Magnetic resonance imaging of injuries to the ankle joint: can it predict clinical outcome?

Objective: To predict clinical outcome after ankle sprains on the basis of magnetic resonance (MR) findings.

Design And Patients: Twenty-nine consecutive patients (mean age 32.9 years, range 13-60 years) were examined clinically and with MR imaging both after trauma and following standardized conservative therapy.

Efficacy of MR imaging in patients suspected of having Morton's neuroma.

Objective: The purpose of our study was to evaluate the role of MR imaging in patients with suspected Morton's neuroma and to assess the value of various MR sequences in this diagnosis.

Materials And Methods: Thirty-two consecutive patients with suspected Morton's neuroma were studied using a 1.0-T MR scanner.

[Comparison between magnetic resonance imaging and arthroscopy for the diagnosis of knee meniscal lesions].

Purpose Of Study: The authors evaluated the use of MR-imaging of the menisci compared to arthroscopy considered as the gold standard by which all noninvasive imaging procedures of the knee have to be measured.

Material And Methods: In a prospective study, we evaluated the use of MRI in 50 patients with clinically suspected disorders of the meniscus, followed by an arthroscopic examination by an experienced arthroscopist. MRI studies were performed after clinical evaluation and were interpreted by an experienced radiologist, who had no knowledge of the clinical findings.

Contrast media in MR arthrography of the glenohumeral joint: intra-articular gadopentetate vs saline: preliminary results.

The purpose of this investigation was to compare gadopentetate and saline as contrast media in MR arthrograms of the glenohumeral joint. In 60 consecutive patients MR arthrograms with either gadopentetate (n = 26) or saline (n = 34) were performed. After injection of gadopentate, 3D gradient-echo (GE) images were obtained (TR 32 ms, TE 10 ms, flip angle 40 degrees).

[Sonography of the musculoskeletal system].

Beside standard radiographs, bone scintigraphy and MR imaging, ultrasonography plays an important role in assessing abnormalities of the musculoskeletal system. Ultrasonography is widely available, inexpensive and provides high-contrast resolution; however, interobserver variability is a major problem. Ultrasonography should only be employed by experienced examiners and for proven indications in order to prevent inadequate results.

Rapid prototyping (stereolithography) in the management of intra-articular calcaneal fractures.

The purpose of this study was to evaluate and compare the diagnostic performance of stereolithography vs workstation-based three-dimensional (3D) reformations in intra-articular calcaneal fractures. A total of 30 intra-articular calcaneal fractures were examined using standard radiographs, coronal CT scans, and 2D and 3D reformations. The CT data were transferred to an outside institution, and stereolithograms were produced from photopolymer resin employing a laser beam system.

[Diagnosis of shoulder impingement syndrome].

This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Shoulder impingement is caused by compression of the supraspinatus tendon underneath the coracoacromial arch, mainly in forward flexion of the arm. Different stages of impingement syndrome are described.

Imaging in degenerative disease of the cervical spine.

Standard radiography of the cervical spine is still the first imaging procedure applied in degenerative disease of the cervical spine. Spondylosis deformans, osteochondrosis and uncovertebral arthrosis are well depicted by such images. Whether or not additional imaging is needed depends on the clinical symptoms.

Current status of imaging of articular cartilage.

Various imaging methods have been applied to assessment of articular cartilage. These include standard radiography, arthrography, CT, CT arthrography, ultrasonography, and MR imaging. Radiography remains the initial musculoskeletal imaging method.

[Vertebral pain in advanced age: radiological diagnosis].

Vertebral pain is common in elderly patients. This article reviews indications and results of imaging in these patients. The differential diagnosis of degenerative disease and the mass important emergency situations are discussed.

[Knee problems--imaging techniques].

Standard radiographs still represent the standard imaging method in knee abnormalities. Major advantages include high spatial resolution, low cost, high availability and standardized imaging technique. Because there is an increasing pressure on the cost of health care, additional imaging should only be employed based on a working hypothesis.

[Magnetic resonance tomography (MRI) of ligament injuries of the upper ankle joint].

This paper discusses MR imaging in injuries to the lateral collateral ankle ligaments. Based on recent publications and our own results MR imaging may be useful for demonstration of ankle ligament tears. However, clinical outcome can probably not be predicted by such diagnosis.

Hereditary sensory and autonomic neuropathy type I (Thévenard's disease).

Radiographic and MR findings of two cases of hereditary sensory and autonomic neuropathy type I are reported. This rare disease has a non-specific radiographic and MR appearance. Differential diagnosis includes other types of hereditary and acquired sensory neuropathies affecting small myelinated and unmyelinated nerve fibers, as well as vascular abnormalities and lesions of the spinal cord.

Metaphyseal peg in geroderma osteodysplasticum: a new genetic bone marker and a specific finding?

We describe two sibs with geroderma osteodysplasticum (GO) who, in addition to the known clinical and radiologic manifestations of the disorder, presented a metaphyseal peg indenting the epiphysis of the long bones, particularly at the knees. The peg was visible only at the age of 4 to 5 years but was invisible in infancy and following physeal closure. This may explain why this anomaly was not described in previous reports of 23 patients in 11 families with GO.

Clinical examination and magnetic resonance imaging in the assessment of ankle sprains treated with an orthosis.

