of femoral neck. The most characteristic cysts secondary to amyloidosis occur in acetabula and proximal femurs. Because of pathologic fracture, surgical repair had to be performed on patient 1 year later AJR:185, December 2005
2 Dialysis-Related Amyloidosis Revisited bioincompatibility of dialysis membranes, and clinical variables [1]. Dialysis-related amyloidosis predominantly involves the osteoarticular system and is clinically manifested by erosive and destructive osteoarthropathies, destructive spondyloarthropathy, and carpal A C Fig year-old woman on hemodialysis for 26 years for lupus nephritis with biopsy-proven dialysis-related amyloidosis. A, Conventional radiograph shows discrete erosion in lateral aspect of acetabulum (arrowhead). No other abnormalities are visible. B, Coronal T1-weighted MR image (TR/TE, 500/14) reconfirms erosion (arrowhead), which is much more obvious than in conventional radiograph. Large intraarticular and periarticular hypointense amyloid deposits (arrows) are also evident. Amyloid deposits show intermediate to low intensity in T1 sequence. C, Corresponding T2-weighted MR image (5,000/122) shows that amyloid deposits (arrows) seen in B have low to intermediate signal intensity on T2-weighted image. D, Axial T1-weighted fat-suppressed MR image (768/14) after administration of contrast material shows only mild peripheral enhancement (arrowheads), which is characteristic of amyloidosis. tunnel syndrome. The common sites of involvement are hips, wrists, shoulders, knees, and spine [1]. In contrast to other types of amyloidosis (e.g., reactive amyloidosis due to chronic inflammatory diseases or multiple myeloma), the visceral form is believed to have a low incidence and to occur late in the course of the disease [1, 2]. Biopsy is nearly always required for definitive diagnosis. However, because histologic confirmation is not always possible and increased serum β 2 -microglobulin level B D AJR:185, December
3 Kiss et al. is not diagnostic, imaging findings combined with history and clinical findings are usually used for assessment of musculoskeletal involvement by dialysis-related amyloidosis. In addition, precise imaging diagnosis is essential for the assessment of dialysis-related amyloidosis before serious complications arise, such as pathologic fracture or compressive myelopathy due to dialysis-related amyloidosis. Strategies for enhancing β 2 -microglobulin clearance include efficient high-flux dialysis methods, hemofiltration, immunoadsorption, and renal transplantation [2]. C A Fig year-old man on hemodialysis for 23 years for chronic glomerulonephritis with biopsy-proven dialysisrelated amyloidosis. A, Conventional radiograph shows radiolucent lesions of various sizes involving carpal bones (arrows). Most have sclerotic margins and some have a lobulated outline. In carpi, lunate and scaphoid are most often affected. B, Longitudinal sonography exhibits thickening of flexor tendon and amyloid tissue in synovial tissue adjacent to tendon (arrows). C, Sagittal T1-weighted MR image (595/20) shows erosions involving lunate bone (solid straight arrows). Lowsignal-intensity tissue representing amyloid is evident within lesion. Amyloid deposits encasing flexor (open arrow) and extensor (curved arrow) tendons are also visible. Marked thickening of flexor tendons caused by amyloid tissue (arrowheads) is evident. (Fig. 3 continues on next page) This article illustrates the radiographic, sonographic, CT, and MRI findings of dialysis-related amyloid arthropathies, spondyloarthropathy, and wrist involvement. Erosive and Destructive Osteoarthropathies Conventional Radiographs On conventional radiographs, bone lesions of amyloidosis show radiolucencies of variable size within the medullary or cortical bone that may cause cortical destruction. They are identified most commonly around the hips (Figs. 1 and 2), in the carpal bones (Fig. 3), and in the shoulders (Fig. 4). Fine sclerotic margins are usually present (Figs. 1, 3A, and 4A). Matrix calcification has not been reported. The cysts are typically located in the periarticular bones and at sites of ligamentous insertions and are frequently bilateral. The deposits of amyloid in the bone can lead to pathologic fracture [3]. The differential diagnosis of multiple lytic bone lesions includes, foremost, metastatic disease and multiple myeloma. Neither of these entities demonstrates a juxta-articular predilection, and a diagnosis of myeloma may be made with laboratory studies. Lytic bone lesions in a patient who B 1462 AJR:185, December 2005
4 Dialysis-Related Amyloidosis Revisited has undergone long-term hemodialysis should also suggest the diagnoses of secondary hyperparathyroidism and brown tumor. Characteristic blood chemistry abnormalities and other stigmata of secondary hyperparathyroidism, such as subperiosteal or subchondral D Fig. 3 (continued) 57-year-old man on hemodialysis for 23 years for chronic glomerulonephritis with biopsy-proven dialysis-related amyloidosis. D, Axial intermediate-weighted fat-suppressed MR image (2,430/30) shows marked thickening of flexor (straight arrows) tendons. Tendons are encased in amyloid tissue (curved arrows). Erosions involving carpal bones (arrowheads) are also visible. E, Coronal T1-weighted image (372/20) shows encasement of carpal bones with amyloid tissue (arrows). Multiple erosions (arrowheads) are also obvious. A Fig year-old man on hemodialysis for 31 years for chronic glomerulonephritis with biopsy-proven dialysis-related amyloidosis. A, Conventional radiograph shows well-defined cystic lesion (arrowhead) with sclerotic rim (arrows) in superior posterior left humeral head. Humeral lesions generally occur around anatomic neck of humerus and in relation to bicipital groove. B, Longitudinal sonogram of left shoulder shows erosion of humeral head (straight arrows), which communicates with joint space. Erosion is filled with echogenic amyloid tissue (curved arrows). (Fig. 4 continues on next page) bone resorption, should be present. Also, brown tumors do not typically occur in a paraarticular location [3]. Other abnormalities that appear on conventional radiographs are periarticular softtissue masses, erosive changes, joint destruction, joint subluxations and dislocations, and digital contractures. Sonography Sonography is an excellent imaging technique for diagnosing the presence of dialysis-re- E B AJR:185, December
