A quantitative assessment of dual energy computed tomography-based material decomposition for imaging bone marrow edema associated with acute knee injury.

Purpose: This study developed methods to quantify and improve the accuracy of dual-energy CT (DECT)-based bone marrow edema imaging using a clinical CT system. Objectives were: (a) to quantitatively compare DECT with gold-standard, fluid-sensitive MRI for imaging of edema-like marrow signal intensity (EMSI) and (b) to identify image analysis parameters that improve delineation of EMSI associated with acute knee injury on DECT images.

Methods: DECT images from ten participants with acute knee injury were decomposed into estimated fractions of bone, healthy marrow, and edema based on energy-dependent differences in tissue attenuation.

Impact of the rotational position of the hindfoot on measurements assessing the integrity of the distal tibio-fibular syndesmosis.

Background: Approximately 20% of patients with ankle fractures demonstrate evidence of syndesmotic injuries. As intra-operative measurements have high specifity but low sensitivity for identifying injuries to the distal tibio-fibular syndesmosis, numerous measurements have been developed to assess pre-operative syndesmosis integrity. Several factors affecting measurements on conventional radiographs and computed tomography (CT) images have been identified.

Cement Augmentation in Sacroiliac Screw Fixation Offers Modest Biomechanical Advantages in a Cadaver Model.

Background: Sacroiliac screw fixation in elderly patients with pelvic fractures is prone to failure owing to impaired bone quality. Cement augmentation has been proposed as a possible solution, because in other anatomic areas this has been shown to reduce screw loosening. However, to our knowledge, this has not been evaluated for sacroiliac screws.