Acetabulum protrusio and center edge angle: new MR-imaging measurement criteria--a correlative study with measurement derived from conventional radiography.

Objective: The goal of this study was to identify a method of measurement for acetabulum protrusio and center edge angle (CEA) using MR imaging of the pelvis that correlated with classic methods using radiographic landmarks.

Materials And Methods: MR images and radiographs of the pelvis in 67 patients (132 hips) were used to identify reliable MR-imaging methods for measuring protrusio acetabulum and CEA that correlated strongly with established radiographic measurements. Protrusio acetabulum was determined using the radiographic criterion that the acetabular line projects medial to the ilioischial line by 3 mm or more in men and 6 mm or more in women.

Coronoid process of the ulna: paleopathologic and anatomic study with imaging correlation. Emphasis on the anteromedial "facet".

Objective: The purpose of this study was to provide a detailed description of the anatomy of the coronoid process of the ulna and to use magnetic resonance (MR) images and anatomic correlation with cadavers to show the macroscopic configuration of this structure.

Materials And Methods: Photography and high-resolution radiography were performed in 26 ulna specimens from the collection of a local museum. MR imaging of the coronoid process of 11 cadaveric elbows was performed.

Medial patellofemoral ligament: cadaveric investigation of anatomy with MRI, MR arthrography, and histologic correlation.

Objective: The purpose of this study was to use MRI with gross anatomic and histologic correlation in cadavers to define the anatomic details of the medial patellofemoral ligament.

Materials And Methods: MRI of seven cadaveric knees was performed before and after intraarticular administration of a gadolinium solution. T1-weighted spin-echo MR images with and without fat suppression were acquired in three planes.

Communication between the proximal tibiofibular joint and knee via the subpopliteal recess: MR arthrography with histologic correlation and stratigraphic dissection.

Objective: The anatomy and functional importance of the proximal tibiofibular joint (TFJ) have rarely been emphasized. Specifically, the detailed anatomic basis and MRI findings of the communication between the proximal TFJ and the knee have not been defined in the literature. To investigate such communication, anatomic and histologic correlation with MRI findings in frozen specimens and dissections of embalmed specimens was used in the study.

Radiographic evaluation of arthritis: inflammatory conditions.

In the presence of joint space narrowing, it is important to differentiate inflammatory from degenerative conditions. Joint inflammation is characterized by bone erosions, osteopenia, soft-tissue swelling, and uniform joint space loss. Inflammation of a single joint should raise concern for infection.

Antibiotic prophylaxis in spine surgery: an evidence-based clinical guideline for the use of prophylactic antibiotics in spine surgery.

Background Context: The objective of the North American Spine Society's (NASS) Evidence-Based Clinical Guideline on Antibiotic Prophylaxis in Spine Surgery is to provide evidence-based recommendations on key clinical questions concerning the use of prophylactic antibiotics in spine surgery. The guideline is intended to address these questions based on the highest quality clinical literature available on this subject as of December 2006. The goal of the guideline recommendations is to assist in delivering optimum, efficacious treatment to prevent surgical site infection.

Anatomical features of plantar aponeurosis: cadaveric study using ultrasonography and magnetic resonance imaging.

Objective: Abnormalities of the plantar aponeurosis are commonly encountered in patients with subcalcaneal heel pain. Understanding normal anatomy is required to accurately diagnose some disorders of the foot. The purpose of our study was to describe the normal anatomy of the plantar aponeurosis, using ultrasonography and MRI with close anatomic correlation in cadavers.

Complex distal insertions of the tibialis posterior tendon: detailed anatomic and MR imaging investigation in cadavers.

Purpose: The purpose of this report was to demonstrate the normal complex insertional anatomy of the tibialis posterior tendon (TPT) in cadavers using magnetic resonance (MR) imaging with anatomic and histologic correlation.

Material And Methods: Ten cadaveric ankles were used according to institutional guidelines. MR T1-weighted spin echo imaging was performed to demonstrate aspects of the complex anatomic distal insertions of the TPT in cadaveric specimens.

Lumbar disc arthroplasty: a critical review.