5 Kiss et al. C E Fig. 4 (continued) 63-year-old man on hemodialysis for 31 years for chronic glomerulonephritis with biopsy-proven dialysis-related amyloidosis. C, Sonogram of right subdeltoid bursa shows polypoidlike synovial thickening (arrows) and large anechoic synovial effusion. D, Coronal T1-weighted MR image (470/12) shows osteolysis in superior posterior humeral head, which communicates with joint (arrow). Low-signal-intensity tissue representing amyloid appears within lesion. Amyloid deposits are also visible within subdeltoid bursa between deltoid muscle and humerus (arrowheads). E, Corresponding T2-weighted MR image (3,000/91) of same lesions. Signal of amyloid tissue (straight arrows) remains low with exception of small rim of high intensity around intraosseous lesion (arrowheads). These findings are characteristic for amyloidosis. Complete rupture of supraspinatus tendon (curved arrow) is apparent. F, Axial T2-weighted MR image (1,250/26) of atlantoaxial joint shows pseudotumoral mass of periodontoid soft tissue (arrowheads) bulging into anterior subarachnoid space and resembling rheumatoid pannus. Pseudotumors are observed at site of synovial or ligamentous structures, namely, atlantoaxial joint synovium and transverse ligament. (Fig. 4 continues on next page) D F 1464 AJR:185, December 2005
6 Dialysis-Related Amyloidosis Revisited \ I G J Fig. 4 (continued) 63-year-old man on hemodialysis for 31 years for chronic glomerulonephritis with biopsy-proven dialysis-related amyloidosis. G, Sagittal T2-weighted MR image (4,280/121) of cervical spine shows pseudotumor (straight arrow) encasing odontoid process. Lesion shows low signal intensity. Erosion in anterior aspect of odontoid process (white arrowhead) is also present. Erosive spondyloarthropathy with anterolisthesis of body of C3 on C4 is obvious in intervertebral level C3/C4 (curved arrow). Low signal in T2-weighted images is present, which allows exclusion of infection. Note also amyloid deposits (black arrowheads) at site of dorsal ligament structures. H, Axial CT scan (bone window settings) of atlantoaxial joint shows erosions and resorption of odontoid process (arrowhead) and body of C2 (arrows) due to pseudotumoral mass of periodontoid soft tissue. I, Sagittal T2-weighted MR image (5,000/131) of thoracic spine shows marked destruction of disk space T8 9 with irregularity of adjacent endplates, multiple erosions, and reactive sclerosis (arrow). Only a little fluid appears within disk space. Hypointense amyloid tissue is obvious in area of right facet joints (black arrowhead) and at site of dorsal ligament structures (white arrowhead). J, Axial T2-weighted MR image (4,500/150) at level of T8 9 shows hypointense amyloid tissue at site of synovial and ligamentous structures of right facet joint infiltrating in epidural space and right neuroforamen (arrowhead). Amyloid deposits (arrows) also appear at site of dorsal ligament structures. (Fig. 4 continues on next page) H AJR:185, December
7 Kiss et al. Fig. 4 (continued) 63- year-old man on hemodialysis for 31 years for chronic glomerulonephritis with biopsy-proven dialysisrelated amyloidosis. K, Sagittal T2-weighted MR image (5,000/122) of lumbar spine shows hypointense amyloid tissue at site of synovial and ligamentous structures of right facet joints of T12 through L5 (arrows). Amyloid deposits also appear at site of dorsal ligament structures (arrowheads). L, Sagittal CT scan reconstruction of upper lumbar spine shows multiple erosions in superior and inferior articular process of facet joints (arrows) caused by amyloid deposits. lated amyloidosis in symptomatic shoulders and wrists of long-term hemodialysis patients. Sonography shows supraspinatus tendon thickening (> 7 mm), biceps tendon thickening (> 4 mm), or rotator cuff tears [4]. In addition, observed abnormalities are amyloid deposits seen as echogenic pads of material between the muscle layers and intraarticular or periarticular in close proximity to the subcoracoid recess, the biceps tendon, or the subacromial subdeltoid bursa [5] (Figs. 4B and 4C). Kay et al. [5] showed that the presence of rotator cuffs > 8 mm in thickness and echogenic pads between muscle groups of the rotator cuff corresponded to the presence of clinically or histologically evident β 2 -microglobulin amyloid with a sensitivity of 72% to 79% and a specificity of 79% to 100%. The measured structures, however, may be transiently edematous: tendinitis and synovitis are the main causes of nonamyloid swelling of the supraspinatus or biceps tendon. Measurement should, therefore, be obtained in the absence of clinical symptoms suggestive of these conditions or, if not possible, repeated 1 month later. Abnormal joint and bursal and peritendinous fluid collections (Fig. 4C) of the shoulder are common. Bursal collections frequently demonstrate loculation, thickening, and irregular borders consistent with synovitis. Sonography of the wrist exhibits thickening of the flexor and/or extensor tendons and amyloid deposits in the area of the synovial membranes (Fig. 3B). K MRI MRI allows assessment of intraosseous, periarticular, and soft-tissue involvement. In most patients, bone lesions show decreased signal intensity on T1-weighted images (Figs. 2B and 4D). T2-weighted images, on the other hand, show various signal intensity patterns that range from hypointense (Figs. 2C and 4E) to hyperintense. The variability in signal intensity is probably caused by the combination of amyloid deposits and fluid collection within the subchondral lesions. Identification of an intraosseous lesion with relatively low signal intensity on both T1- and T2-weighted images is helpful in the diagnosis of amyloidosis. Following IV injection of gadolinium-based contrast, the bone lesions usually show moderate enhancement (Fig. 2D). Synovial thickening can also be identified on T1- and T2-weighted