Reliability of MRI Detection of Kaplan Fiber Injury in Pediatric and Adolescent Patients with ACL Tears.

Background: While studies have described Kaplan fiber (KF) injury in up to 60% of adults with anterior cruciate ligament (ACL) tears, the incidence of KF injury in the pediatric and adolescent population remains unknown.

Purpose: To (1) determine the reliability of using magnetic resonance imaging (MRI) to identify KF injury in the pediatric and adolescent population and (2) define the incidence of KF injury in these patients with acute ACL injuries.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

CT-Guided Percutaneous Spine Biopsy Specimen Adequacy, Pathology Concordance, and Negative Predictive Value with Battery-Powered Drill and Manual Approaches.

Objective: Determine computed tomography-guided percutaneous spine biopsy specimen adequacy, pathology-imaging concordance, and negative predictive value with battery-powered drill vs manual approach.

Materials And Methods: One-hundred-fourteen consecutive computed tomography-guided percutaneous spine biopsies in 109 patients (age: 61.1 ± 15.

CT-guided transforaminal epidural steroid injections: do needle position and degree of foraminal stenosis affect the pattern of epidural flow?

Objective: To determine the effect of needle position and foraminal stenosis on contrast flow directionality during CT-guided transforaminal epidural steroid injections (TFESI).

Materials And Methods: One hundred five consecutive CT-guided injections were performed in 68 patients (mean age, 65.5 years) from January 1 to December 31 2017, all with preceding MRI.

Diagnostic yield of repeat CT-guided biopsy for suspected infectious spondylodiscitis.

Objective: The purpose of this study was to examine the yield of repeat CT-guided biopsy in patients with suspected infectious spondylodiscitis following an initial biopsy with negative microbiology, and to identify factors associated with successful pathogen isolation.

Materials And Methods: In this retrospective study, 21 patients (12 men, 9 women; mean age, 52, range, 12-84) were identified with clinically and radiologically suspected infectious spondylodiscitis who underwent repeat biopsy following negative cultures from an initial biopsy. The microbe yield as well as demographic, clinical, and laboratory findings were reviewed and statistical analysis was performed.

The association of the medial joint vacuum phenomenon with ulnar collateral ligament injury in symptomatic elbows of younger athletes.

Objective: To determine the prevalence of intra-articular gas (IAG) on elbow radiography and evaluate variables, including IAG, as predictors of UCL injury.

Materials And Methods: This IRB-approved retrospective study consisted of 241 consecutive elbow radiographic studies containing AP radiographs with valgus stress of both symptomatic and asymptomatic sides in 234 patients. The IAG, medial joint space (MJS), and MJS difference between the symptomatic and asymptomatic elbow (MJSD) were evaluated by two readers, as well as patient age, gender, sport played, and handedness.

Genomic Resistance Patterns to Second-Generation Androgen Blockade in Paired Tumor Biopsies of Metastatic Castration-Resistant Prostate Cancer.

Purpose: Patients with castration-resistant prostate cancer (CRPC) receive second-generation androgen-deprivation therapy, but frequently experience relapse or do not respond. Understanding the genetic mechanisms of resistance will help to identify strategies and biomarkers that are essential for the next line of therapy.

Patients And Methods: We analyzed whole exomes of patient-matched pre- and post-treatment tumors from patients with CRPC.

Osteomyelitis of the lower extremity: pathophysiology, imaging, and classification, with an emphasis on diabetic foot infection.

Osteomyelitis is inflammation of the bone caused by an infectious organism, and is a difficult clinical problem. The pathophysiology, imaging, and classification of osteomyelitis are challenging, varying with the age of the patient (child versus adult), the chronicity of the infection (acute versus chronic), and the route of spread (hematogenous versus contiguous focus), as well as the immune and vascular status of the patient and affected region. The two most common classification schemes are those of Lew and Waldvogel, and Cierny and Mader.

The Lumbar Neural Foramen and Transforaminal Epidural Steroid Injections: An Anatomic Review With Key Safety Considerations in Planning the Percutaneous Approach.

Objective: The purpose of this article is to review the anatomy of the lumbar neural foramen and to describe techniques of transforaminal epidural steroid injections with emphasis on safety. Rare cases of paraplegia have been reported.

Conclusion: Although no consensus currently exists about which approach is the safest, knowledge of the foraminal anatomy is a key consideration when choosing a needle approach for transforaminal epidural steroid injections.

Giant cell-rich osteosarcoma of the parotid gland: An exceptionally rare entity at an unusual site.

Giant cell-rich osteosarcoma is a rare histologic variant of conventional osteosarcoma that affects mainly the extremities. Extraskeletal giant cell-rich osteosarcoma is therefore exceedingly rare. Here, we report the first case of this uncommon tumor involving the parotid gland in a 62-year-old male who presented with initial right jaw swelling.

Tibial tunnel and pretibial cysts following ACL graft reconstruction: MR imaging diagnosis.

Tunnel cyst formation is a rare complication after anterior cruciate ligament reconstruction, usually occurring 1-5 years post-operatively, which may occasionally be symptomatic. There are multiple proposed theories regarding the etiology of tunnel cysts. Theories include necrosis, foreign-body reaction, lack of complete graft osteo-integration, and intravasation of articular fluid.

The proximal hamstring muscle-tendon-bone unit: a review of the normal anatomy, biomechanics, and pathophysiology.

Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries.

Entrapment neuropathies III: lower limb.

Clinicians frequently encounter compressive neuropathies of the lower extremity. The clinical history and physical examination, along with electrodiagnostic testing and imaging studies, lead to the correct diagnosis. The imaging characteristics of the compression neuropathies can include acute and chronic changes in the nerves and the muscles they innervate.