Developing an in situ LED irradiation system for small-angle X-ray scattering at B21, Diamond Light Source.

Beamline B21 at the Diamond Light Source synchrotron in the UK is a small-angle X-ray scattering (SAXS) beamline that specializes in high-throughput measurements via automated sample delivery systems. A system has been developed whereby a sample can be illuminated by a focused beam of light coincident with the X-ray beam. The system is compatible with the highly automated sample delivery system at the beamline and allows a beamline user to select a light source from a broad range of wavelengths across the UV and visible spectrum and to control the timing and duration of the light pulse with respect to the X-ray exposure of the SAXS measurement.

Diagnosis and treatment of flexor tendon injuries of the hand: what the radiologist needs to know.

This article reviews the diagnosis and treatment of flexor tendon injuries of the hand highlighting flexor tendon anatomy, important pre-operative imaging findings, surgical options, and post-operative complications. Imaging plays a key role in guiding treatment of these difficult to manage injuries. Thus, it is important for radiologists to have a sound understanding of factors important in treatment decision-making.

Pronator syndrome and anterior interosseous nerve palsy due to neurolymphomatosis: a case report.

Pronator syndrome is a median nerve entrapment neuropathy that can be difficult to diagnose due to its variable presentation and objective findings. Neurolymphomatosis is an uncommon disease in which malignant lymphocytes infiltrate central or peripheral nerve endoneurium and is often missed for prolonged periods prior to diagnosis. We present a rare case of pronator syndrome and anterior interosseous nerve palsy due to neurolymphomatosis that was occult on initial MRI in spite of the presence of a median nerve mass discovered intra-operatively during neurolysis.

Extended and weightbearing wrist 3-T MRI using a novel harness and flexible 24-channel glove coil to evaluate carpal kinematics: a pilot study in 10 volunteers.

Background: Wrist pain in the extended or extended weightbearing positions may be incompletely evaluated using standard magnetic resonance imaging (MRI) with standard rigid clamshell coils in the neutral position.

Purpose: To evaluate a flexible 24-channel glove coil and harness when imaging the wrist in neutral, dorsally extended, and weightbearing positions.

Material And Methods: Ten wrists in 10 asymptomatic volunteers (mean age = 29 years) were scanned.

Acute and Chronic Elbow Disorders: MR Imaging-Ultrasonography Correlation.

Elbow pain is very common and can be due to many pathologic conditions. After radiographs are obtained, advanced imaging is often necessary. Both ultrasonography and MR imaging can be used to evaluate the many important soft-tissue structures of the elbow, with each modality having advantages and disadvantages in certain clinical scenarios.

Swinging injuries in competitive baseball players.

Injuries are common in competitive baseball players and can occur in all facets of the game. The majority of the existing literature on injuries in baseball players has focused on injuries secondary to the overhead throw with very little attention given to injuries sustained while batting. The baseball swing is a complex, often violent, motion that predisposes batters to a variety of injuries affecting the spine, trunk, pelvis, and extremities.

Can MR neurography of the common peroneal nerve predict a residual motor deficit in patients with foot drop?

Objective: To determine if MR neurography of the common peroneal nerve (CPN) predicts a residual motor deficit at 12-month clinical follow-up in patients presenting with foot drop.

Materials And Methods: A retrospective search for MR neurography cases evaluating the CPN at the knee was performed. Patients were included if they had electrodiagnostic testing (EDX) within 3 months of imaging, ankle and/or forefoot dorsiflexion weakness at presentation, and at least 12-month follow-up.

Ventricular arrhythmias in Kearns-Sayre syndrome: A cohort study using the National Inpatient Sample database 2016-2019.

Background: Degeneration of the cardiac conduction system resulting in complete heart block (CHB), ventricular arrhythmias (VA), and sudden cardiac death (SCD) is recognized in patients with Kearns-Sayre syndrome (KSS) and is potentially preventable with permanent pacemaker (PPM) implantation. However, other mechanisms for SCD have been proposed, and the efficacy of implanting a defibrillator instead of PPM remains to be investigated.

Methods: We utilized the National Inpatient Sample (NIS) database 2016-2019 to investigate the risk of VA or dysrhythmic cardiac arrest (dCA) in KSS patients.

Nerve Imaging in the Wrist.

Neuropathic symptoms involving the wrist are a common clinical presentation that can be due to a variety of causes. Imaging plays a key role in differentiating distal nerve lesions in the wrist from more proximal nerve abnormalities such as a cervical radiculopathy or brachial plexopathy. Imaging complements electrodiagnostic testing by helping define the specific lesion site and by providing anatomical information to guide surgical planning.

Imaging Evaluation of Medial and Lateral Elbow Pain: Acute and Chronic Tendon Injuries of the Humeral Epicondyles.

Medial and lateral elbow pain are often due to degenerative tendinosis and less commonly due to trauma. The involved structures include the flexor-pronator tendon origin in medial-sided pain and the extensor tendon origin in lateral-sided pain. Multimodality imaging is often obtained to verify the clinically suspected diagnosis, evaluate the extent of injury, and guide treatment decisions.

Delayed Diagnosis of Cardiac Amyloidosis Secondary to Multiple Myeloma.

Cardiac amyloidosis is a rare condition with only 2,500 new cases reported yearly in the United States of America (USA). The prognosis of cardiac amyloidosis is particularly grim. The median survival is 6 months from onset of congestive heart failure (CHF) symptoms.

US-guided Musculoskeletal Interventions of the Body Wall and Core with MRI and US Correlation.