Lumbar disc arthroplasty may be the most innovative and exciting development in the history of spinal surgery. Manufacturers and proponents cite the ability of these devices to relieve pain while preserving motion at the disc space. The preservation of motion is hypothesized to lower the risk of adjacent segment disease and, thereby, improve long-term outcomes.

Magnetic resonance imaging of the femoral trochlea: evaluation of anatomical landmarks and grading articular cartilage in cadaveric knees.

Purpose: The purpose of the study was to define magnetic resonance imaging (MRI) findings before and after contrast medium opacification of the knee joint in cadaveric specimens to demonstrate anatomical landmarks of the trochlear surface in relation to the neighboring structures, and to evaluate different MRI sequences in the detection of cartilage defects of the trochlear and patellar surface of the knee.

Materials And Methods: The morphology and relationship of the proximal trochlear surface to the prefemoral fat of the distal femur were investigated by use of different MR sequences before and after intra-articular gadolinium administration into the knee joint in ten cadaveric knees. Anatomic sections were subsequently obtained.

Articular nodular fasciitis in the glenohumeral joint.

We describe a case of multiple intra-articular masses in the glenohumeral joint of a 15-year-old patient. The patient was treated with arthroscopic excision of the masses and synovectomy. Histological and immunohistochemical studies were consistent with those of a nodular fasciitis.

Imaging findings of complications affecting the upper extremity in intravenous drug users: featured cases.

Infections generally occur in intravenous drug abuse (IVDA) patients, most commonly affecting the spine and proximal joints. Numerous serious musculoskeletal complications of IVDA may involve the upper extremity, however. Soft-tissue complications in the upper extremity of IVDA patients include cellulitis, ulceration, abscess, pyomyositis, septic bursitis, tenosynovitis, and necrotizing fasciitis.

Anatomic features of metatarsal heads that simulate erosive disease: cadaveric study using CT, radiography, and dissection with special emphasis on cross-sectional characterization of osseous anatomy.

Objective: The purpose of our study was to characterize and describe normal osseous contours of the metatarsal heads that may simulate erosive changes.

Materials And Methods: CT of the metatarsal heads was performed in six human cadaveric feet, and 3D reformatted images were analyzed. Subsequently, five feet were sectioned in planes corresponding to those at imaging for anatomic correlation, and one foot was anatomically dissected for correlation.

Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology.

Objective: To correlate the amount of bone marrow edema (BME) calculated by magnetic resonance imaging(MRI) with clinical findings, histopathology, and radiographic findings, in patients with advanced hip osteoarthritis(OA).

Materials And Methods: The study was approved by The Institutional Human Subject Protection Committee. Coronal MRI of hips was acquired in 19 patients who underwent hip replacement.

Hoffa's fat pad injuries and their relationship with anterior cruciate ligament tears: new observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers.

Purpose: To determine the normal anatomic relationships of Hoffa's fat pad with the anterior cruciate ligament (ACL) and with the frequency of Hoffa's fat pad abnormalities in ACL-deficient knees.

Design: Retrospective clinical study on patients and observational anatomic study on cadavers. The study was approved by the Institutional Review Board.

Diagnosis and treatment of human seminal plasma hypersensitivity.

Background: Human seminal plasma hypersensitivity is a rare disorder that is often misdiagnosed. While this disorder is well described in the allergy and immunology literature, few cases exist in the gynecologic literature.

Case: A young woman presented to our allergy clinic with recurrent vaginal burning, swelling, and itching occurring approximately 10 minutes postcoitally.

Popliteomeniscal fascicles: anatomic considerations using MR arthrography in cadavers.

Objective: This study was performed to examine the normal MR arthrographic anatomy of the popliteomeniscal fascicles with specific reference to the number of popliteomeniscal fascicles, thickness and course of the fascicles, and presence of other posterior attachments from the medial aponeurosis of the popliteus musculotendinous region.

Materials And Methods: Multiplanar 1.5-T MR arthrography of 10 cadaveric knees was performed using a quadrature knee coil.