images. Amyloid deposits in bursa result in bursitis, particularly in the subacromial subdeltoid, olecranon, iliopectineal, and popliteal bursae. In the intraarticular spaces, nodular lesions appear with decreased or intermediate signal intensity on T1-weighted images and decreased signal intensity on T2-weighted images. These lesions communicate with the subchondral bone lesions [6] (Figs. 4D and 4E). The lesions from pigmented villonodular synovitis, hemophilia, hemorrhagic geodes, and long-standing ischemic necrosis can show decreased signal intensity on T2-weighted images. These conditions should be included in a differential diagnosis. Destructive Spondyloarthropathy Destructive spondyloarthropathy is thought to be closely related to dialysis-related amyloidosis. Histologic examination of excised tissue shows β 2 -microglobulin amyloidal deposits in the intervertebral disk, the synovium of apophyseal joints, and the ligamentum flavum [7]. The syndrome is radiographically characterized by erosions of the anterosuperior and/or anteroinferior corners of the vertebral body, severe narrowing of the intervertebral disk space, and erosions and cysts of adjacent vertebral plates with minimal osteophyte formation (Figs. 4G, 4I, 5A, and 5B). As the disease progresses, vertebral body collapse, subluxation, or listhesis may occur. Single, or usually multiple, spinal levels reveal rapidly progressive destructive lesions [8]. CT is the best method for detecting small areas of osteolysis in cortical bone or osseous erosion, and it may be helpful in assessment of the distribution and extent of destructive changes (Figs. 4H and 4L). MRI demonstrates amyloid deposits in the intervertebral disk, in the synovium of apophyseal joints (Figs. 4I 4K), and in the ligamentum flavum. It may be difficult to differentiate changes secondary to dialysis-related amyloidosis from spondylodiscitis. In spondylodiscitis, structures that are involved show decreased signal intensity on T1-weighted MR images and increased signal intensity on T2-weighted and STIR images. Several studies have reported low signal L 1466 AJR:185, December 2005
8 Dialysis-Related Amyloidosis Revisited intensity in the affected intervertebral disks and adjacent vertebral endplates on both T1- and T2-weighted spin-echo MR images. Many investigators have also reported the absence of paraspinal masses. Conversely, other study groups have reported abnormal high signal intensity in the affected structures on T2-weighted MR images. In most cases, however, low signal is present in T2-weighted images (Fig. 4G) and allows exclusion of an infection [8]. Gout and calcium pyrophosphate deposition disease (CPPD) may involve the intervertebral disk and adjacent endplates, producing changes that may simulate those of infective spondylitis. It may also be difficult to differentiate other disorders such as neuropathic osteoarthropathy or severe intervertebral osteochondrosis [8]. The lower part of the cervical spine is most frequently involved [8]. The thoracic (Figs. 4I A Fig year-old woman on hemodialysis for 15 years for chronic glomerulonephritis with biopsy-proven dialysis-related amyloidosis. A, Lateral radiograph of cervical spine shows erosive spondyloarthropathy from C2 through C7 intervertebral levels, with narrowing of intervertebral disk space and extensive erosion and reactive sclerosis of adjacent vertebral endplates. Segments C2 through C5 are particularly affected. No relevant osteophytosis is evident; 10- mm anterolisthesis of body of C2 on C3 (black curved arrow) and 5-mm anterolisthesis of body of C3 on C4 (white curved arrow) are apparent. Resorption of C3 and C4 anterior margins (straight arrows) is also shown, a finding similar to that of infectious spondylodiscitis. B, Lateral radiograph of cervical spine obtained 2 years later shows severe progression of disease with progressive narrowing of intervertebral spaces from C2 through C7 (arrowheads). In patients with destructive spondyloarthropathy who are undergoing hemodialysis, radiographic progression of abnormalities is often rapid that is, over a period of months. and 4J) or lumbar (Figs. 4K and 4L) spine is occasionally affected, but involvement of the occipitoatlantoaxial region is uncommon. Hypertrophy of the synovia of the atlantoaxial joints, resembling the pannus of rheumatoid arthritis, produces soft-tissue masses (pseudotumors) that surround the dens (Figs. 4F 4H). The affected patient is at risk of developing severe neurologic complications that may require surgical intervention. Carpal Tunnel Syndrome The most common condition requiring surgery in patients on long-term dialysis is carpal tunnel syndrome [9]. In the wrist, changes due to dialysis-related amyloidosis are most frequently observed on the volar and interosseous borders of the carpal bones, but with extensive involvement, changes of the dorsal aspect are B also possible (Figs. 3C and 3D). Synovial involvement results in infiltration of the carpal tunnel, widening of the scapholunate and distal radioulnar articulations, disruption of the triangular fibrocartilage complex, and numerous erosions (Figs. 3A 3E). Conclusion Dialysis-related amyloidosis is characterized by various imaging appearances. In patients undergoing long-term hemodialysis, cystic and destructive lesions on conventional radiographs, echogenic soft-tissue abnormalities in intra- or periarticular structures, and relatively low-signal-intensity masses on T2- weighted MR images should raise the suspicion of dialysis-related amyloidosis. When evaluating amyloidosis, MRI is well suited for showing the extent and distribution of osseous, articular, and soft-tissue involvement in dialysis-related amyloidosis, considerably adding to the information obtained from conventional radiographic, CT, and sonographic studies. Conventional radiography often underestimates the extent of the disease. References 1. Danesh F, Ho LT. Dialysis-related amyloidosis: history and clinical manifestations. Semin Dial 2001; 14: Tan SY, Pepys MB, Hawkins PN. Treatment of amyloidosis. Am J Kidney Dis 1995; 26: Ross LV, Ross GJ, Mesgarzadeh M, et al. Hemodialysis-related amyloidomas of bone. Radiology 1991; 178: Sommer R, Valen GJ, Ori Y, et al. Sonographic features of dialysis-related amyloidosis of the shoulder. J Ultrasound Med 2000; 19: Kay J, Benson CB, Lester S, et al. Utility of highresolution ultrasound for the diagnosis of dialysis-related amyloidosis. Arthritis Rheum 1992; 35: Otake S, Tsuruta Y, Yamana D, et al. Amyloid arthropathy of the hip joint: MR demonstration of presumed amyloid lesions in 152 patients with longterm hemodialysis. Eur Radiol 1998; 8: Marcelli C, Perennou D, Cyteval C, et al. Amyloidosis-related cauda equina compression in long-term hemodialysis patients. Spine 1996; 21: Theodorou DJ, Theodorou SJ, Resnick D. Imaging in dialysis spondyloarthropathy. Semin Dial 2002; 15: Cobby MJ, Adler RS, Swartz R, et al. Dialysis-related amyloid arthropathy: MR findings in four patients. AJR 1991; 157: AJR:185, December
