Magnetic resonance imaging of cartilage and cartilage repair.

Magnetic resonance (MR) imaging of articular cartilage has assumed increased importance because of the prevalence of cartilage injury and degeneration, as well as the development of new surgical and pharmacological techniques to treat damaged cartilage. This article will review relevant aspects of the structure and biochemistry of cartilage that are important for understanding MR imaging of cartilage, describe optimal MR pulse sequences for its evaluation, and review the role of experimental quantitative MR techniques. These MR aspects are applied to clinical scenarios, including traumatic chondral injury, osteoarthritis, inflammatory arthritis, and cartilage repair procedures.

Magnetic reasonance imaging of the surgically repaired meniscus: a 13-year follow-up study of 13 knees.

Background: This study was initiated to evaluate the long-term outcome of meniscal sutures and to correlate clinical findings with MRI findings. We were interested to see if a clinically healed meniscus also showed as such on MRI and if degenerative changes were present

Patients And Methods: We studied prospectively 13 patients (7 men) aged between 29 and 50 years, who had undergone closed meniscus repair between 1985 and 1988 using an inside-out technique, clinically and with MRI, with a mean follow-up time of 13 years.

Results: Meniscal suture gave good clinical long-term results: all patients got a Hospital for Special Surgery score of more than 75%.

Normal and transplanted lateral knee menisci: evaluation of extrusion using magnetic resonance imaging and ultrasound.

The aim of the study is to develop a clinically useful and reproducible method for evaluating lateral meniscal extrusion in normal and transplanted knees under different axial loading conditions. Magnetic resonance imaging (MRI) and ultrasound (US) were used to assess meniscal extrusion. Both types of imaging were performed at least 6 months postoperatively (mean 23.

[Long-term assessment of arthroscopic meniscus repair].

Purpose Of The Study: A prospective study was set up to evaluate meniscal suturing using an inside-out technique.

Materials And Methods: Of an initial group of 20 patients who underwent closed meniscus repair between 1985 and 1988 using an inside-out technique, 13 were studied. All patients were subjected to a clinical examination and an magnetic resonance imaging (MRI) investigation.

Distal femoral cortical irregularity in a 13-year old boy. A case report.

Distal femoral cortical irregularity (DFCI) is a benign entity presenting with either an irregular appearance or a focal radiolucency within the posterior cortex of the distal femur. Atypical cases should be differentiated from malignant lesions. The typical location of the lesion at the attachment of the head of the medial gastrocnemius muscle can be visualised using different imaging techniques.

Arthroscopic meniscus repair: inside-out technique vs. Biofix meniscus arrow.

A retrospective study evaluated meniscal suturing using an inside-out technique vs. an all-inside technique (Biofix meniscus Arrow). Fifty-five knees in 55 patients who underwent closed meniscus repair between 1985 and 1995 were divided in two groups: 20 managed by an inside-out technique; and 35 managed by an all-inside technique.

Dose reduction in patients undergoing chest imaging: digital amorphous silicon flat-panel detector radiography versus conventional film-screen radiography and phosphor-based computed radiography.

Objective: We sought to compare the radiation dose delivered to patients undergoing clinical chest imaging on a full-field digital amorphous silicon flat-panel detector radiography system with the doses delivered by a state-of-the-art conventional film-screen radiography system and a storage phosphor-based computed radiography system. Image quality was evaluated to ensure that the potential reduction in radiation dose did not result in decreased image acuity. SUBJECTS AND METHODS.

Quantified measurement of subacromial impingement.

We modified the Hawkins impingement maneuver in order to develop a quantifiable and reproducible impingement test. The involved anatomic structures were examined with magnetic resonance imaging of 3 cadaveric shoulders. The reproducibility of the clinical sign was assessed with an interobserver and intraobserver reliability test, with calculation of the intraclass correlation coefficient (ICC).

Ruptured tuboovarian abscess causing peritonitis in a postmenopausal woman. A difficult diagnosis on imaging.

Pelvic inflammatory disease with tuboovarian abscess is rare in postmenopausal women. Clinical and sonographic findings are usually sufficient to recognize pelvic inflammatory disease in premenopausal women, but in the elderly the disease may easily be overlooked, largely by unexpectedness. Computed tomography can be helpful when the clinical and sonographic findings are complex or equivocal.

