Ulnar-sided wrist pain is a challenging clinical scenario due to multiple overlapping pathologies and involved anatomic structures. Advanced imaging such as magnetic resonance imaging can be used as an effective diagnostic adjunct if interpreted correctly. In this article, clinically relevant structures and radiographic correlates of the ulnar wrist are discussed and a corresponding systematic approach to reviewing magnetic resonance imaging is presented.
View Article and Find Full Text PDFPurpose: Understanding all factors that may impact radiation dose and procedural time is crucial to safe and efficient image-guided interventions, such as fluoroscopically guided sacroiliac (SI) joint injections. The purpose of this study was to evaluate the effect of flow pattern (intra- vs. periarticular), patient age, and body mass index (BMI) on radiation dose and fluoroscopy time.
View Article and Find Full Text PDFObjective: To update the prevalence and morphology of the accessory abductor digiti minimi muscle using 3T MRI.
Materials And Methods: A retrospective study of 3T wrist MRI was performed. Presence and morphology of the accessory abductor digiti minimi were evaluated in addition to its relationship to the ulnar nerve.
Objective: Determine the prevalence of the accessory sacroiliac joint in the pediatric population and describe variant sacroiliac joint morphology that may predispose patients to the development of an accessory sacroiliac joint.
Materials And Methods: One hundred and seventy-eight high-resolution pelvic CT scans of patients aged 0 to 15 years were reviewed for the presence of an accessory sacroiliac joint. Patients were stratified based on age and gender.
Ultrasound evaluation of the median nerve is commonly performed in patients with suspected carpal tunnel syndrome. Radiologists should be familiar with variant anatomy of the median nerve to assist clinicians in the management of these patients, particularly when surgery is being considered. A 63-year-old female was being evaluated for a ganglion cyst and was incidentally found to have a bifid median nerve with wandering ulnar division which coursed superficial to the third digit flexor digitorum superficialis (FDS) muscle belly.
View Article and Find Full Text PDFObjectives: Multicentric reticulohistiocytosis (MRH), a rare histiocytic disease that can mimic other rheumatic conditions, may be associated with cancer and other autoimmune disorders. To better understand the disorder and its other associations, we aimed to evaluate clinical correlates and outcomes of all patients with MRH seen at Mayo Clinic, Rochester between 1980 and 2017.
Methods: A retrospective medical record review was conducted to identify all patients with MRH between 1 January 1980 and 30 April 2017.
Disease activity in rheumatoid arthritis usually subsides in pregnancy, however a subset of patients have worsened symptoms with joint pain and swelling. Monitoring and mitigating disease activity in pregnancy is important for preventing deforming structural changes which can affect the ability of the patient to care for themselves and the newborn. Ultrasound is a safe and low-cost imaging modality for detecting active changes from an inflammatory arthritis, which can help guide management.
View Article and Find Full Text PDFThe purpose of this series is to review the appearance of plantar fibromatosis with high-resolution ultrasonography (US) and highlight a new imaging sign termed the "comb sign." A retrospective study was performed for patients with a clinical diagnosis of plantar fibromatosis. Charts of 43 patients (age range, 26-77 years; mean age, 54 years) were reviewed to gather patient demographics and symptoms.
View Article and Find Full Text PDFObjective: To highlight the MRI characteristics of pathologically proven amyloidosis involving the peripheral nervous system (PNS) and determine the utility of MRI in directing targeted biopsy for aiding diagnosis.
Materials And Methods: A retrospective study was performed for patients with pathologically proven PNS amyloidosis who also underwent MRI of the biopsied or excised nerve. MRI signal characteristics, nerve morphology, associated muscular denervation changes, and the presence of multifocal involvement were detailed.
Objective: To highlight the significance and imaging characteristics of Morel-Lavallée (ML) lesions, which have been well characterized on MRI, but are potentially under-recognized on CT.
Materials And Methods: Twenty-eight Morel-Lavallée lesions were identified in 18 patients and were all clinically or surgically confirmed. Lesions were grouped into acute (<3 days), subacute (3-30 days), and chronic (>30 days) at the time of CT imaging.