ELENI ANDIPA General Hospital of Athens G. Gennimatas
ELENI ANDIPA General Hospital of Athens G. Gennimatas Technological advances over the last years have caused a dramatic improvement in ultrasound quality and resolution An established imaging modality
More informationUltrasound Evaluation of Masses
Ultrasound Evaluation of Masses Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant: Bioclinica Advisory Panel: GE,
More informationUS finding of the shoulder (with live demonstration) 인제의대상계백병원 안재기
US finding of the shoulder (with live demonstration) 인제의대상계백병원 안재기 Shoulder US Biceps tendon & Rotator Cuff Long Head of Biceps Tendon Subscapularis tendon Supraspinatus tendon Infraspinatus tendon Teres
More informationCase 27 Clinical Presentation
53 Case 27 Clinical Presentation 40-year-old man presents with acute shoulder pain and normal findings on radiographs. 54 RadCases Musculoskeletal Radiology Imaging Findings (,) Coronal images of the shoulder
More informationGout. Crystal deposition disease: Imaging perspectives. Crystal associated arthropathies. Clinical Stages of Gout 07/06/60
Crystal associated arthropathies Crystal deposition disease: Imaging perspectives Warapat Virayavanich, MD Ramathibodi hospital, Mahidol University Commonly seen arthropathy MSU (gout) CPPD HADD Uncommon
More informationUltrasound assessment of most frequent shoulder disorders
Ultrasound assessment of most frequent shoulder disorders Poster No.: C-2026 Congress: ECR 2014 Type: Educational Exhibit Authors: S. P. Ivanoski; Ohrid/MK Keywords: Trauma, Athletic injuries, Arthritides,
More informationRotator Cuff and Biceps Pathology
Rotator Cuff and Biceps Pathology Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant: Bioclinica Advisory Board:
More informationSPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION
CLINICAL VIGNETTE 2017; 3:2 SPINAL MAGNETIC RESONANCE IMAGING INTERPRETATION Editor-in-Chief: Idowu, Olufemi E. Neurological surgery Division, Department of Surgery, LASUCOM/LASUTH, Ikeja, Lagos, Nigeria.
More informationAnatomy of the Musculoskeletal System
Anatomy of the Musculoskeletal System Kyle E. Rarey, Ph.D. Department of Anatomy & Cell Biology and Otolaryngology University of Florida College of Medicine Outline of Presentation Vertebral Column Upper
More informationISPUB.COM. Spectrum Of MRI Findings In Musculoskeletal Tuberculosis: Pictoral Essay. P Chudgar INTRODUCTION SPINE
ISPUB.COM The Internet Journal of Radiology Volume 8 Number 2 Spectrum Of MRI Findings In Musculoskeletal Tuberculosis: Pictoral Essay P Chudgar Citation P Chudgar.. The Internet Journal of Radiology.
More informationUltrasound of the Hip: Anatomy, Pathology, and Procedures
Ultrasound of the Hip: Anatomy, Pathology, and Procedures Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Outline Hip Joint Native hip
More informationLipoma Arborescens of Subacromial-subdeltoid Bursa: Ultrasonographic Findings
C A S E R E P O R T Lipoma Arborescens of Subacromial-subdeltoid Bursa: Ultrasonographic Findings Amelia Bargiela*, Esther Rodriguez, Rafaela Soler The present study describes the ultrasound findings of
More informationRheumatoid Arthritis 2. Inflammatory Diseases. Definition. Imaging Signs
Rheumatoid Arthritis 2 Definition " Epidemiology Affects 2% of the population Peak incidence (diagnosis) in 4th and 5th decades Women affected 3 4 times more often than men Increased familial incidence
More informationCommon Applications for Sonography and Guided Intervention: Shoulder
Common Applications for Sonography and Guided Intervention: Shoulder Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant:
More informationMRI findings in proven Mycobacterium tuberculosis (TB) spondylitis
CASE ORIGINAL REPORT ARTICLE MRI findings in proven Mycobacterium tuberculosis (TB) spondylitis D J Kotzé, MB ChB L J Erasmus, MB ChB Department of Diagnostic Radiology, University of the Free State, Bloemfontein
More informationAnkylosing spondylitis: A Pictorial Review
Ankylosing spondylitis: A Pictorial Review Poster No.: P-0009 Congress: ESSR 2012 Type: Scientific Exhibit Authors: J. Acosta Batlle, B. Palomino Aguado, M. D. Lopez Parra, S. 1 2 3 2 4 1 2 Hernandez Muñiz,
More informationAPPROPRIATE USE GUIDELINES
APPROPRIATE USE GUIDELINES Appropriateness of Advanced Imaging Procedures (MRI, CT, Bone Scan/PET) in Patients with Shoulder Pain CDI QUALITY INSTITUTE: PROVIDER LED ENTITY (PLE) Compiled by Rob Liddell,
More informationMRI evaluation of the shoulder: Beyond rotator cuff
MRI evaluation of the shoulder: Beyond rotator cuff Poster No.: C-2447 Congress: ECR 2015 Type: Educational Exhibit Authors: C. Rumie, A. Vasquez, J. A. Abreu, A. P. Guarnizo, O. Rivero, 1 1 2 3 1 1 1
More informationMessage of the Month for GPs June 2013
Message of the Month for GPs June 2013 Dr Winn : Consultant Musculoskeletal Radiologist, Manchester Royal Infirmary Imaging of the musculoskeletal system Musculoskeletal pain is a common problem in the
More informationMUSCULOSKELETAL RADIOLOGY
MUSCULOSKELETAL RADOLOGY SECTON www.cambridge.org Achilles tendonopathy/rupture Characteristics Describes pathology of the combined tendon of the gastro-soleus complex, which inserts onto the calcaneum.
More informationImaging of Cervical Spine Trauma Tudor H Hughes, M.D.