This is a prospective clinical study of treatment of ankle sprains with an ankle brace that permits ankle dorsiflexion and plantarflexion of 20 degrees, but limits inversion and eversion for 6 weeks. The ankle brace is followed by physiotherapy for another 6 weeks. Thirty patients were evaluated with clinical examination and magnetic resonance (MR) imaging before treatment and after 12 weeks of treatment.

Correlation of MR imaging, CT arthrography, and arthroscopy of the shoulder.

Rotator cuff tears and instability of the glenohumeral joint are a common cause of chronic shoulder pain and disability. Currently CT arthrography is the method of choice to evaluate the extent of osseous and soft tissue abnormalities. This study was undertaken to determine if magnetic resonance imaging was able to depict post-dislocation abnormalities and rotator cuff pathology and if MRI can replace CT arthrography.

Titanium implant for the osteosynthesis of massive allograft reconstruction to improve follow-up by magnetic resonance imaging.

In twelve patients with local aggressive or malignant bone tumors allograft reconstruction after limb sparing procedures were performed using titanium implants for osteosynthesis. In eleven of these patients magnetic resonance imaging studies could be completed. Distortions of the images were limited to the vicinity of the implants and did not preclude detailed analysis of the gross anatomy and of fine articular structures involving and adjacent to the allografts used.

Knee evaluation in two systems and magnetic resonance imaging after operative treatment of posterior cruciate ligament injuries.

We reviewed 30 patients operated on because of acute (n = 14) or chronic (n = 16) rupture of the posterior cruciate ligament (PCL) with an average follow-up time of 6.9 years. The clinical outcome was expressed using the OAK and the International Knee Documentation Committee (IKDC) evaluation forms.

Posterolateral aspect of the knee: improved MR imaging with a coronal oblique technique.

Purpose: To determine if angling the coronal plane in magnetic resonance (MR) imaging of the knee increases the conspicuity of the posterolateral structures.

Materials And Methods: A coronal oblique MR imaging sequence performed parallel to the popliteal tendon proximally was added to our routine study in patient knee examinations. One hundred patients (age range, 12-72 years) underwent MR imaging.

MR imaging versus alternative imaging techniques.

MR imaging is the method of choice in evaluating a large number of soft-tissue abnormalities; however, it has certain draw-backs, some of which may make other imaging methods more suitable. MR imaging is more expensive than alternative imaging methods; it may not be affordable for screening purposes and for diagnoses obtainable by less expensive imaging methods. In addition, immediate scheduling is not always possible for MR imaging, and an MR scanner may not be available close to the patient's home, which may be important for imaging follow-up.

MR arthrography of the hip: improved imaging of the acetabular labrum with histologic correlation in cadavers.

Objective: The objective of this study was to correlate findings on conventional MR imaging and MR arthrography of the hip with pathologic findings in cadavers with abnormal labra to determine (1) the efficacy of MR imaging in assessing labral degeneration, (2) whether delineation of the labrum from the joint capsule is possible, and (3) if the conspicuity of surface abnormalities of the labrum is improved by administering intraarticular contrast material.

Materials And Methods: Twelve cadaveric hip joints were obtained from elderly cadavers. Each hip was examined using fat-suppressed three-dimensional spoiled GRASS (gradient-recalled acquisition in the steady state) (SPGR) imaging and T1-weighted spin-echo imaging before and after intraarticular injection of contrast material.

Assessment of articular cartilage thickness of the humeral head: MR-anatomic correlation in cadavers.

Objective: The purpose of our study was to evaluate several commonly used MR sequences to determine how accurately each demonstrates the thickness of the articular cartilage of the humeral head.

Materials And Methods: Ten cadaveric shoulders (age at death, 58-92 years; mean, 79 years) were imaged with fat-suppressed transaxial T1-weighted spin-echo three-dimensional gradient-recalled sequences, both before and after injection of 12 ml of diluted gadopentetate dimeglumine. Articular cartilage was measured to the nearest 10th of a millimeter on the MR images and corresponding anatomic sections.

[Ultrasonography and magnetic resonance tomography (MRI) of tendon injuries].

Both ultrasound and MR imaging have become increasingly important for the assessment of tendon abnormalities. Ultrasound is widely available and is mainly suitable for emergency situations in traumatology and as a screening method. For soft tissue imaging only up-to-date sonographic equipment should be used.

[Aortic elongation: merely mimicked in increased thoracic kyphosis? radiologic-pathologic correlation].

The purpose of this investigation was to demonstrate that the radiologically "elongated" thoracic aorta corresponds to an increase in anatomical aortic length and is not merely mimicked by increased thoracic kyphosis with shortening of the thoracic cage. 50 consecutive autopsies were included (age at death: 33-90 years, mean 65.1 years).

Fast spin-echo inversion-recovery imaging versus fast T2-weighted spin-echo imaging in bone marrow abnormalities.

Rationale And Objectives: The purpose of this investigation is to compare a fat-suppressed T2-weighted fast spin-echo (FSE) sequence in bone marrow abnormalities with an FSE STIR sequence that recently has become commercially available.

Methods: Fast spin-echo images (repetition time [TR], 3500-5000 mseconds; echo time [TE], 96-114 mseconds) and FSE STIR images (TR, 3000-5000 mseconds; TE, 32-40 mseconds; inversion time [TI], 140-150 mseconds) were compared quantitatively and qualitatively calculating signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), and lesion conspicuity and using a qualitative scoring system.

Results: Signal-to-noise ratio (mean +/- standard deviation) was 36.