Symptomatic osteochondromas: imaging features.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
D Karasick
Publications and source records attributed to D Karasick.
Complications of cervical spine fusion: imaging features.
Explore the source record for details and available documents.
Bone Screws↗
Osseous metaplasia associated with amyloid-producing plasmacytoma of bone: a report of two cases.
Amyloid-producing plasmacytoma of bone is a rare myeloma variant. We describe two patients with plasmacytomas of bone with extensive amyloid deposition and metaplastic bone formation which can be confused on imaging with osteosarcoma. Histologic confirmation was obtained in both cases. Metaplastic new bone formation was identified within these lesions and appears to be responsible for the radiographic appearances.
Aged↗
The os trigonum syndrome: imaging features.
The os trigonum syndrome refers to symptoms produced by pathology of the lateral tubercle of the posterior talar process. Pain can be caused by disruption of the cartilaginous synchondrosis between the os trigonum and the lateral talar tubercle as a result of repetitive microtrauma and chronic inflammation. Additional etiologies include trigonal process fracture, flexor hallucis longus tenosynovitis, posterior tibiotalar impingement by bone block, and intraarticular loose bodies. This pictorial essay explores the role of imaging modalities in the diagnosis and treatment of the os trigonum syndrome, a symptom complex that may present difficult diagnostic problems.
Adult↗
Preoperative assessment of symptomatic bunionette deformity: radiologic findings.
A symptomatic bunionette (tailor's bunion) is a painful bony prominence on the lateral side of the fifth metatarsal head, often associated with an inflamed thickened adventitious bursa and hypertrophic keratoses or calluses. The diagnosis is based on the presence of pain that is most often caused by pressure from footwear. The purpose of this essay is to illustrate the radiographic abnormalities of bunionettes and useful angular measurements as they relate to the preoperative evaluation of symptomatic bunionette deformity.
Adult↗
Adhesive capsulitis of the shoulder: MR diagnosis.
OBJECTIVE: Adhesive capsulitis is a clinical syndrome of pain and severely decreased joint motion ("frozen shoulder") caused by thickening and contraction of the joint capsule and synovium. Although arthrographic criteria for the diagnosis have been described, to our knowledge, the MR characteristics have not been reported. Accordingly, we studied the MR findings in 10 patients with this syndrome. MATERIALS AND METHODS: MR images of 25 subjects were included in the study. Nine had adhesive capsulitis documented by arthrography, and one had adhesive capsulitis proved at surgery. The MR findings in these patients were compared with those of 15 asymptomatic volunteers. Images were assessed for thickness of the joint capsule and synovium, for thickness of the coracohumeral ligament, and for volume of articular fluid. Capsule and synovium thickness was measured adjacent to the axillary recess. The volume of intraarticular fluid was calculated from direct measurements of the axillary recess and biceps tendon sheath. The rotator cuff interval was qualitatively evaluated for the presence of abnormal tissue. RESULTS: Thickening of capsule and synovium on MR images was characteristic of adhesive capsulitis, with a significant difference between mean thickness in patients with adhesive capsulitis (5.2 mm) and in asymptomatic volunteers (2.9 mm) (p < .01). Capsule and synovium thickness greater than 4 mm was a specific (95%) and sensitive (70%) criterion for the diagnosis of adhesive capsulitis. There was no significant difference in volume of articular fluid or thickness of the coracohumeral ligament between patients with adhesive capsulitis and asymptomatic volunteers (p > .5). The rotator cuff interval was not useful for assessing changes of adhesive capsulitis. CONCLUSION: Joint capsule and synovium thickness greater than 4 mm is a useful MR criterion for the diagnosis of adhesive capsulitis. The volume of articular fluid seen on MR images is not significantly diminished in patients with adhesive capsulitis.
Adult↗
Fractures of the vertebrae with spinal cord injuries in patients with ankylosing spondylitis: imaging findings.
Ankylosing spondylitis is a systemic rheumatologic disorder of adults that results in disease-specific inflammation and eventual ossification at the site of ligamentous insertion into bone. The resulting spinal ankylosis causes biomechanical alterations that predispose the patient to serious spinal injury even in the presence of minor trauma. With the loss of spinal flexibility and increased bone fragility, there is a propensity for vertebral fracture, instability, and increased neurologic complications. Illustrative examples of the imaging modalities are presented, as they contribute to the detection of fractures and spinal cord injuries in patients with ankylosing spondylitis.
