Direct MR arthrography without image guidance: a practical guide, joint-by-joint.

Direct MR arthrography (dMRA) is a fundamental technique in diagnosing pathology in major peripheral joints, allowing for precise evaluation of intra-articular structures. Although injection guidance is typically performed using imaging techniques such as ultrasound or fluoroscopy, puncture via anatomical landmarks may be useful in certain circumstances where it has been proven to be a safe and effective procedure. This paper describes the indications and injection technique of dMRA, joint by joint, focusing on the different technical details, from the most common locations, like the shoulder or hip, to those with more restricted clinical indications, such as the wrist, knee, elbow, or ankle.

[From bone marrow edema to osteonecrosis. New concepts].

The widespread use of MRI in the diagnosis of articular pathology has allowed for an improved knowledge of a series of disturbances that occur with epiphyseal bone edema as a main radiological sign, featured as low signal intensity of the bone marrow on T1 and high signal on STIR and fat saturated T2 sequences. The new etiopathogenic theories postulate a clear differentiation between primary and secondary osteonecrosis. While secondary osteonecrosis is related to risk factors, primary osteonecrosis is a result of a subcondral insufficiency fracture.

[The safety of magnetic resonance imaging: an analysis based on a review of incidents at the Osatek Center].

Objective: To evaluate the dangers to persons in a magnetic resonance imaging (MRI) environment and review Osatek's safety policies.

Material And Method: We review and analyze the incidents occurring throughout our organization from 1994 to 2004 to establish their frequency, causal risk, and effects. Incident registers were implemented in all units in 2001.

Bone marrow edema syndrome of the foot: one year follow-up with MR imaging.

Objective: To describe the MR findings of bone marrow edema syndrome (BMES) of the foot and its evolution at 1 year follow-up.

Design And Patients: Twenty-five of 32 patients with disabling foot and ankle pain unrelated to trauma diagnosed as BMES when MR imaging demonstrated a bone marrow edema pattern in one or more bones without any radiological or underlying clinical cause, were re-evaluated by MR imaging 1 year later.

Results: On the initial MR examinations an average of 4.

Squamous cell carcinoma of the oesophagus in a patient with Klippel-Trenaunay syndrome.

The Klippel-Trenaunay syndrome (KTS) is a rare disorder characterized by a triad of port-wine stains, varicose veins, and bony or soft tissue hypertrophy of one extremity. Digestive bleeding is the most commonly observed gastrointestinal manifestation. In rare cases, the syndrome is associated with malignancies.

Hypoglossal schwannoma: an uncommon cause of twelfth-nerve palsy.

Hypoglossal schwannoma is an uncommon cause of 12th nerve palsy. We here report a pathologically proven case of left 12th nerve schwannoma in a 56-year-old woman who presented with progressive left tongue hemiatrophy and in whom cranial MRI disclosed a mass near the foramen jugular. Surgery showed a mass involving the hypoglossal nerve and the pathological examination was diagnostic of schwannoma.

Masses and pseudomasses of the hand and wrist: MR findings in 134 cases.

Objective: To assess the utility of magnetic resonance imaging (MRI) in the investigation of palpable masses in the hand or wrist. DESIGN AND PATIENTS. We retrospectively reviewed the MRI examinations and case records of 134 patients referred because of a palpable mass in the hand or wrist.

Atypical MRI presentation of a small splenic hamartoma.

Hamartomas of the spleen usually appear isointense on T1-weighted MR images and hyperintense on T2-weighted images. We describe a histologically proven case which presented as a small (2.5 cm) focal mass isointense to splenic parenchyma on T1-weighted images and hypointense on both turbo-spin-echo T2 and short T1 inversion recovery images.

Resolution of a brainstem abscess through antituberculous therapy.

We describe an immunocompetent patient with a solitary brainstem abscess that responded to antituberculous therapy. Although prompt surgical therapy has been advocated, the possibility of medical resolution of brainstem tuberculous abscesses should be considered.

Bilateral vertebral artery dissection in a patient with afibrinogenemia.

Background: Afibrinogenemia, a rare coagulation disorder, has not been associated with vertebral artery dissections.

Case Description: A 28-year-old woman with afibrinogenemia developed spontaneous neck pain followed by a right medullary infarction, and MR angiography showed extensive bilateral vertebral artery dissection. She was treated with fibrinogen replacement and anticoagulants and showed a favorable evolution, with only mild residual right upper arm incoordination.

Focal xanthogranulomatous pyelonephritis simulating malignancy in children.

Xantogranulomatous pyelonephritis is a severe chronic form of renal parenquimal infection that usually results in diffuse renal destruction. An unusual case of xanthogranulomatous pyelonephritis in a child is reported which presented as a focal mass without calculus in a functioning kidney and was diagnosed as a renal tumor.

Arteriovenous fistulas in the neck: diagnosis with color Doppler sonography.

We report the use of color Doppler imaging in the diagnosis of four arteriovenous fistulas in the neck region: two had a traumatic origin and two were spontaneous. A perivascular color artifact was the most common initial finding on color images to indicate the underlying abnormality. In all four cases, a low-resistance flow with high systolic and diastolic velocities was observed in the feeding artery.

Diagnostic utility of color Doppler ultrasound in lower limb deep vein thrombosis in patients with clinical suspicion of pulmonary thromboembolism.

The diagnosis of pulmonary thromboembolism is frequently based on ventilation-perfusion scintigraphy and ascending lower limb venography when pulmonary angiography is not available. The aim of this study is to compare color Doppler ultrasound against ascending venography in the evaluation of the lower limb deep vein system in patients with clinical suspicion of pulmonary embolism, with special attention to calf veins. We prospectively studied 30 patients with clinical suspicion of pulmonary embolism in whom a color Doppler ultrasound and venogram were performed with no more than a 3-h interval between both procedures.