Ultrasound-Guided Injections of HYADD4 for Knee Osteoarthritis Improves Pain and Functional Outcomes at 3, 6, and 12 Months without Changes in Measured Synovial Fluid, Serum Collagen Biomarkers, or Most Synovial Fluid Biomarker Proteins at 3 Months.

Background: Prior studies have demonstrated improved efficacy when intra-articular (IA) therapeutics are injected using ultrasound (US) guidance. The aim of this study was to determine if clinical improvement in pain and function after IA hyaluronic acid injections using US is associated with changes in SF volumes and biomarker proteins at 3 months.

Methods: 49 subjects with symptomatic knee OA, BMI < 40, and KL radiographic grade II or III participated.

ACR Appropriateness Criteria® Inflammatory Back Pain: Known or Suspected Axial Spondyloarthritis: 2021 Update.

Inflammatory back pain is a hallmark feature of axial spondyloarthritis, a heterogeneous group of inflammatory disorders which affects the sacroiliac joints and spine. Imaging plays a key role in diagnosis of this disease and in facilitating appropriate treatment. This document provides evidence-based recommendations on the appropriate use of imaging studies during multiple stages of the clinical evaluation of patients with suspected or known axial spondyloarthritis.

Metal Artifact Reduction Sequence Magnetic Resonance Imaging Abnormalities in Asymptomatic Patients With a Ceramic-on-Ceramic Total Hip Replacement.

Background: Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) has recently gained increased utilization as a screening modality in patients with a total hip arthroplasty (THA). Fluid collections have been documented in asymptomatic patients with various bearing surfaces. The purpose of this study is to determine the frequency and types of MARS MRI-documented abnormalities in asymptomatic patients with a ceramic-on-ceramic (CoC) THA.

ACR Appropriateness Criteria® Primary Bone Tumors.

Although primary bone tumors are relatively uncommon, appropriate imaging evaluation is essential when they are suspected or incidentally detected. In almost all cases, radiographs are the most appropriate initial imaging study for screening and characterization of primary bone tumors. Radiographs often provide sufficient information for diagnosis and to guide the treating clinician.

ACR Appropriateness Criteria® Suspected Osteomyelitis of the Foot in Patients With Diabetes Mellitus.

Diabetes-related foot complications such as soft-tissue infection, osteomyelitis, and neuropathic osteoarthropathy account for up to 20% of all diabetic-related North American hospital admissions. Radiography of the foot is usually appropriate as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. For follow-up examination, MRI of the foot with or without contrast enhancement demonstrates excellent soft-tissue contrast and sensitivity to marrow abnormalities with high-resolution detail in multiple anatomic planes and is usually appropriate when osteomyelitis or early neuropathic arthropathy is suspected.

ACR Appropriateness Criteria Acute Hand and Wrist Trauma.

Hand and wrist injuries are common reasons for musculoskeletal-related emergency department visits. Imaging is essential for evaluating many of these injuries. In most cases, conventional radiographs provide sufficient information to guide the treating clinician.

ACR Appropriateness Criteria Suspected Spine Trauma.

Injuries to the cervical and thoracolumbar spine are commonly encountered in trauma patients presenting for treatment. Cervical spine injuries occur in 3% to 4% and thoracolumbar fractures in 4% to 7% of blunt trauma patients presenting to the emergency department. Clear, validated criteria exist for screening the cervical spine in blunt trauma.

Traumatic Atlanto-Occipital Dissociation and Atlantoaxial Instability: Concomitant Ligamentous Injuries without Neurologic Deficit: A Case Report.

Case: A 35-year-old man was involved in a motor-vehicle collision and sustained multiple thoracoabdominal and extremity injuries. A high injury burden and a normal neurologic examination contributed to a delay in diagnosing a ligamentous, combined atlanto-occipital dissociation (AOD) and vertical atlantoaxial injury (AAI). Additional imaging revealed the combined injury, and the patient underwent an occipitocervical fusion.

Diagnostic yield of repeat CT-guided biopsy for suspected infectious spondylodiscitis.

