Sonographic characterization of the lumbar intervertebral disk with anatomic correlation and histopathologic findings.

Objective: The purpose of this study was to describe the normal anatomy and abnormalities of the lumbar intervertebral disk with sonography in cadaveric specimens and to correlate the sonographic findings with pathologic findings.

Methods: Sonographic imaging with both 4.5- and 10-MHz linear array transducers was performed on 35 lumbar intervertebral disks in 13 human cadaveric spines.

Postresectional pulmonary oxidative stress in lung cancer patients. The role of one-lung ventilation.

Objective: The authors conducted a prospective analysis in order to investigate through lipid peroxidation metabolites the generation of oxygen free radicals after one-lung ventilation (OLV).

Methods: From 2001 to 2003, 212 patients were prospectively studied for lung reexpansion/reperfusion injury. They were classified in six groups.

Osteonecrosis of the patella: diagnostic imaging perspective.

Disability from knee dysfunction has important implications on a patient's performance of simple day-to-day tasks, work-related duties, and leisure activities, including sports. Diagnostic imaging is of fundamental importance in the clinical evaluation of the patient with knee pain. The use of magnetic resonance imaging (MRI) for the assessment of knee pain and dysfunction has increased over the past few years as orthopedic surgeons and radiologists have familiarized themselves with the unique advantages of this modality.

Cognitive task analysis for teaching technical skills in an inanimate surgical skills laboratory.

Background: The teaching of surgical skills is based mostly on the traditional "see one, do one, teach one" resident-to-resident method. Surgical skills laboratories provide a new environment for teaching skills but their effectiveness has not been adequately tested. Cognitive task analysis is an innovative method to teach skills, used successfully in nonmedical fields.

Avulsion fractures of the medial and lateral malleoli of the ankle in cadavers: new radiographic projections for improved diagnosis.

The malleolar attachment sites of the tibionavicular (TN), tibiocalcaneal (TC), posterior tibiotalar (PTT), anterior talofibular (ATF), and calcaneofibular (CF) ligaments of 3 cadaveric ankles were dissected. Standard and new radiographic projections of the ankle were obtained with the foot in different positions and various degrees of beam angulation. Simulated avulsion injuries related to these ligaments were created, and the visibility of these structures was assessed.

MR imaging of uncommon recurrence of fibrolipomatous hamartoma of the ulnar nerve.

We present the MR and histopathologic findings of fibrolipomatous hamartoma (FLH) of the ulnar nerve in a 54-year-old woman, a lipomatous process that rarely affects the ulnar nerve. The case illustrated is further unusual as a local soft tissue recurrent mass developed over a remarkably long course of the disease.

Sonography and venography of the lower extremities for diagnosing deep vein thrombosis in symptomatic patients.

The purpose of this study was to investigate the efficacy of sonography and the frequency of indeterminate sonographic examinations in the evaluation of patients with suspected lower extremity deep vein thrombosis (DVT). We prospectively evaluated 136 symptomatic patients (157 extremities) with suspected DVT using sonography and contrast-enhanced venography (n=106 patients, 115 extremities). Using venography as the reference standard for diagnosing DVT, the sensitivity and specificity of sonography was 92.

Evaluation of osteoporosis in orthopedic practice: a review of current diagnostic modalities.

It is increasingly recognized that osteoporosis should be of utmost importance to all, because of the large size of the affected population and the staggering implications of osteoporotic fractures on morbidity, mortality, and medical costs. Osteoporosis is one of the most prevalent conditions associated with aging, and, as the demographics shift toward an older population, a dramatic increase in the number of osteoporotic fractures is expected in coming years. Fortunately, osteoporosis is a disease that can be easily diagnosed, owing to the growing armamentarium of diagnostic tests that should be familiar to orthopedic surgeons, radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, and generally all physicians with a special interest in bone metabolism.

Osteoporosis and fractures: the size of the problem.

The public health impact of osteoporosis-related fractures is enormous, with important economic implications. Government agencies and health-care providers must recognize the importance of early diagnosis of osteoporosis, implement policies for the prevention of disease, and develop effective payment policies for densitometry examinations.

Fractures of proximal portion of fifth metatarsal bone: anatomic and imaging evidence of a pathogenesis of avulsion of the plantar aponeurosis and the short peroneal muscle tendon.

Purpose: To evaluate the normal anatomy of the structures supporting the proximal portion of the fifth metatarsal bone and investigate the pathogenesis of fractures in this region.

Materials And Methods: In two cadaveric feet, the region of the lateral component of the plantar aponeurosis (PAL), short peroneal muscle (SPM) tendon, and third peroneal muscle (TPM) tendon was dissected. These two foot specimens and four nondissected foot specimens were studied at magnetic resonance (MR) imaging.