Voriconazole-induced periostitis (VIP) is a rare but increasingly encountered entity since Food and Drug Administration (FDA) approval of the second generation antifungal medication in 2002. Literature reports most commonly include transplant recipients on immunosuppressive therapy simultaneously requiring antifungal therapy. Nontransplant patients receiving long-term voriconazole have an equal risk of developing the disease, but may experience a delay in diagnosis due to a lack of familiarity with the process outside of the post-transplant and/or immunosuppressed population.
View Article and Find Full Text PDFPurpose: To present the incidence, demographics, and clinical presentation of patients diagnosed with renal fibromuscular dysplasia (FMD) who underwent computed tomography (CT) angiography for evaluation of living renal donor protocol.
Methods And Materials: A retrospective review was performed from January 1, 2000, to December 31, 2011 on patients who underwent CT angiography for evaluation of living renal donor protocol. Of 2,640 patients identified, only patients with a diagnosis of FMD by the radiology report underwent independent reader evaluation of CT angiography for the presence of FMD and associated characteristics.
We report the case of a 24 year old male who had a retained bullet within his thoracic spine from a gunshot wound resulting in paraplegia. After 7 months he began experiencing painful dysesthesias at his sensory level. Repeat imaging demonstrated migration of the bullet as well as the development of intramedullary dystrophic calcification associated with the bullet.
View Article and Find Full Text PDFSmall-caliber tube thoracostomy is a valuable treatment for various pathologic conditions of the pleural space. Smaller caliber tubes placed under image guidance are becoming increasingly useful in numerous situations, are less painful than larger surgical tubes, and provide more accurate positioning when compared with tubes placed without image guidance. Basic anatomy and physiology of the pleural space, indications, and contraindications of small caliber tube thoracostomy, techniques for image-guided placement, complications and management of tube thoracostomy, and fundamental principles of pleurodesis are discussed in this review.
View Article and Find Full Text PDFIndoleamine 2,3-dioxygenases-1 (Ido1) and -2 initiate the kynurenine pathway of tryptophan metabolism. In addition to the established immune regulatory effects of Ido1 and the ability of nitric oxide to regulate Ido1 activity, it is now also known that Ido1-mediated metabolism of tryptophan to kynurenine can modulate vascular tone. Ido activity is reportedly elevated in stroke patients and correlates with increased risk of death.
View Article and Find Full Text PDFControl of blood vessel tone is central to vascular homeostasis. Here we show that metabolism of tryptophan to kynurenine by indoleamine 2,3-dioxygenase (Ido) expressed in endothelial cells contributes to arterial vessel relaxation and the control of blood pressure. Infection of mice with malarial parasites (Plasmodium berghei) or induction of endotoxemia in mice led to endothelial expression of Ido, decreased plasma tryptophan concentration, increased kynurenine concentration and hypotension.
View Article and Find Full Text PDFRumination in response to negative affect has been found to predict the onset, severity, and duration of depressive symptoms. Few researchers, however, have considered rumination within bipolar disorder, nor have studies considered parallel responses that might intensify positive affect. The current study examined self-reported rumination in response to both negative and positive affect among people diagnosed via the SCID with BPD (n = 28), major depressive disorder (MDD; n = 35), or no mood disorder (n = 44).
View Article and Find Full Text PDFObjective: The anastomosis of peripheral nerves is a demanding procedure that has potential complications due to foreign body reactions elicited by sutures. In this study, the sutureless in vivo anastomosis of rat tibial nerves was successfully performed, using for the first time a chitosan-based laser-activated adhesive. The nerve thermal damage caused by the laser irradiation was quantitatively assessed.
View Article and Find Full Text PDFThe presence of members of the family Helicobacteraceae in the colon of children was investigated using PCR, denaturing gradient gel electrophoresis, and fluorescent in situ hybridization. The rate of detection of species belonging to the Helicobacteraceae family in children with inflammatory bowel disease (92%) and irritable bowel syndrome (100%) was found to be significantly higher than that in healthy children (25%) (P < 0.05).
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