Imaging of Cervical Spine Trauma Tudor H Hughes, M.D. General Considerations Most spinal fractures are due to a single episode of major trauma. Fatigue fractures of the spine are unusual except in the
More informationRadiologic features of a pyrophosphate-like arthropathy associated with long-term dialysis
Skeletal Radiol (1987) 16:437-441 Skeletal Radiology Radiologic features of a pyrophosphate-like arthropathy associated with long-term dialysis Ethan M. Braunstein, M.D. 1, Kathleen Menerey, M.D. 2, William
More informationBilateral Shoulder Pain
HR J Bilateral Shoulder Pain, p. 64-69 Clinical Case - Test Yourself Bilateral Shoulder Pain Musculoskeletal Eirini D. Savva, Rafaela M. Smarlamaki, Foteini I. Terezaki Department of Radiology, University
More information102 Results RESULTS. Age Mean=S.D Range 42= years -84 years Number % <30 years years >50 years
102 Results RESULTS A total of 50 cases were studied 39 males and 11females.Their age ranged between 16 years and 84 years (mean 42years). T1 and T2WI were acquired for all cases in sagittal and axial
More informationOSTEOPHYTOSIS OF THE FEMORAL HEAD AND NECK
908 RDIOLOGIC VIGNETTE OSTEOPHYTOSIS OF THE FEMORL HED ND NECK DONLD RESNICK Osteophytes are frequently considered the most characteristic abnormality of degenerative joint disease. In patients with osteoarthritis,
More informationManagement of Skip-Lesions in Dialysis-Related Cervical Spondyloarthropathy
ISPUB.COM The Internet Journal of Neurosurgery Volume 3 Number 1 Management of Skip-Lesions in Dialysis-Related Cervical Spondyloarthropathy S Chandela, J Llena, J Houten Citation S Chandela, J Llena,
More information석회성건염 한양의대재활의학교실 이규훈
석회성건염 한양의대재활의학교실 이규훈 Definition Calcifying tendinitis Acute or chronically painful condition that is caused by inflammation around calcium deposits located in or around the tendons Vascularized, viable
More informationGiant-cell tumor of the tendon sheath: when must we suspect it?
Giant-cell tumor of the tendon sheath: when must we suspect it? Poster No.: C-0538 Congress: ECR 2014 Type: Educational Exhibit Authors: C. Santos Montón, J. M. Alonso Sánchez, D. C. Cuellar, P. A. Chaparro
More information4/28/2010. Fractures. Normal Bone and Normal Ossification Bone Terms. Epiphysis Epiphyseal Plate (physis) Metaphysis
Fractures Normal Bone and Normal Ossification Bone Terms Epiphysis Epiphyseal Plate (physis) Metaphysis Diaphysis 1 Fracture Classifications A. Longitudinal B. Transverse C. Oblique D. Spiral E. Incomplete
More informationtriquetrum in rheumatoid arthritis
Ann. rheum. Dis. (1976), 35, 46 Early abnormalities of pisiform and triquetrum in rheumatoid arthritis DONALD RESNICK From the Department of Radiology, Veterans Administration Hospital, San Diego, and
More informationPage 2 of 48
Conventional Radiography (CR), Computed Tomography (TC) and Magnetic Resonance imaging (MRI): What every radiologist should know about Calcium Pyrophosphate Dihydrate (CPPD) Crystal Deposition Disease?
More informationBasic Radiographic Principles Part II
Basic Radiographic Principles Part II Kristopher Avant, D.O. October 19 th, 2016 I have no disclosures relevant to the material presented in this discussion. Good Stuff!!! 1 Really? Really! Musculoskeletal
More informationRadiologic Pathologic Correlation of Intraosseous Lipomas. Tim Propeck 1, Mary Anne Bullard 1, John Lin 1, Kei Doi 2, William Martel 1
Downloaded from www.ajronline.org by 148.251.232.83 on 04/10/18 from IP address 148.251.232.83. opyright RRS. For personal use only; all rights reserved Radiologic Pathologic orrelation of Intraosseous
More informationFunctional Orthopedic Imaging Capturing Motion, Flow and Perfusion. Case Study Brochure Centre University Hospital Nancy.
Capturing Motion, Flow and Perfusion dynamic volume CT Case Study Brochure Centre University Hospital Nancy http://www.toshibamedicalsystems.com Toshiba Medical Systems Corporation 2013. All rights reserved.
More informationUltrasound of the Shoulder
Ultrasound of the Shoulder Patrick Battaglia, DC, DACBR Logan University, Department of Radiology Outline Review ultrasound appearance of NMSK tissues Present indications for ultrasound of the shoulder.
More informationUltrasound of Shoulder Pathology and Intervention 서울대학교병원재활의학과 김기원
Ultrasound of Shoulder Pathology and Intervention 서울대학교병원재활의학과 김기원 Ultrasound for Shoulder Disorder Advantage Dynamic evaluation Immediate clinical correlation + Intervention Weakness Diagnostic accuracy?
More informationMRI XR, CT, NM. Principal Modality (2): Case Report # 2. Date accepted: 15 March 2013
Radiological Category: Musculoskeletal Principal Modality (1): Principal Modality (2): MRI XR, CT, NM Case Report # 2 Submitted by: Hannah Safia Elamir, D.O. Faculty reviewer: Naga R. Chinapuvvula, M.D.
