MR Imaging of Tumors and Tumor-Like Conditions of the Hip.

The hip joint is home to a diverse range of neoplasms, as well as many pseudo lesions, including post-traumatic, infectious, and degenerative processes. Through careful evaluation of the clinical context, location, and imaging features, these entities can be distinguished, enabling accurate and efficient diagnosis. While not exhaustive, this article reviews a selection of benign, malignant, and non-neoplastic lesions affecting the hip bones, cartilage, and soft tissues, focusing on their notable imaging and pathologic features.

Cervical Medial Branch Block Volume Dependent Dispersion Patterns as a Predictor for Ablation Success: A Cadaveric Study.

Background: Neck pain is one of the most common causes of chronic pain and the fourth leading cause of disability worldwide; it is estimated that between 36% and 67% of this pain is due to facet arthropathy. For patients who have pain refractory to conservative treatments literature supports management with diagnostic cervical medial branch blocks (MBBs) to identify the associated facet innervation as the source of pain followed by therapeutic radiofrequency ablation (RFA) of the identified nerves. Cervical RFA has good published outcomes; however, the procedure is dependent upon the specificity of the diagnostic block to achieve maximal success.

Lumbar Medial Branch Block Volume-Dependent Dispersion Patterns as a Predictor for Ablation Success: A Cadaveric Study.

Background: Lumbar facet arthropathy is a common cause of low back pain. Literature supports treatment with radiofrequency ablation (RFA) of associated nerves that innervate lumbar facets when alternative conservative therapies have failed. Diagnostic local anesthetic blocks precede therapeutic ablation, but have a false-positive rate of 27%-63%, and some authors have questioned their utility in predicting therapeutic response to RFA.

Currently Recommended TON Injectate Volumes Concomitantly Block the GON: Clinical Implications for Managing Cervicogenic Headache.

Background: Headache (HA) is a significant cause of morbidity globally. Despite many available treatment options, HAs that are refractory to conservative management can be challenging to treat. Third occipital nerve (TON) and greater occipital nerve (GON) irritation are potential etiologic agents of primary and cervicogenic HAs that can be targeted using minimally invasive treatment options such as nerve blocks or radiofrequency ablation.

A rare case of pseudotumor formation associated with methyl methacrylate hypersensitivity in a patient following cemented total knee arthroplasty.

Hypersensitivity to orthopedic implant materials has been well documented with potential catastrophic consequences if not addressed pre-operatively. The spectrum of reactions is wide, from mild non-specific pain with localized erythema to severe periprosthetic inflammatory destruction and pseudotumor formation. It is therefore essential to identify patients who have or are at risk for implant-associated hypersensitivity.

The physician payments sunshine act: what the average radiologist and manager need to know.

The Physician Payments Sunshine Act (PPSA) was enacted in 2010 and requires applicable manufacturers of medical devices, drugs, biological material, or medical supplies to report payments or transfers of value that are provided to physicians or teaching hospitals. PPSA has value in creating greater transparency in the financial relationships between industry, physicians, and teaching hospitals, and in potentially reducing problematic conflicts of interest. PPSA requires that this data be published, in searchable form, on a public website.

Evaluation of vertebral fractures on lateral chest radiographs of inner-city postmenopausal women.

We assessed the prevalence of vertebral fractures as a marker for osteoporosis on lateral chest radiographs in inner-city, minority, postmenopausal women. We reviewed outpatient lateral chest radiographs on all women 55 years and older at an inner-city hospital during two randomly selected months, August 2000 and April 2002. There were 106 women with a mean age of 65 (range 55-89) years, 45 were Hispanic, 42 Black, 9 White, 10 of other ethnicity.

MRI features of confirmed "pre-slip" capital femoral epiphysis: a report of two cases.

We describe the morphologic and signal changes detected about the proximal femoral growth plate in two patients with hip pain preceding the progression to slipped capital femoral epiphysis using magnetic resonance imaging.

MR imaging and CT of vascular anomalies and connections in patients with congenital heart disease: significance in surgical planning.

To plan effective management of congenital heart disease, one needs the clearest understanding of the anatomy. Although echocardiography and angiography are the dominant imaging modalities in patients with congenital heart disease, magnetic resonance (MR) imaging and computed tomography (CT) are valuable noninvasive adjuncts. MR imaging and CT are effective in demonstrating the complex cardiovascular morphology present in congenital heart disease, especially the extracardiac morphology.

HIPAA security: compliance in radiology--an academic radiology department's plan contrasted with a small private practice.

In complying with the HIPAA security regulations, the large, multi-site academic radiology department is quite different from the small, private radiology practice. This article compares and contrasts the methods each of these two model organizations use to achieve compliance. In common between the two organizations is that complete documentation of the procedures and processes involved in data management must be prepared and reviewed.

PACS and RIS: approaches to integration.

PACS and RIS have traditionally been discrete information systems with separate databases. Maintaining more than one database containing identical data sets creates the potential for outdated information being used in parallel with accurate information. Today, because of increased implementation of PACS and improved Web technology, this problem must be solved.

The diagnostic role of gadolinium enhanced MRI in distinguishing between acute medullary bone infarct and osteomyelitis.

