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Biomedical subjects

T L Pope

Publications and source records attributed to T L Pope.

At least 37 records · Page 2Linked to original sources

Synovial osteochondromatosis.

Primary or idiopathic synovial osteochondromatosis is an uncommon condition probably caused by synovial metaplasia and typically resulting in multiple calcified periarticular bodies. Synovial osteochondromatosis also may occur secondary to other joint disorders. This article reviews the pathogenesis, pathologic features, clinical features, and radiologic imaging of synovial osteochondromatosis. The differentiation of synovial osteochondromatosis from other conditions associated with periarticular calcified bodies is discussed.

Arthrography↗

MR imaging of knee ligaments.

MR imaging is an excellent modality with which to diagnose injuries of the major knee ligaments preoperatively. Strict attention to the mechanism of injury and physical examination findings and to MR imaging acquisition and section selection are essential to diagnostic success.

Anterior Cruciate Ligament↗

Meniscal ossicle.

Meniscal ossicles are rare and may cause diagnostic difficulty on plain radiograph at presentation. Magnetic resonance imaging is useful in detecting meniscal ossicles because their characteristic appearance on MRI can differentiate them from other disease. Arthroscopy can also diagnose the meniscal ossicle, which in our patient appeared as a swelling in the meniscus. If the patient is asymptomatic before the time of diagnosis, removal of the ossicle may not be indicated and, as with our patient, normal function is possible with the ossicle retained.

Adult↗

Three-dimensional MRI of the glenoid labrum.

The objective of this study was to assess the accuracy of three-dimensional (3D) magnetic resonance imaging (MRI) reformation in the evaluation of tears of the glenoid labrum complex (GLC). Fifty-five shoulders were evaluated by MRI using standard spin-echo sequences. Gradient-refocused-echo axial projections were used to assess the GLC on the two-dimensional (2D) studies. Three-dimensional Fourier transform multiplanar gradient-recalled imaging with a resolution of 0.7 mm was also performed in all patients. Independent analyses of the anterior and posterior labra were performed in a blinded manner for both the 2D and 3D studies by three experienced musculoskeletal radiologists. Observations of the imaging studies were compared with the videoarthroscopic findings. The appearance of the GLC was rated on a scale of 0 to 4 (0-2 = normal, 3, 4 = abnormal or torn). The diagnostic confidence was averaged from the three reader's scores. Anterior labral tears were effectively detected with sensitivities of 89% and 96% and specificities of 96% and 100% (P < 0.0001) for the 2D and 3D studies, respectively. For posterior labral tears, the sensitivity and specificity of the 2D method were 47% and 98%, respectively. The sensitivity and specificity of the 3D volume sequence were 53% and 98%, respectively. The lower sensitivity of both imaging methods for detecting posterior labral tears may be influenced by the smaller number (n = 5) of arthroscopically confirmed cases in our study and reflects the difficulty of visualizing the posteroinferior borders of the GLC with present MRI techniques.

Adult↗

Imaging of the total knee arthroplasty.

We have reviewed the essentials of TKA imaging. Because the purpose of a knee arthroplasty is to relieve pain and improve function, radiographs should be viewed in the context of these goals.

Humans↗

Isolated subacromial bursal fluid on MRI of the shoulder in symptomatic patients: correlation with arthroscopic findings.

Fluid in the subacromial bursa (SAB) is a common finding on magnetic resonance (MR) images of the shoulder, and the implications of this finding have not been clarified. We retrospectively reviewed and correlated the MR features with arthroscopic findings in 21 symptomatic patients who had fluid in the SAB on MR imaging without demonstrable rotator cuff tear. Rotator cuff impingement was the most frequent surgical finding (42.9%). Other frequent surgical observations were glenoid labrum abnormality (28.6%), bursitis (19%), and supraspinatus tendinitis (14.3%). Distribution of acromial types was similar to that reported by Bigliani et al., and impingement was evenly distributed among acromial types in our study population. We conclude that in our patient population group the MR finding of isolated SAB fluid in symptomatic patients is highly likely to be associated with the finding of other abnormalities in the shoulder joint at surgery.

Acromion↗

MRI of knee ligaments.

The stability of the knee depends on the integrity of its ligaments. Pain, clinical history, and nonspecific physical findings may hinder clinical diagnosis of acute ligamentous injury. Most major knee ligaments have uniform low signal intensity on all imaging sequences, and diagnosis of injury is based on periligamentous soft tissue edema, increased signal within the ligament, or disrupted structures. Correlation of of findings from routine sagittal, coronal, and axial MRI scans usually yields a definitive diagnosis of knee ligamentous injury. This article reviews normal anatomy, function, mechanism of injury, and normal and pathological MRI findings of the major knee ligaments.

Humans↗

MR diagnosis of superior labral anterior posterior (SLAP) injuries of the glenoid labrum: value of routine imaging without intraarticular injection of contrast material.