More informationArthritis due to deposition diseases: differential diagnosis in conventional radiology
Arthritis due to deposition diseases: differential diagnosis in conventional radiology Poster No.: C-1599 Congress: ECR 2016 Type: Educational Exhibit Authors: A. P. Pissarra, R. R. Domingues Madaleno,
More informationUltrasonographic Evaluation of Painful Shoulder joint in rural population
Original article: Ultrasonographic Evaluation of Painful Shoulder joint in rural population Dr. Pankaj Garg*, Dr. V.N. Marathe, Dr. S. G. Gandage, Dr.S.G.Kachewar Department of Radiology, Rural Medical
More informationThe role of CT and MRI in evaluation of Osteoid Oteoma
The role of CT and MRI in evaluation of Osteoid Oteoma Elene Iordanishvili Tbilisi Sate Medical University Instructor: Prof. Dr. Ketevan Kotetishvili Department of Physics Georgian Technical University
More informationPigmented Villonodular Synovitis PVNS
February 2002 Pigmented Villonodular Synovitis PVNS Amy Gillis, Harvard Medical School Year III 47 year old female Our Patient Right hip pain since age 20 No history of trauma Diagnosed with DJD of R hip
More informationCarpal instability in rheumatoid arthritis and
Annals of the Rheumatic Diseases, 1977, 36, 311-318 Carpal instability in rheumatoid arthritis and calcium pyrophosphate deposition disease Pathogenesis and roentgen appearance D. RESNICK AND G. NIWAYAMA
More informationThe Upper Limb II. Anatomy RHS 241 Lecture 11 Dr. Einas Al-Eisa
The Upper Limb II Anatomy RHS 241 Lecture 11 Dr. Einas Al-Eisa Sternoclavicular joint Double joint.? Each side separated by intercalating articular disc Grasp the mid-portion of your clavicle on one side
More informationESSENTIALS OF PLAIN FILM INTERPRETATION: SPINE DR ASIF SAIFUDDIN
ESSENTIALS OF PLAIN FILM INTERPRETATION: SPINE DR ASIF SAIFUDDIN Consultant Musculoskeletal Radiologist Royal National Orthopaedic Hospital Stanmore,UK. INTRODUCTION 2 INTRODUCTION 3 INTRODUCTION Spinal
More informationMR IMAGING OF THE WRIST
MR IMAGING OF THE WRIST Wrist Instability Dissociative Pattern apparent on routine radiographs Non-dissociative Stress / positional radiographs Dynamic fluoroscopy during stress Arthrography MRI / MR arthrography
More informationTopics. Musculoskeletal Infection Extremities. Detection of Infection. Role of Imaging in Extremity Infection. Detection of Infection
Topics Musculoskeletal Infection Extremities Nuttaya Pattamapaspong M.D. Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Role of imaging in extremity infection
More informationPragmatic ultrasound in the diagnosis of soft tissue rheumatic pain. Plamen Todorov
Pragmatic ultrasound in the diagnosis of soft tissue rheumatic pain Plamen Todorov INTRODUCTION Soft tissue rheumatism: nonsystemic, focal pathological syndromes involving the periarticular structures.
More informationOriginal Report. The Reverse Segond Fracture: Association with a Tear of the Posterior Cruciate Ligament and Medial Meniscus
Eva M. Escobedo 1 William J. Mills 2 John. Hunter 1 Received July 10, 2001; accepted after revision October 1, 2001. 1 Department of Radiology, University of Washington Harborview Medical enter, 325 Ninth
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Abscess, epidural, 822 824 Achilles tendon rupture, 894 895, 981 982 Acromioclavicular separations, shoulder pain in, 751 753 Adhesive capsulitis,
More informationSonographic appearance of chronic inflammatory rheumatism
Sonographic appearance of chronic inflammatory rheumatism Poster No.: C-2237 Congress: ECR 2013 Type: Educational Exhibit Authors: H. Elfattach, F. Houari, O. Addou, M. Maaroufi, S. Tizniti ; 1 1 1 1 2
More informationUrgent Cases and Foreign Bodies
Urgent Cases and Foreign Bodies Catherine J. Brandon, MD, MS University of Michigan Ann Arbor, MI, USA Introduction: Patients added on to the schedule from the emergency department or as urgent add-on
More informationFISH VERTEBRAE RADIOLOGIC VIGNETTE DONALD L. RESNICK
~ 1073 RADIOLOGIC VIGNETTE FISH VERTEBRAE DONALD L. RESNICK The term fish verfebru is applied to a vertebral body that has an abnormal shape characterized by biconcavity due to depression of its superior
More informationImaging of Ankle and Foot pain
Imaging of Ankle and Foot pain Pramot Tanutit, M.D. Department of Radiology Faculty of Medicine, Prince of Songkla University 1 Outlines Plain film: anatomy Common causes of ankle and foot pain Exclude:
More informationAssessment of crystal deposition diseases with High Resolution Ultrasound
Assessment of crystal deposition diseases with High Resolution Ultrasound Poster No.: C-2223 Congress: ECR 2010 Type: Educational Exhibit Topic: Musculoskeletal Authors: A. Miquel, P. Bienvenot, C. Pradel,
More informationFiguring out the "fronds"-synovial proliferative disorders of the knee.
Figuring out the "fronds"-synovial proliferative disorders of the knee. Poster No.: C-1209 Congress: ECR 2014 Type: Educational Exhibit Authors: S. Sivasubramanian; Tamil Nadu/IN Keywords: Imaging sequences,
More informationMR Imaging in Athlete s Hip/Pelvis
MR Imaging in Athlete s Hip/Pelvis Tara Lawrimore, MD FRCPC Department of Radiology Musculoskeletal Division Massachusetts General Hospital Harvard Medical School No disclosures MR and Hip Pain in the
More information8/4/2012. Causes and Cures. Nucleus pulposus. Annulus fibrosis. Vertebral end plate % water. Deforms under pressure
Causes and Cures Intervertebral discs Facet (zygopophyseal) joints Inter body joints Spinal nerve roots Nerve compression Pathological conditions Video Causes of back pain Nucleus pulposus Annulus fibrosis
More informationUpdate - Imaging of the Spondyloarthropathies. Spondyloarthropathies. Spondyloarthropathies
Update - Imaging of the Spondyloarthropathies Donald J. Flemming, M.D. Dept of Radiology Penn State Hershey Medical Center Spondyloarthropathies Family of inflammatory arthritides of synovium and entheses
More informationChronic knee pain in adults - a multimodality approach or which modality to choose and when?
Chronic knee pain in adults - a multimodality approach or which modality to choose and when? Poster No.: P-0157 Congress: ESSR 2013 Type: Authors: Keywords: DOI: Scientific Exhibit E. Ilieva, V. Tasseva,
More informationdevelopment of erosive osteoarthritis?
