Utility of Zero Echo Time MRI for the Diagnosis and Characterization of Ankle Fractures.

Zero echo time (ZTE) imaging is a relatively new magnetic resonance (MR) pulse sequence that provides bone-soft tissue contrast similar to that of computed tomography (CT). We sought to (1) determine the accuracy of ZTE MRI for the diagnosis of common ankle fractures and (2) investigate whether ZTE imaging sequences are equivalent to the gold standard of CT for the characterization of fracture fragments. We conducted a prospective case series of 54 patients with acute ankle trauma, in whom ZTE MRI was performed, followed by surgical reduction.

MRI findings correlate with difficult dissection during proximal hamstring repair and with postoperative sciatica.

Objective: This study examines the correlation between MRI findings and difficult dissection during proximal primary hamstring repair and postoperative sciatica.

Materials And Methods: A total of 32 cases of surgically repaired hamstring tendon tears that underwent preoperative and postoperative MRI were divided into sciatica (n = 12) and control (n = 20) groups based on the presence or absence of postoperative sciatica. Cases were scored by two blinded musculoskeletal radiologists for imaging features associated with difficult surgical dissection and the development of subsequent sciatica.

Partial Flexor Tendon Injury Causing Locking: Illustration of the Utility of Dynamic Ultrasound.

Clinical diagnosis of partial flexor tendon lacerations is challenging because tendon function may be preserved. Although some partial flexor tendon tears can be managed conservatively, pain, stiffness, and triggering/locking may result, requiring surgical management. The mechanism by which this occurs has been investigated in animal and cadaver studies but has not been demonstrated in patients with real-time, in vivo imaging.

Pain After Hip Arthroplasty: MR Imaging/Ultrasound Correlation.

MR imaging and ultrasound (US) have complementary roles for the comprehensive assessment of painful hip arthroplasty. Both modalities demonstrate synovitis, periarticular fluid collections, tendon tears and impingement, and neurovascular impingement, often with features indicating the causative etiology. MR imaging assessment requires technical modifications to reduce metal artifact, such as multispectral imaging, and optimization of image quality, and a high-performance 1.

Dynamic ultrasound assessment of hip instability and anterior and posterior hip impingement.

Objective: In this technical report, we describe our protocol for the dynamic sonographic evaluation of the hip and assess reliability of the ultrasound assessment of hip microinstability.

Materials And Methods: Our clinical experience with a standardized dynamic ultrasound of the hip performed in a series of 27 patients with imaging performed by an experienced musculoskeletal radiologist during physical examination by an orthopedic surgeon specializing in hip preservation is illustrated with clinical photographs and ultrasound images from volunteers and selected patients. Interrater reliability for the diagnosis of microinstability was calculated.

Deep-learning-reconstructed high-resolution 3D cervical spine MRI for foraminal stenosis evaluation.

Objective: To compare standard-of-care two-dimensional MRI acquisitions of the cervical spine with those from a single three-dimensional MRI acquisition, reconstructed using a deep-learning-based reconstruction algorithm. We hypothesized that the improved image quality provided by deep-learning-based reconstruction would result in improved inter-rater agreement for cervical spine foraminal stenosis compared to conventional two-dimensional acquisitions.

Materials And Methods: Forty-one patients underwent routine cervical spine MRI with a conventional protocol comprising two-dimensional T2-weighted fast spin echo scans (2 axial planes, 1 sagittal plane), and an isotropic-resolution three-dimensional T2-weighted fast spin echo scan reconstructed over a 4-h time window with a deep-learning-based reconstruction algorithm.

Evaluation of deep learning reconstructed high-resolution 3D lumbar spine MRI.

Objectives: To compare interobserver agreement and image quality of 3D T2-weighted fast spin echo (T2w-FSE) L-spine MRI images processed with a deep learning reconstruction (DLRecon) against standard-of-care (SOC) reconstruction, as well as against 2D T2w-FSE images. The hypothesis was that DLRecon 3D T2w-FSE would afford improved image quality and similar interobserver agreement compared to both SOC 3D and 2D T2w-FSE.

Methods: Under IRB approval, patients who underwent routine 3-T lumbar spine (L-spine) MRI from August 17 to September 17, 2020, with both isotropic 3D and 2D T2w-FSE sequences, were retrospectively included.

3D MRI of the Spine.

Three-dimensional (3D) magnetic resonance imaging of the spine is now clinically feasible due to technological advancements. Its advantages over two-dimensional imaging include higher in-plane spatial resolution and the ability for reformation in any plane that enables time savings in image acquisition and aids more accurate interpretation. Multispectral 3D techniques for imaging around metal are sometimes useful for evaluating anatomy adjacent to spinal fixation hardware.

MRI Visualization of Polyethylene Post Fractures in Posterior Stabilized Total Knee Arthroplasty.

Polyethylene post fracture is a recognized complication of posterior stabilized total knee arthroplasty. Two radiologists retrospectively reviewed MRI examinations of 19 reported post fractures in 18 patients; all fractures were subsequently confirmed surgically with no false-positive cases. All post fractures were visualized as a combination of post deformity and signal-void fragment in a joint recess.

Quantitative Ultrasound Assessment of the Achilles Tendon Under Varied Loads.

This Institutional Review Board-approved pilot study attempted to detect the correlation between ultrasound shear wave elastographic measures and tendon loads. Five male fresh-frozen cadaveric Achilles tendons were loaded in 10-N increments from 0 to 60 N. Shear wave velocity measurements within each Achilles tendon were obtained at each load in longitudinal and transverse orientations.

Ultrasound Diagnosis of Osteophytic Impingement of the Popliteus Tendon After Total Knee Replacement.

We report our experience with 6 patients who had total knee replacements with lateral-sided knee pain, referred for ultrasound (US) assessment and US-guided injection. All cases showed an osteophyte within the popliteus sulcus of the lateral femoral condyle impinging on the adjacent tendon. Five of 6 patients reported improvement of symptoms immediately after US-guided injection of an anesthetic and a steroid.