OBJECTIVE: Superior labral anterior posterior (SLAP) lesions are peculiar types of tears that involve the superior and anterior aspects of the glenoid labrum and extend posteriorly. The biceps tendon may also be involved in the injury. There have been conflicting reports in the literature about the value of MR imaging in depicting these injuries. Some authors have advocated imaging in special planes and, more recently, the use of intraarticular injection of contrast material to facilitate the diagnosis of SLAP injuries. Symptoms of SLAP injury of the glenoid labrum are nonspecific, and patients are often imaged according to routine imaging protocols that include images in axial, oblique coronal, and oblique sagittal planes using spin-echo pulse sequences. Intraarticular injection of contrast material is not part of routine MR imaging of the shoulder. We sought to determine the value of routine MR imaging without intraarticular contrast enhancement in the diagnosis of SLAP injuries of the glenoid labrum. MATERIALS AND METHODS: The MR images of eight patients with arthroscopically proved SLAP lesions were selected for this study. The MR imaging appearance of the glenoid labrum, biceps tendon attachment, and rotator cuff tendons were retrospectively evaluated in the axial, oblique coronal, and oblique sagittal planes in each case. The findings were correlated with the surgical observations. RESULTS: All eight patients showed an abnormal labrum on the coronal MR images, on 88% of the axial images, and on 50% of the sagittal images. An oblique or horizontal linear focus of increased signal was seen to traverse the labrum in 50% of the cases on sagittal images. Fifty percent of the cases also showed an intraarticular body, presumably representing the displaced fragment of a bucket-handle tear, on all imaging planes (the MR "Cheerio" sign). CONCLUSION: Routine MR imaging of the shoulder without intraarticular injection of contrast material is useful in the diagnosis of SLAP injuries of the glenoid labrum.

Adult↗

Comparison of axial T1 spin-echo and T1 fat-saturation magnetic resonance imaging techniques in the diagnosis of chondromalacia patellae.

To test the diagnostic value of T1 spin-echo and T1 fat-saturated magnetic resonance images (MRIs), we reviewed axial T1-weighted images with and without fat saturation in 20 patients with clinically suspected chondromalacia of the patella. All scans were obtained on 1.5-MR units. The scans were randomly ordered and reviewed independently at different times by two radiologists without knowledge of the arthroscopy results. The sensitivity of the individual techniques for detecting grade 3 or 4 chondromalacia patellae was 92% for fat-saturated axial T1-weighted images alone, and 67% for axial T1-weighted images without fat saturation. The sensitivity of the combined techniques was 100% for grades 3 and 4 and 90% for all grades (0 to 4). Chondromalacia patellae is diagnosed more accurately by using T1 fat saturation than by using T1 spin-echo images. With a combination of the two techniques, accuracy is 90% to 100%.

Adolescent↗

Case report 733. Calcific tendinitis of the origin of the medial and lateral heads of the rectus femoris muscle and the anterior iliac spin (AIIS).

Calcific tendinitis at the site of origin of the rectus femoris muscle is a rare lesion. Presumed to be formed by deposition of hydroxyapatite crystals, this entity may be confused with other lesions such as os acetabuli or posttraumatic abnormalities. The characteristic location and appearance of the calcifications in a symptomatic patient with no history of trauma should allow diagnosis and subsequent symptomatic therapy.

Calcinosis↗

Plain and computed radiography for detecting experimentally induced pneumothorax in cadavers: implications for detection in patients.

Pneumothorax was induced in cadavers to determine the effects of patient positioning and imaging modality (conventional screen-film and computed radiography) on radiographic findings. Chest radiography, with cadavers in the supine frontal, erect frontal, and left lateral decubitus positions, was performed at baseline and after injection of incremental quantities of air into the pleural space. Five radiologists independently interpreted each radiograph. The ability of the radiologists to diagnose pneumothorax varied by cadaver position and depended on volume of air. Overall, the left lateral decubitus view was most sensitive (88%) for diagnosis of pneumothorax, followed by the erect (59%) and supine (37%) views. Receiver operating characteristic curves and multiple repeated measures analysis of variance revealed no statistically significant difference between diagnostic proficiency with conventional screen-film radiography and that with computed radiography. The authors conclude that the lateral decubitus view is superior to the erect and supine views for pneumothorax detection and that conventional and computed radiography perform similarly in pneumothorax detection.

Cadaver↗

MR imaging of patellar tendinitis.

To identify magnetic resonance (MR) imaging characteristics of normal patellar tendons and those affected by tendinitis, the authors evaluated MR images obtained in 10 healthy volunteers, in 50 patients who underwent MR imaging for evaluation of knee structures other than the patellar tendon, in 11 patients with patellar tendinitis, and in two athletes with patellar tendon injuries. Normal tendons had uniformly low signal intensity on T1-, T2-, and proton-density-weighted images and displayed distinct margins, and the anteroposterior (AP) diameter slightly increased proximally to distally. It was concluded that the AP diameter of a normal tendon, in its proximal portion, should not exceed 7 mm. In patellar tendinitis, the tendon showed increased signal intensity on T1-, T2-, and proton-density-weighted images and increased AP diameter proximally. The margins of affected tendons were indistinct, especially posterior to the thickened segment. In all groups studied, women had thicker proximal tendons than did men.

Adult↗

Radiologic findings of diseases involving the maxilla and mandible.

The purpose of this pictorial essay is to illustrate the radiologic appearances of diseases involving the maxilla and mandible. The high prevalence of dental disease results in inflammatory, infectious, and reactive processes that must be distinguished from more serious conditions with similar radiologic features. Because of their association with odontogenic tissues, lesions of the maxilla and mandible may have radiologic findings not seen in other bones. Furthermore, nonodontogenic cysts and tumors that occur elsewhere in the skeleton may exhibit unique radiologic characteristics when associated with teeth. This pictorial essay presents the radiologic characteristics of inflammatory lesions, developmental abnormalities, fibroosseous lesions, benign cysts and tumors, and malignant lesions of the maxilla and mandible.

Cysts↗