Adult↗
Fractures and dislocations of the foot.
The incidence and severity of fractures and dislocations vary depending on their location and on the direction of the forces responsible for the injury. The radiologist's role in evaluation of the injured foot is to recognize the types of injuries produced by particular forces. Because there is considerable overlap of fractures and dislocations of the foot and ankle, evaluation of one area to the neglect of the other can lead to significant oversights and failure to recognize additional injury patterns. For example, fractures of the talus, calcaneus, base of the fifth metatarsal, and to a lesser extent, the cuboid and navicular bones may masquerade as ankle sprains or malleolar injuries. The most important aspects to correct interpretation of traumatized foot radiographs are (1) pertinent clinical history, (2) a complete radiographic series, and (3) detection of soft-tissue swelling or injury.
Child↗
MRI of the ankle and hindfoot.
MRI of the ankle and hindfoot has become a widely used diagnostic test. The major indications for MRI of this region are disorders of tendons and bones. Avascular necrosis is common in the foot, usually seen after talus fractures or spontaneously in the metatarsal heads. Other causes of a marrow edema pattern include occult fractures, arthritic disorders, reactions to altered biomechanics, osteomyelitis, and regional migratory osteoporosis. The most frequently diseased tendons in the ankle are the Achilles, posterior tibial, and peroneal. MRI can be used to diagnose most disorders of these tendons, as well as stage these disorders to allow appropriate therapy. Most of these tendon disorders follow a recognized sequence of progression using the Achilles tendon as a model.
Achilles Tendon↗
Anterior cervical spine fusion: struts, plugs, and plates.
Bone grafting in the cervical spine is an expanding and rapidly changing area. Its success depends on the presence of bone formation, bone incorporation, and ongoing adaptive remodeling to mechanical loads. The evaluation of anterior cervical spine grafts requires a basic understanding of bone graft physiology, its clinical applications, and its postoperative appearances. The roles of routine radiography, polydirectional tomography, computed tomography, and magnetic resonance imaging in the assessment and follow-up of the postoperatively grafted cervical spine will be discussed. The main focus of this paper is to review current surgical procedures utilized for stabilizing the cervical spine as well as to discuss the radiologist's role in the imaging of this region.
Bone Plates↗
Posterior tibial tendon tears: utility of secondary signs for MR imaging diagnosis.
To assess the range of appearance of both torn and normal posterior tibial tendons (PTTs) and to evaluate secondary signs related to abnormal biomechanics as aids in diagnosing PTT tears, 23 patients with complete PTT tears and 34 control patients were examined with magnetic resonance imaging at 1.5 T. Examiners were blinded to diagnosis. The diameter of the PTT was measured at the insertion and at the level of the ankle. The torn and control PTTs were bulbous distally (respective mean values, 6.2 mm vs 4.6 mm), with overlap in the range of tendon size. All PTTs also had overlap in the frequency of intra-tendon signal intensity (torn PTTs, 83%, vs control PTTs, 41%; T1-weighted, 61%, vs T2-weighted, 22%). The presence of a talonavicular abnormality was both a sensitive (82%) and specific (100%) sign of a PTT tear. The presence of medial tubercle hypertrophy (sensitivity, 89%; specificity, 75%) and an accessory navicular bone (sensitivity, 20%; specificity, 100%) were useful secondary signs of a complete PTT tear.
Adolescent↗
Functional disorders of the anus and rectum: findings on defecography.
In the past decade, interest in the anorectal region and the mechanism of continence and defecation has been increasing. Subsequently, techniques to visualize the anorectum have been introduced; evacuation proctography and defecography have been used to describe the dynamic radiologic evaluation of this area. Also, developments in anorectal manometry, electromyography, and transrectal sonography have renewed interest in defecography, particularly in categorizing the functional disorders including rectocele, intussusception and prolapse, enterocele, descending perineum syndrome, dyskinetic puborectalis muscle, solitary rectal ulcer syndrome, and incontinence.