The objective of the study was to evaluate the diagnostic utility of contrast enhanced magnetic resonance imaging (MRI) for distinguishing between acute medullary bone infarct and osteomyelitis. There were 11 patients (age 6-34 years) presented to our institution between December 1994 and February 1998 with a clinical differential diagnosis of acute bone infarct versus osteomyelitis and inconclusive radiographs were imaged using MRI. All but one received i.

Computerized bone densitometric analysis: operator-dependent errors.

Purpose: To determine the nature and relative frequency of operator-dependent data analysis errors in dual x-ray absorptiometry.

Materials And Methods: Over 40 months, 2,528 dual x-ray absorptiometric examinations of the forearm, femoral neck, and lumbar spine were performed by 11 technologists by using standard techniques and software. Each analysis was reviewed by a radiologist; errors were recorded and corrected.

Complications related to osteopenia in the thoracic spine on admission chest radiographs of substance abuse detoxification patients.

Objective: To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification.

Design And Patients: We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years).

Slipped capital femoral epiphysis: a physeal lesion diagnosed by MRI, with radiographic and CT correlation.

Objective: To define and compare early lesions associated with slipped capital femoral epiphysis (SCFE) on magnetic resonance imaging (MRI), computed tomography (CT) and radiography.

Design And Patients: Thirteen patients with 15 symptomatic hips due to SCFE underwent radiography and MRI; CT was performed in 12 patients. SCFE was graded on radiographs, head/neck angles and qualitative changes were evaluated on CT, and morphologic/signal abnormalities were determined on MRI.

Magnetic resonance imaging and computerized tomography of a gravid leopard tortoise (Geochelone pardalis pardalis) with metabolic bone disease.

Secondary nutritional metabolic bone disease was diagnosed in a gravid leopard tortoise (Geochelone pardalis pardalis). Diagnosis was based upon history, physical examination, hematology, plasma biochemistry, and radiography. Despite induced oviposition and treatment of metabolic bone disease for 8 wk, the tortoise's condition deteriorated.

HLA-DRB1 and DQB typing of Hispanic American patients with rheumatoid arthritis: the "shared epitope" hypothesis may not apply.

Objective: To determine whether the association of particular MHC class II alleles and the DRB1 "shared epitope" with disease susceptibility and severity in rheumatoid arthritis (RA) applies to ethnic groups other than Caucasian Americans.

Methods: 67 Hispanic American patients with RA and a similar number of ethnically matched controls were typed for DRB1 using polymerase chain reaction methods. DR4 subtype and DQB1 type were determined for the subjects positive for DR4.

Pulmonary pseudonodules on computed tomography: a common pitfall caused by degenerative arthritis.

This study assessed the prevalence of pseudonodules of the lung on computed tomography (CT) related to degenerative arthritis at the distal first rib and sternum. A total of 250 serial chest CT scans were retrospectively reviewed by a chest and a musculoskeletal radiologist. A pseudonodule was defined as a round or oval opacity identified on lung window surrounded by aerated lung and superimposable on an osseous structure on the immediate cephalad slice.

Calcification of the ligamentum arteriosum in adults: CT features.

Objective: The present study describes the frequency and pattern of ligamentum arteriosum calcification seen on chest CT in adults.

Materials And Methods: We retrospectively reviewed 402 sequential unenhanced chest CT studies for ligamentum arteriosum calcification, atherosclerotic cardiac or aortic calcification, and granulomatous calcification. The pattern of calcification was characterized as curvilinear, punctate, or clumped.

MRI of the Stener lesion.

Objective: To assess the utility of MR in detecting surgically induced Stener lesions (displaced thumb ulnar collateral ligaments) in cadaveric models.

Design: Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL.

Diagnosis of partial tears of the anterior cruciate ligament of the knee: value of MR imaging.

Objective: The purpose of our study was to assess the ability of MR imaging to detect partial tears of the anterior cruciate ligament (ACL) as these injuries, if extensive enough, may result in ligamentous insufficiency or predispose to subsequent acquired knee instability.

Materials And Methods: A review of all arthroscopic reports from two institutions during the periods 1990-1992 and 1992-1993, respectively, revealed 13 patients with partial tears of the ACL. Thirteen cases each of intact and completely ruptured anterior cruciate ligaments on arthroscopy were randomly selected as controls from the same report review.

O'Donoghue's triad: magnetic resonance imaging evidence.

Objective: The objective was to search for magnetic resonance imaging evidence of medial collateral ligament (MCL) injury in knees with proven tears of the anterior cruciate ligament (ACL) and medial meniscus; the three abnormalities that make up O'Donoghue's triad. Although the MCL injury can be unapparent clinically, knee joint stability may be compromised.

Design: The superficial portion of the MCL was evaluated on 19 MR studies of 16 knees with arthroscopically proven ACL and medial meniscal tears.

CT scans through metal scanning technique versus hardware composition.

Objective: Streak artifact on CT scans of metal containing areas has been a long standing problem. Although several artifact reducing methods have been used to improve image quality, most have been limited by requiring specialized equipment or lengthy complex calculations that are not automated. Others have shown that increasing the beam energy results in increased thickness of metal that may be imaged by CT without severe image degradation.