Chest, abdominal, and groin pain are common patient complaints that can be due to a variety of causes. Once potentially life-threatening visceral causes of pain are excluded, the evaluation should include musculoskeletal sources of pain from the body wall and core muscles. Percutaneous musculoskeletal procedures play a key role in evaluating and managing pain, although most radiologists may be unfamiliar with applications for the body wall and core muscles.

Kearns-Sayre Syndrome With Persistent Ventricular Tachycardia Refractory to Shocks and Medications.

Cardiovascular conduction delay makes up part of the triad associated with Kearns-Sayre syndrome (KSS). Although there have been a few reported cases of prolonged Qtc and polymorphic ventricular tachycardia associated with this disease, despite the use of automatic implantable cardioverter defibrillators (AICD) for secondary prevention, some cases have been reported where the use of AICD did not help. We present a case of a 62-year-old male with KSS who came to the emergency department (ED) after two episodes of syncope.

3D MRI of the Shoulder.

Magnetic resonance imaging provides a comprehensive evaluation of the shoulder including the rotator cuff muscles and tendons, glenoid labrum, long head biceps tendon, and glenohumeral and acromioclavicular joint articulations. Most institutions use two-dimensional sequences acquired in all three imaging planes to accurately evaluate the many important structures of the shoulder. Recently, the addition of three-dimensional (3D) acquisitions with 3D reconstructions has become clinically feasible and helped improve our understanding of several important pathologic conditions, allowing us to provide added value for referring clinicians.

Intravenous contrast does not improve detection of nerve lesions or active muscle denervation changes in MR neurography of the common peroneal nerve.

Objective: To evaluate the effect of intravenous (IV) contrast on sensitivity, specificity, and accuracy of magnetic resonance (MR) neurography of the knee with attention to the common peroneal nerve (CPN) in identifying nerve lesions and active muscle denervation changes.

Materials And Methods: A retrospective search for contrast-enhanced MR neurography cases evaluating the CPN at the knee was performed. Patients with electrodiagnostic testing (EDX) within 3 months of imaging were included and those with relevant prior surgery were excluded.

A heuristic study of the similarities and differences in offender characteristics across potential and successful serial sexual homicide offenders.

This heuristic study examined potential serial sexual homicide offenders (SSHOs), an unacknowledged offender group comprised of aspiring and probable SSHOs, and compared them with successful SSHOs. Data were collected on six aspiring SSHOs who each failed a single homicide attempt, 16 probable SSHOs who committed 17 homicides in separate events, and 13 successful SSHOs who killed 90 victims in separate events. The study results indicate that while potential SSHOs share more in common with successful SSHOs than they do with single-victim nonsexual homicide offenders, and that there is an overlap between potential SSHOs and successful SSHOs, there is currently insufficient evidence to suggest that there are discreet transitions among categories.

Right Atrial and Ventricular Collapse After Cardiopulmonary Resuscitation.

Prompt and effective chest compressions is the cornerstone cardiopulmonary resuscitation and has been found to improve cardiac arrest outcomes. Despite being rare, a wide variety of cardiac and pulmonary complications due to chest compressions have been identified. We present a case of a young, otherwise healthy female developing toxic shock syndrome and ultimately cardiac arrest requiring chest compressions found to cause right atrial and ventricular collapse on echocardiography.

Ultrasound-guided microwave ablation in the treatment of inguinal neuralgia.

Chronic groin pain can be due to a variety of causes and is the most common complication of inguinal hernia repair surgery. The etiology of pain after inguinal hernia repair surgery is often multifactorial though injury to or scarring around the nerves in the operative region, namely the ilioinguinal nerve, genital branch of the genitofemoral nerve, and the iliohypogastric nerve, is thought to be a key factor in causing chronic post-operative hernia pain or inguinal neuralgia. Inguinal neuralgia is difficult to treat and requires a multidisciplinary approach.

Contrast-enhanced ultrasound-guided musculoskeletal biopsies: our experience and technique.

Objective: To present our experience with contrast-enhanced ultrasound (CEUS)-guided musculoskeletal soft tissue biopsies in a busy interventional clinic.

Materials And Methods: After IRB approval was obtained and informed consent was waived, we retrospectively reviewed all CEUS-guided musculoskeletal biopsies performed from December 1, 2018 to March 2, 2020. Relevant pre-procedure imaging was reviewed.

Scurvy Due to Selective Diet in a Seemingly Healthy 4-Year-Old Boy.

Scurvy is a rare disease in developed nations. In the field of pediatrics, it primarily is seen in children with developmental and behavioral issues, malabsorptive processes, or diseases involving dysphagia. We present the case of an otherwise developmentally appropriate 4-year-old boy who developed scurvy after gradual self-restriction of his diet.

Sudden cardiac arrest in the field in an 18-year-old male athlete with Noonan syndrome: case presentation and 5-year follow-up.

We present a case of sudden cardiac arrest in the field with complete neurological recovery in an 18-year-old athlete with phenotypic Noonan syndrome. Evaluation revealed interventricular septal thickness of 18 mm without left ventricular outflow tract obstruction and no other identifiable structural, electrophysiologic, or genetic abnormality except isolated heterozygous variant for desmoplakin DSP variant p.Lys2103Glu, with unknown clinical significance.

Imaging of the post-operative medial elbow in the overhead thrower: common and abnormal findings after ulnar collateral ligament reconstruction and ulnar nerve transposition.

Ulnar collateral ligament (UCL) reconstruction is now being performed more commonly and on younger patients than in prior decades. As a result, radiologists will increasingly be asked to evaluate elbow imaging of patients presenting with pain who have had UCL reconstruction. It is essential for radiologists to understand the normal and abnormal imaging appearances after UCL reconstruction and ulnar nerve transposition, which is also commonly performed in overhead-throwing athletes.