Annals of the Rheumatic Diseases, 1989; 48, 183-187 Scientific papers Is chronic renal failure a risk factor for the development of erosive osteoarthritis? I J S DUNCAN,' N P HURST,' A DISNEY,2 R SEBBEN,3
More informationCalcific Tendinitis of the Long Head of the Biceps Brachii Distal to the Glenohumeral Joint: Plain Film
1011 Calcific Tendinitis of the Long Head of the Biceps Brachii Distal to the Glenohumeral Joint: Plain Film Radiographic Findings Amy Beth Goldman1 Calcific tendinitis is a painful condition related to
More informationCLINICAL CONCEPTS FOR ORTHOPEDICS. CMS Clinical Concepts
CLINICAL CONCEPTS FOR ORTHOPEDICS CMS Clinical Concepts ICD 10 LESSONS FROM OFFICE DOCUMENTATION Presented by Dr. Frankeny OUR CHALLENGE: CHANGING OUR DOCUMENTATION ICD 10 Learn the nomenclature Documenting
More informationRenal osteodystrophy revisited: A didactic review of imaging, pathophysiology, and differential diagnosis
Renal osteodystrophy revisited: A didactic review of imaging, pathophysiology, and differential diagnosis Poster No.: C-2174 Congress: ECR 2010 Type: Educational Exhibit Topic: Musculoskeletal Authors:
More informationMRI of the Shoulder What to look for and how to find it? Dr. Eric Handley Musculoskeletal Radiologist Cherry Creek Imaging
MRI of the Shoulder What to look for and how to find it? Dr. Eric Handley Musculoskeletal Radiologist Cherry Creek Imaging MRI of the Shoulder Benefits of Ultrasound: * Dynamic * Interactive real time
More informationBones? Did someone say bones? 12/31/2012. W.R Reinus, MD MBA FACR
William R. Reinus, MD MBA FACR Temple University Medical Center Aug 2012 (55) 1 Bones? Did someone say bones? 2 ABC S OF ARTHRITIS Arthritis: By definition, any disease that is jointcentered: Both sides
More informationMusculoskeletal MR Protocols
Musculoskeletal MR Protocols Joint-based protocols MSK 1: Shoulder MRI MSK 1A: Shoulder MR arthrogram MSK 1AB: Shoulder MR arthrogram (instability protocol) MSK 2: Elbow MRI MSK 2A: Elbow MR arthrogram
More informationBenefits of Aspiration and Injection JOINT INJECTIONS. Injection Indications. Mechanism of Action 1/11/2016
Benefits of Aspiration and Injection JOINT INJECTIONS Mark Niedfeldt, M.D. Medical College of Wisconsin Decrease or resolution of pain Decrease or resolution of inflammation Decrease or resolution of effusion
More informationHYPEROSTOSIS AND OSSIFICATION IN THE CERVICAL SPINE
564 RADIOLOGIC VIGNETTE HYPEROSTOSIS AND OSSIFICATION IN THE CERVICAL SPINE DONALD RESNICK A variety of diseases can produce hyperostosis or ossification in the cervical spine. Included among these are
More informationSurgical Management of Cervical Spondyloarthropathy in Hemodialysis Patients
The Open Orthopaedics Journal, 2010, 4, 39-43 39 Open Access Surgical Management of Cervical Spondyloarthropathy in Hemodialysis Patients Panayiotis Spinos 1, Charalambos Matzaroglou *,2, Meni Partheni
More informationMUSCULOSKELETAL IMAGING FOR PHYSICAL THERAPISTS. COMBINED SECTIONS MEETING 2006 San Diego, CA February 1-5, 2006
MUSCULOSKELETAL IMAGING FOR PHYSICAL THERAPISTS COMBINED SECTIONS MEETING 2006 San Diego, CA February 1-5, 2006 John Meyer, DPT, OCS University of Southern California Department of Athletic Medicine Los
More informationCase Report: CASE REPORT OF FACET ARTHROPATHY INDUCED NERVE ROOT COMPRESSION RESULTING IN MOTOR WEAKNESS AND PAIN
Cox Technic Case Report #100 published at www.coxtechnic.com (sent October 2011 on 10/11/11 ) 1 Case Report: CASE REPORT OF FACET ARTHROPATHY INDUCED NERVE ROOT COMPRESSION RESULTING IN MOTOR WEAKNESS
More informationIndex. B Backslap technique depth assessment, 82, 83 diaphysis distal trocar, 82 83
Index A Acromial impingement, 75, 76 Aequalis intramedullary locking avascular necrosis, 95 central humeral head, 78, 80 clinical and functional outcomes, 95, 96 design, 77, 79 perioperative complications,
More informationComplex Fractures and Hip Dislocations
IMAGING OF HIP PAIN Patients may present with acute (< 2 weeks) or chronic hip pain. Acute pain may be related or not related to an acute traumatic event such as fall or trauma from a motor vehicle accident.
More informationExtraarticular Lateral Ankle Impingement
Extraarticular Lateral Ankle Impingement Poster No.: C-1282 Congress: ECR 2016 Type: Educational Exhibit Authors: C. Cevikol; Keywords: Trauma, Diagnostic procedure, MR, CT, Musculoskeletal system, Musculoskeletal
More informationArticular disease of the hand - the target joint approach
Articular disease of the hand - the target joint approach Poster No.: C-1817 Congress: ECR 2016 Type: Educational Exhibit Authors: R. R. Domingues Madaleno 1, A. P. Pissarra 1, I. Abreu 2, A. Canelas 1,
More informationMusculoskeletal Ultrasound. Technical Guidelines SHOULDER
Musculoskeletal Ultrasound Technical Guidelines SHOULDER 1 Although patient s positioning for shoulder US varies widely across different Countries and Institutions reflecting multifaceted opinions and
More informationAnkle impingement syndromes - pictorial review.
Ankle impingement syndromes - pictorial review. Poster No.: P-0148 Congress: ESSR 2015 Type: Educational Poster Authors: R. D. T. Mesquita, J. Pinto, J. L. Rosas, A. Vieira ; Porto/PT, 1 2 2 3 1 1 3 Matosinhos/PT,
More informationAnkle impingement syndromes - pictorial review.