Psammomatoid ossifying fibroma of the ethmoid.

We present a 16 year-old girl who suffered since one year of a painless slow growing mass on the left medial orbital rim causing globe displacement. CT-scan and MRI of the orbit with T1 and T2 weighted images showed the presence of a large mucocoele in the frontal sinus. This occurred secondary to the obstruction of the sinonasal tract by a bony tumour.

Long-term assessment of arthroscopic meniscus repair: a 13-year follow-up study.

A prospective study was set up to evaluate meniscal suturing using an inside-out technique. Of an initial group of 20 patients who underwent closed meniscus repair between 1985 and 1988 using an inside-out technique, 13 were studied. All patients were subjected to a clinical examination and a magnetic resonance imaging (MRI) investigation.

Fast magnetic resonance imaging with contrast for soft tissue sarcoma viability.

Because dynamic (fast) contrast-enhanced magnetic resonance imaging with its temporal resolution allows evaluation of contrast kinetics of soft tissue sarcomas, its efficacy for defining viable tumor in these neoplasms was studied for three applications: biopsy localization, chemotherapeutic response, and differentiation between recurrence and inflammation after treatment. After conventional T1-weighted and T2-weighted magnetic resonance sequences to localize the lesion, patients had dynamic contrast-enhanced magnetic resonance imaging with fast and ultrafast sequences and postprocessing techniques (subtraction, time-intensity curves, and parametric color-encoding). In 10 of 40 patients, dynamic imaging more precisely defined the most malignant foci of tumor for biopsy than conventional magnetic resonance imaging.

Parosteal osteosarcoma of the humerus.

The authors report the case of a 50-year-old man who presented with nontraumatic swelling of the left upper arm. The diagnosis of parosteal osteosarcoma of the humerus was made after diagnostic workup. A long diaphyseal segment of the humerus containing the tumor was resected with a healthy margin of soft tissues and was irradiated extracorporeally with a single dose of 30 Gray.

Repair of chronic ruptures of the anterior cruciate ligament using allograft reconstruction and a ligament augmentation device.

A prospective study was performed to determine the effect of a ligament augmentation device (LAD) on the replacement of the anterior cruciate ligament (ACL) using tendon allografts. Twenty-five patients were followed for 66 to 98 months after tendon allograft replacement with LAD reinforcement for ACL rupture. The evaluation was done using the form of the International Knee Documentation Committee (IKDC), the Lysholm score and the Tegner scale.

Dynamic Contrast-Enhanced MR Imaging for Soft Tissue Sarcomas.

Dynamic contrast-enhanced magnetic resonance imaging has recently emerged as an important method for evaluating soft tissue sarcomas for biopsy localization, chemotherapeutic response, and long-term follow-up because of its ability to detect viable tumor. This article presents the basic principles of contrast kinetics in soft tissue sarcomas after bolus injection of contrast agent and discusses the current postprocessing methods (subtraction, first-pass image and time-intensity curves with region of interest, and color-encoded techniques) used to display these dynamic studies. Because of its excellent temporal resolution, dynamic MR imaging can delineate the early uptake of contrast agent in sarcomas within seconds after injection, almost synchronous with arterial enhancement, and thereby differentiate the rapidly enhancing viable tumor from the nonenhancing necrotic tumor and the late enhancing changes after surgery, radiation therapy, and chemotherapy.

Neurofibromatosis, gigantism, elephantiasis neuromatosa and recurrent massive subperiosteal hematoma: a new case report and review of 7 case reports from the literature.

The authors report the case of a 13-year-old patient with neurofibromatosis (NF-I), who suffered blunt trauma to the left tibia in 1993. The diagnosis of subperiosteal hematoma was made. Treatment consisted of temporary rest.

Recurrent massive subperiosteal hematoma in a patient with neurofibromatosis.

The authors report the case of a 13-year-old neurofibromatosis (NF-I) patient who suffered a blunt trauma in 1993. The diagnosis of subperiosteal hematoma was made. The pathogenesis of subperiosteal hematoma is discussed.