Anal Canal↗
Tear of the posterior tibial tendon causing asymmetric flatfoot: radiologic findings.
OBJECTIVE: The purpose of this study was to describe the preoperative radiographic appearance of the acquired asymmetric flatfoot caused by a tear of the posterior tibial tendon. These radiographic changes reflect the loss of tendon function and the development of flatfoot deformity. SUBJECTS AND METHODS: Preoperative radiographs of 30 patients (mean age, 48 years) with surgically proved complete tears of the posterior tibial tendon were evaluated. Erect anteroposterior and lateral views of the feet were obtained in all patients and were frequently supplemented with anteroposterior views of the ankles to evaluate valgus tilt. Calcaneal plantar, talocalcaneal, and talometatarsal angles were measured on radiographs and compared with the measurements in normal control subjects. Additional osseous and soft-tissue abnormalities were also evaluated. RESULTS: Findings on preoperative radiographs of the foot were abnormal in 50% of patients. These abnormalities included decreased calcaneal plantar angle (50%), increased lateral talometatarsal angle (47%), increased anterior talocalcaneal angle (43%), and increased lateral talocalcaneal angle (13%). Bone and soft-tissue abnormalities included osteoporosis (37%), medial soft-tissue swelling (27%), tarsal osteoarthritis (20%), distal tibial proliferative changes (7%), and the presence of accessory navicular bones (17%). CONCLUSION: Multiple abnormalities of the intertarsal relationships are seen as a result of tears of the posterior tibial tendon with the development of hindfoot valgus, midfoot abduction, and forefoot pronation.
Female↗
Computed tomography of talocalcaneal coalition: imaging techniques.
The diagnosis of symptomatic talocalcaneal coalition requires an imaging study that demonstrates precise anatomic detail. Computed tomography affords the best method for the diagnosis. This essay reviews the computed tomographic anatomy of talocalcaneal coalitions in several projections and stresses the routine use of the angled coronal and direct sagittal projections.
Adolescent↗
Value of polydirectional tomography in the assessment of the postoperative spine after anterior decompression and vertebral body autografting.
With the growing number of orthopedic reconstructive spinal procedures, the use of bone grafting has steadily increased in the past decade. An understanding of the biology of bone grafting is essential for both the clinician and radiologist. Despite the advent of computed tomography and magnetic resonance imaging, conventional polydirectional tomography remains an important tool in the evaluation of vertebral body autografts. Trispiral or hypocycloidal tomography plays a valuable role in the assessment of bone graft fusion and possible complications, especially in the presence of metallic fixation devices. We present our imaging experience derived from 375 patients with cervical, thoracic, or lumbar anterior spinal fusion. True graft complications occurred in 27 patients (7%) and consisted of fracture (4%), malpositioning (3%), and infection (less than 1%).
Adult↗
Giant cell tumor of tendon sheath: spectrum of radiologic findings.
Giant cell tumor of tendon sheath is the second most common tumor of the hand. It can also occur in larger joints. Radiologic features include a soft-tissue mass with or without osseous erosion. Less commonly, it can cause periostitis or permeative osseous invasion; it may rarely calcify. The entire imaging spectrum of this lesion is presented, with emphasis on atypical appearances which can mimic other lesions.
Adolescent↗
Trauma to the elbow and forearm.
Elbow and forearm trauma constitute a significant percentage of upper extremity injuries. A thorough understanding of the anatomy and mechanism of injury is necessary for obtaining the most accurate radiographic interpretation in both the pediatric and adult populations. Proper radiographic positioning and choice of the best imaging modality are crucial to ensure the best orthopedic treatment and reduce the incidence of post-treatment complications.
Adult↗
Hallux rigidus deformity: radiologic assessment.
Hallux rigidus (osteoarthritis leading to reduced motion) is one of the most common afflictions of the first metatarsophalangeal joint. The diagnosis is based on the presence of pain, specific physical findings, and certain radiologic features. In this essay, we illustrate the grades of radiologic changes, which are an integral part of the surgeon's preoperative evaluation, and show examples of the postoperative radiologic appearance.
Diagnosis, Differential↗