Ankle impingement syndromes - pictorial review. Poster No.: P-0148 Congress: ESSR 2015 Type: Educational Poster Authors: R. D. T. Mesquita, J. Pinto, J. L. Rosas, A. Vieira ; Porto/PT, 1 2 2 3 1 1 3 Matosinhos/PT,
More informationDISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS
DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS Lyndon B. Gross M.D. Ph.D. The Orthopedic Center of St. Louis SHOULDER PAIN Third most common musculoskeletal
More informationAnatomy Workshop Upper Extremity David Ebaugh, PT, PhD Workshop Leader. Lab Leaders: STATION I BRACHIAL PLEXUS
Anatomy Workshop Upper Extremity David Ebaugh, PT, PhD Workshop Leader Lab Leaders: STATION I BRACHIAL PLEXUS A. Posterior cervical triangle and axilla B. Formation of plexus 1. Ventral rami C5-T1 2. Trunks
More informationMRI and ultrasound in the post operative rizarthrosis patient
MRI and ultrasound in the post operative rizarthrosis patient Poster No.: C-2190 Congress: ECR 2012 Type: Educational Exhibit Authors: L. Fernandes, P. Alves, J. Lopes Dias, J. Pereira, R. D. T. 1 2 3
More informationGlenohumeral Joint Instability. Static Stabilizers of the GHJ. Static Stabilizers of the GHJ. Static Stabilizers of the GHJ
1 Glenohumeral Joint Instability GHJ Joint Stability: Or Lack Thereof! Christine B. Chung, M.D. Assistant Professor of Radiology Musculoskeletal Division UCSD and VA Healthcare System Static Stabilizers
More informationLigaments of Elbow hinge: sagittal plane so need lateral and medial ligaments
Ligaments of Elbow hinge: sagittal plane so need lateral and medial ligaments Ulnar Collateral ligament on medial side; arising from medial epicondyle and stops excess valgus movement (lateral movement)
More informationSeronegative spondyloarthropathies : A Pictorial Review
Seronegative spondyloarthropathies : A Pictorial Review Poster No.: P-0008 Congress: ESSR 2012 Type: Scientific Exhibit Authors: J. Acosta Batlle, B. Palomino Aguado, M. D. Lopez Parra, S. 1 2 3 2 4 1
More informationUltrasound of Mid and Hindfoot Pathology
Ultrasound of Mid and Hindfoot Pathology Levon N. Nazarian, M.D. Professor of Radiology Thomas Jefferson University Hospital Disclosures None relevant to this presentation Educational Objective Following
More informationIndex. Note: Page numbers of article titles are in boldface type.
Magn Reson Imaging Clin N Am 12 (2004) 185 189 Index Note: Page numbers of article titles are in boldface type. A Acromioclavicular joint, MR imaging findings concerning, 161 Acromion, types of, 77 79
More informationof the lumbar facet joints there
Skeletal Radiol (1999) 28:215±219 International Skeletal Society 1999 A R T I C L E Dominik Weishaupt Marco Zanetti Norbert Boos Juerg Hodler MR imaging and CT in osteoarthritis of the lumbar facet joints
More informationMRI IN NONOSSEOUS ABNORMALITIES OF THE FOREFOOT: A PICTORIAL REVIEW
MRI IN NONOSSEOUS ABNORMALITIES OF THE FOREFOOT: A PICTORIAL REVIEW I Delgado, P Melloni, M Veintemillas, R Valls, M Vilagran, A Valera UDIAT. Sabadell (Barcelona). Spain. PURPOSE To catalog the wide spectrum
More informationSkeletal System. Bones & Joints
Skeletal System Bones & Joints Vertebral Column Upper Limb Lower Limb OUTLINE Clinical Related Features Arrangements Features of the Joints Vertebral Column (Overview) Costal Element Regional Features
More informationSCAHPO-LUNATE DISSOCIATION
SCAHPO-LUNATE DISSOCIATION Introduction Scapho-lunate dissociation is the most common significant ligamentous injury of the wrist. The condition is also sometimes referred to as rotary subluxation of the
More informationTrauma & Orthopaedic Undergraduate Syllabus
Trauma & Orthopaedic Undergraduate Syllabus Introduction The purpose of this document is to provide a recommended syllabus for medical students in Trauma & Orthopaedics (T&0). It should help students on
More informationWhat can Imaging tell us?
What can Imaging tell us? David Connell FRANZCR, FFSEM (UK) Assoc Professor Dept of Medicine, Nursing & Healthcare Monash University, Melbourne, Australia Assoc Professor Sport & Exercise Medicine Research
More informationCitation Acta medica Nagasakiensia. 2000, 45
NAOSITE: Nagasaki University's Ac Title Author(s) Pictorial Essay Magnetic Resonance Related Disorders Uetani, Masataka; Hashmi, Rashid; N Hayashi, Kuniaki Citation Acta medica Nagasakiensia. 2000, 45
More informationRevised Dec Spine MR Protocols
Spine MR Protocols Sp 1: Cervical spine MRI without contrast Sp 2: Pre- and post-contrast cervical spine MRI Sp 3: Pre- and post-contrast cervical spine MRI (multiple sclerosis protocol) Sp 4: Thoracic
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 9/22/2012 Radiology Quiz of the Week # 91 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationIndex. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acromioclavicular joint injuries in football players, 318, 319 ALPSA. See Anterior labroligamentous periosteal sleeve avulsion. Anterior
More informationPediatric Musculoskeletal Ultrasound: Cases reviewed and lessons learned
Pediatric Musculoskeletal Ultrasound: Cases reviewed and lessons learned Jessica Leschied, MD Sections of Pediatric and Musculoskeletal Radiology C.S. Mott Children s Hospital University of Michigan Ann
More informationSpondyloarthritis: A Gouty Display
Spondyloarthritis: A Gouty Display Preetam Gongidi 1*, Shawn Gough-Fibkins 2 1. Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA 2. Broward General Medical Center,
More informationThe Elbow 3/5/2015. The Elbow Scanning Sequence. * Anterior Joint (The anterior Pyramid ) * Lateral Epicondyle * Medial Epicondyle * Posterior Joint
Scanning Sequence * Anterior Joint (The anterior Pyramid ) * Lateral Epicondyle * Medial Epicondyle * Posterior Joint Anterior Elbow Pyramid Courtesy of Jay Smith, MD. Vice chair PMR Mayo Clinic Rochester,
More informationIntroduction to Ultrasound Examination of the Hand and upper
Introduction to Ultrasound Examination of the Hand and upper Emil Dionysian, M.D. Ultrasound of upper ext. Upside Convenient Opens another exam dimension Can be like a stethoscope Helps 3-D D visualization
More information