Localization of specific joint causing hindfoot pain: value of injecting local anesthetics into individual joints during arthrography.

Objective: The purpose of this study was to evaluate the utility of selective injection of local anesthetic into hindfoot articulations for localizing the source of posttraumatic pain and to compare clinical response with the severity of degenerative change in the various articulations evident on plain radiographs or CT scans.

Subjects And Methods: Anesthetic arthrography was performed in 18 patients with posttraumatic hindfoot pain. In all, 32 joints were assessed: 15 talocalcaneonavicular, 11 subtalar, five ankle, and one calcaneocuboid.

Injuries of the superior portion of the glenoid labrum involving the insertion of the biceps tendon: MR imaging findings in nine cases.

The goal of this investigation was to describe the MR appearance of traumatic fraying or detachment of the superior portion of the glenoid labrum including the insertion of the tendon of the long head of the biceps. This condition is caused either by an acute injury or by repeated overhead motion during participation in sports. In nine patients with such a lesion, the arthroscopic report and MR images were available for review.

Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation.

Standard proton-density- and T2-weighted magnetic resonance (MR) imaging and MR arthrography were used to depict rotator cuff disease in 36 shoulders in 36 patients; the findings were compared with arthroscopic findings in every patient. In 19 rotator cuffs normal at arthroscopy, MR arthrography revealed no tear in 16 patients, a partial tear in one patient, and a full-thickness tear in two patients. Standard proton-density- and T2-weighted images were normal in 15 of these patients and revealed a partial tear in two patients and a full-thickness tear in two patients.

The PCL line: an indirect sign of anterior cruciate ligament injury.

A new sign of anterior cruciate ligament (ACL) tear based on secondary changes of the posterior cruciate ligament (PCL) is described. Thirty-one patients with magnetic resonance (MR) examinations of the knee suspicious for ACL injury and 50 normal controls were examined. In each patient a line was drawn adjacent and parallel to the posterior margin of the distal portion of the PCL and was extended proximally.

MR findings in asymptomatic shoulders: a blind analysis using symptomatic shoulders as controls.

We performed a blind prospective analysis of the shoulders of 20 asymptomatic volunteers, aged 25 to 55 years, to determine the frequency of magnetic resonance (MR) findings considered abnormal in symptomatic patients. Twenty symptomatic patients were used as controls. With regard to the asymptomatic shoulders, all 20 had intact rotator cuff tendons, although six (30%) of the tendons had abnormal internal signal, and one (5%) had abnormal morphology.

Gadopentetate dimeglumine-enhanced MR imaging of the musculoskeletal system.

Contrast-enhanced MR imaging with gadopentetate dimeglumine has been used in the evaluation of musculoskeletal disorders only in recent years, and for the most part it is still under investigation. Review of the literature identified potential uses for this technique: (1) in the spine, for differentiation between scar tissue and recurrent disk herniation and for evaluation of epidural tumors; (2) in musculoskeletal tumors, for differentiation between tumor necrosis and peritumoral edema and for characterization and evaluation of tumors before and after treatment; (3) in the joints for delineation of cartilage and tendon tears, with intraarticular injection, and for differentiation between pannus and joint effusion, with IV injection; and (4) for delineation of infectious processes. Further studies are needed to confirm most of these potential indications.

MR arthrography of the shoulder: comparison with conventional MR imaging.

Twenty-three patients underwent both conventional MR imaging of the shoulder and MR shoulder arthrography for clinically suspected labral or rotator cuff abnormalities. Images obtained before and after contrast administration were studied independently, and without knowledge of clinical findings, by two radiologists for the presence of abnormalities of the glenoid labrum or rotator cuff. Results were correlated with surgical findings in all patients.

Rheumatoid knee: role of gadopentetate-enhanced MR imaging.

Physical examination is often insufficient in distinguishing between joint effusion and inflamed synovium in the knee joints of patients with rheumatoid arthritis. The authors prospectively evaluated the role of intravenously administered gadopentetate dimeglumine in distinguishing between these two conditions. Fourteen patients with classic rheumatoid arthritis were examined first by a rheumatologist and then by means of magnetic resonance (MR) imaging with T1- and T2-weighted sequences.

Magnetic resonance imaging of the shoulder.

MR imaging has proved to be of great value in the assessment of musculoskeletal imaging. Its superiority in evaluating knee and spine pathology is well established. Recent studies also have established an important role for MR imaging in the assessment of shoulder disorders.

Magnetic resonance imaging of the knee.

MRI has been in widespread clinical use since 1985 and in this short time has dramatically altered musculoskeletal imaging. The technology continues to become increasingly sophisticated; as both clinicians and radiologists become more familiar with its possibilities, further elucidation of pathologic processes affecting the knee will occur. In addition, advanced computer software has allowed a decrease in imaging time, which will allow a decrease in cost of this once-expensive technique.

Jogging causes acute changes in the knee joint: an MR study in normal volunteers.

As MR imaging allows evaluation of soft-tissue structures not previously possible with imaging techniques, we undertook a preliminary study to evaluate the effects of a popular form of exercise (jogging) on the knee. The specific question prompting our investigation was, does repetitive impulse loading produced by jogging cause acute structural changes within the knee that are visible by MR imaging? The knees of 10 healthy subjects were examined on a 1.5-T MR system before and immediately after 30 min of continuous jogging.

Advanced imaging of the wrist.

Abnormalities of the wrist present a difficult diagnostic challenge requiring thorough evaluation of both osseous and soft-tissue structures. Advanced techniques such as scintigraphy, computed tomography, three-phase arthrography, and, most recently, magnetic resonance imaging have added greatly to our understanding of wrist pathology. This article discusses the application of these techniques in imaging the wrist.

Is MR better than arthrography for evaluating the ligaments of the wrist? In vitro study.

The purpose of this study was to determine the relative merits of MR imaging and three-compartment digital arthrography in the assessment of carpal ligaments in vitro. We performed MR imaging and arthrography in 10 normal wrists of fresh cadavers ranging in age from 48 to 71 years, and compared the appearance of the interosseous ligaments and triangular fibrocartilage complex with findings on anatomic sections of the joints. In six of the specimens, relatively T1-weighted MR images, 800/20 (TR/TE), preceded three-compartment digital arthrography performed with standard contrast material.