Objective: The purpose of this study was to examine the yield of repeat CT-guided biopsy in patients with suspected infectious spondylodiscitis following an initial biopsy with negative microbiology, and to identify factors associated with successful pathogen isolation.

Materials And Methods: In this retrospective study, 21 patients (12 men, 9 women; mean age, 52, range, 12-84) were identified with clinically and radiologically suspected infectious spondylodiscitis who underwent repeat biopsy following negative cultures from an initial biopsy. The microbe yield as well as demographic, clinical, and laboratory findings were reviewed and statistical analysis was performed.

ACR Appropriateness Criteria Shoulder Pain-Traumatic.

Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic. This pain may be the result of either fracture (the clavicle, scapula, or proximal humerus) or soft-tissue injury (most commonly of the rotator cuff, acromioclavicular ligaments, or labroligamentous complex). Imaging assessment of traumatic shoulder pain begins with conventional radiography and, depending on physical examination findings, will require MRI or MR arthrography for assessment of soft-tissue injuries and CT for delineation of fracture planes.

Osteomyelitis of the lower extremity: pathophysiology, imaging, and classification, with an emphasis on diabetic foot infection.

Osteomyelitis is inflammation of the bone caused by an infectious organism, and is a difficult clinical problem. The pathophysiology, imaging, and classification of osteomyelitis are challenging, varying with the age of the patient (child versus adult), the chronicity of the infection (acute versus chronic), and the route of spread (hematogenous versus contiguous focus), as well as the immune and vascular status of the patient and affected region. The two most common classification schemes are those of Lew and Waldvogel, and Cierny and Mader.

Acute non-contact anterior cruciate ligament tears are associated with relatively increased vastus medialis to semimembranosus cross-sectional area ratio: a case-control retrospective MR study.

Objective: Hamstring muscle deficiency is increasingly recognized as a risk factor for anterior cruciate ligament (ACL) tears. The purpose of this study is to evaluate the vastus medialis to semimembranosus cross-sectional area (VM:SM CSA) ratio on magnetic resonance imaging (MRI) in patients with ACL tears compared to controls.

Materials And Methods: One hundred knee MRIs of acute ACL tear patients and 100 age-, sex-, and side-matched controls were included.

The Lumbar Neural Foramen and Transforaminal Epidural Steroid Injections: An Anatomic Review With Key Safety Considerations in Planning the Percutaneous Approach.

Objective: The purpose of this article is to review the anatomy of the lumbar neural foramen and to describe techniques of transforaminal epidural steroid injections with emphasis on safety. Rare cases of paraplegia have been reported.

Conclusion: Although no consensus currently exists about which approach is the safest, knowledge of the foraminal anatomy is a key consideration when choosing a needle approach for transforaminal epidural steroid injections.

Iliopsoas bursal extension of lipohemarthrosis: A novel imaging finding associated with hip fracture.

Lipohemarthrosis is well known to be associated with intra-articular fractures throughout the body. Despite the relatively common occurrence of hip fracture and the frequency of communication between the hip joint and iliopsoas bursa, to the best of our knowledge, a fat-fluid level involving the iliopsoas bursa secondary to a hip fracture has not previously been reported. The following is a case report of a 48-year-old male who sustained an acute femoral neck fracture and was found to have distension of the iliopsoas bursa with a fat-fluid level resulting from extra-capsular extension of a lipohemarthrosis.

Using a web-based image quality assurance reporting system to improve image quality.

Objective: The purpose of this study is to show the impact of a web-based image quality assurance reporting system on the rates of three common image quality errors at our institution.

Materials And Methods: A web-based image quality assurance reporting system was developed and used beginning in April 2009. Image quality endpoints were assessed immediately before deployment (period 1), approximately 18 months after deployment of a prototype reporting system (period 2), and approximately 12 months after deployment of a subsequent upgraded department-wide reporting system (period 3).

Pain levels within 24 hours after UFE: a comparison of morphine and fentanyl patient-controlled analgesia.

The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization (UFE) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia (PCA) versus fentanyl PCA. We carried out a prospective, nonrandomized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE. Pain perception levels were obtained on a 0-10 scale for the 24-h period after UFE.