Magnetic resonance discography in cadavers: tears of the annulus fibrosus.

The purpose of this study was to investigate the diagnostic capabilities of magnetic resonance discography in the detection of tears of the annulus fibrosus, and to compare the findings with those derived from conventional magnetic resonance imaging. Twenty-four intervertebral discs from cadavers were examined with magnetic resonance imaging and magnetic resonance discography, and anatomic correlation was done. Forty-six annular tears were documented on anatomic inspection of the specimens.

Imaging modalities in the assessment of osteoporosis.

Imaging can be helpful in the diagnosis and treatment of osteoporosis. Several imaging modalities have become available to assess bone mass in the peripheral, axial, or entire skeleton. The basic principles, indications, and limitations of each imaging method are presented.

Primary non-odontogenic tumors of the jawbones: an overview of essential radiographic findings.

The jawbones, namely the maxilla and mandible, can be the sites of a multitude of neoplastic conditions. Given the variety of processes affecting this particular anatomic area, formulation of a precise diagnosis often can be challenging to the radiologist and the clinician, who may not be familiar with the imaging findings fundamental to diagnosis. Although advanced imaging methods have been developed, routine radiography remains the mainstay in the initial assessment of osseous lesions involving the jawbones.

Cartilaginous endplates of the spine: MRI with anatomic correlation in cadavers.

Purpose: The purpose of this work was to describe the MR appearance of cartilaginous endplates (CEPs) with close anatomic correlation in cadavers derived from elderly subjects.

Method: High-resolution MRI was performed on five cadaveric lumbar spines, and a total of 48 CEPs were studied with T1-weighted spin echo, T2-weighted fast spin echo, and fat-suppressed 3D spoiled GRASS gradient echo (SPGR) MR images. All specimens underwent anatomic sectioning, and gross anatomic findings were correlated with those of MRI.

Dual-energy X-ray absorptiometry in diagnosis of osteoporosis: basic principles, indications, and scan interpretation.

Dual-energy x-ray absorptiometry is currently the most commonly used modality for the diagnosis of osteoporosis, allowing fast, accurate, and noninvasive measurements of bone mineral density. In this review we discuss the principles, applications, advantages, and limitations of this diagnostic technique.

Imaging in dialysis spondyloarthropathy.

Destructive spondyloarthropathy has recently been described in patients who undergo maintenance hemodialysis for chronic renal disease. The condition most frequently involves the lower segment of the cervical spine, although the craniocervical junction also may be affected. Although the pathogenesis of destructive spondyloarthropathy remains unclear, the disorder is thought to relate to a hemodialysis-associated amyloidosis.

Osteoporosis: prevention and diagnostic work-up.

Prevention of osteoporosis has assumed a paramount role in the decrease of osteoporotic fractures and the associated medical costs. A thorough diagnostic work-up of the patient with osteoporosis helps the physician exclude secondary causes of bone loss and acquire useful data for staging the disease, and contributes to planning the correct therapeutic management.

Distinct focal lesions of the femoral head: imaging features suggesting an atypical and minimal form of bone necrosis.

Objective: To document the imaging findings observed in patients with an unusual pattern of abnormality of the femoral head, most likely representing osteonecrosis.

Design And Patients: The imaging findings in 11 patients (10 men, 1 woman; age range 32-55 years) with a distinct lesion of the femoral head were reviewed with particular attention to the morphologic appearance, location, and extent of the lesion(s) in the proximal femur.

Results: The 16 lesions identified in these patients extended to the subchondral area.

Visualization of ankle tendons and ligaments with MR imaging: influence of passive positioning.

Purpose: To determine if passive positioning of the ankle influences the MR imaging appearance of ankle tendons and ligaments.

Methods: A positioning device was used during imaging of 10 volunteers. Axial and coronal T1-weighted images were acquired in six positions of the ankle, and the appearance of the tendons and lateral ligaments was subjectively evaluated.

Treatment of osteoporosis: current status and recent advances.

With the advent of new treatment choices, osteoporosis should no longer be considered an inevitable part of aging but rather a disease that can be treated. This article provides an overview of recent advances in treatment of osteoporosis.

MR imaging of abnormalities of the plantar fascia.

Foot pain and disability may curtail the performance of simple routine tasks, work-related duties, and athletic activities. Disorders of the plantar fascia are commonly encountered in the diagnostic evaluation of subcalcaneal heel pain. The approach to imaging the ankle and foot has undergone significant amendment with the introduction of magnetic resonance (MR) imaging.

Bullets and biliptysis.

Biliptysis is a dramatic physical finding which suggests the presence of a direct communication (fistula) between the biliary and bronchial tree. We report a bronchial biliary fistula resulting from penetrating thoracoabdominal trauma and the use of positive-pressure ventilation to obtain initial fistula control prior to definitive surgical repair.