Magnetic resonance imaging (MRI) in the clearance of the cervical spine in blunt trauma: a meta-analysis.

Background: There is a subset of blunt trauma patients that present with symptoms suspicious for cervical spine injury or with unreliable clinical exams whose initial plain radiographs or cervical computed tomography (CT) scan are negative. Uncertainty remains, however, because no gold standard has been established for definitively clearing the cervical spine of injury in this patient cohort. Individual studies have detailed the use of magnetic resonance imaging (MRI) in this patient population without conclusive results.

Degenerative lumbar spinal stenosis: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis.

Background Context: The objective of the North American Spine Society (NASS) evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (DLSS) is to provide evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of DLSS. The guideline is intended to reflect contemporary treatment concepts for symptomatic DLSS as reflected in the highest quality clinical literature available on this subject as of April 2006. The goals of the guideline recommendations are to assist in delivering optimum, efficacious treatment, and functional recovery from this spinal disorder.

Leontiasis ossea: a paleopathologic case report.

We describe the archeological and imaging findings of a unique specimen (skull and mandible) with leontiasis ossea (LO) that is on display in the National Museum of Anthropology and History in Mexico City. The specimen shows diffuse and irregular periosteal bone proliferation, which produces a grossly nodular appearance involving the neurocranium and the facial skeleton. Plain radiography and helical computed tomography revealed generalized hyperostosis obliterating the maxillary and sphenoidal sinuses and 2 exuberant bony masses arising from the maxilla with encroachment of the anterior nasal aperture.

Posterior capsular fibrosis in professional baseball pitchers: case series of MR arthrographic findings in six patients with glenohumeral internal rotational deficit.

In the high-performance athlete, acquired thickening of the posterior joint capsule is a proposed etiology for glenohumeral internal rotational deficit (GIRD). The purpose of this study was to present our MR arthrographic imaging observations of posterior capsular thickening in professional baseball players who present with reduced throwing velocity related to pain and clinical findings of internal rotational deficit of the glenohumeral joint. Our observations of MR imaging features in patients with clinical and arthroscopic manifestations of GIRD lesions include articular surface partial thickness tears of the supraspinatus and infraspinatus tendons, superoposterior subluxation of the humeral head and SLAP tears of the labrum.

The role of the journal club in neurosurgical training.

Objective: The journal club (JC) plays a traditional role in resident education. However, little has been written on its current role in neurosurgical training programs. Our goal was to determine resident perception of JCs, factors that make JCs successful, and identifying variables for improving JCs.

Molecular imaging: integration of molecular imaging into the musculoskeletal imaging practice.

Chronic musculoskeletal diseases such as arthritis, malignancy, and chronic injury and/or inflammation, all of which may produce chronic musculoskeletal pain, often pose challenges for current clinical imaging methods. The ability to distinguish an acute flare from chronic changes in rheumatoid arthritis, to survey early articular cartilage breakdown, to distinguish sarcomatous recurrence from posttherapeutic inflammation, and to directly identify generators of chronic pain are a few examples of current diagnostic limitations. There is hope that a growing field known as molecular imaging will provide solutions to these diagnostic puzzles.

Antihyperalgesic effects of vanilloid-1 and bradykinin-1 receptor antagonists following spinal cord injury in rats.

Object: The authors previously discovered that genes for the bradykinin-1 (B1) receptor and the transient receptor potential vanilloid subtype 1 (TRPV1) were overexpressed in animals exhibiting thermal hyperalgesia (TH) following spinal cord injury (SCI). They now report the effect of TRPV1 (AMG9810) and B1 (Lys-[Des-Arg9,Leu8]-bradykinin) antagonists on TH in animals following SCI.

Methods: The rats were subjected to contusion SCI and then divided into groups in which TH did or did not develop.

Evidence-based spine surgery.

Study Design: Literature review.

Objective: To describe the state of the literature regarding the performance of lumbar fusion for low back pain due to degenerative disease of the spine.

Summary Of Background Data: The effectiveness and costs associated with spinal surgery have been a topic of significant debate in both the popular press and professional literature.