Skeletal radiology
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Review Case Reports
Posterior atlantoaxial dislocation complicating odontoid fracture without neurologic deficit: a case report and review of the literature.
Traumatic posterior atlantoaxial dislocation associated with odontoid fracture is extremely rare, with only eight cases reported thus far in the English literature. This report concerns a 47-year-old female who presented with considerable pain and stiffness in the neck without a neurologic deficit after injury due to a fall. ⋯ No cord compression or intramedullary cord signal abnormalities were detected at the level of the atlantoaxial dislocation. A pedicle screw fixation/fusion was performed via a posterior approach following successful closed reduction.
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Lipomatosis of nerve (LN) is a condition of massive peripheral nerve enlargement frequently associated with hypertrophy within the distribution of the nerve, and most commonly affecting the distal limbs. We sought to understand if LN of the lumbosacral plexus would be associated with the trophic effects of LN on surrounding tissue within the pelvis, which may be clinically occult, but present on MRI. ⋯ LN is broader in anatomical reach than previously understood. Proximal plexal innervation may be involved, with a consequent effect on axial skeleton and intrapelvic structures.
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The purpose of this study is to investigate the distal insertions of the semimembranosus tendon with MR imaging, correlated with findings in cadavers. ⋯ Although the anatomy of the distal semimembranosus tendon is complex, six different semimembranosus insertions can be identified on routine proton density and FFE sequences at 3 T. Analysis of images at defined levels in the three imaging planes simplifies MR interpretation of the anatomy of the distal semimembranosus tendon.
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To assess the sensitivity of ultrasound in detecting soleus muscle lesions diagnosed on magnetic resonance imaging (MRI) and to characterize their location, ultrasound pattern, and evolution. ⋯ Ultrasound is not a sensitive technique for detecting and assessing soleus traumatic tears compared with MRI, although the sensitivity is enhanced by a thorough anatomically based ultrasound examination. Timing of the ultrasound examination may be of importance. Each type of soleus injury appears to have a characteristic ultrasound pattern based on a defect of connective expansions, the existence of small myofascial filiform collections, and the rarefaction of the fibrillar area.
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Necrotizing fasciitis (NF) is a rare, life-threatening soft-tissue infection and a medical and surgical emergency, with increasing incidence in the last few years. It is characterized by a rapidly spreading, progressive necrosis of the deep fascia and subcutaneous tissue. Necrotizing fasciitis is often underestimated because of the lack of specific clinical findings in the initial stages of the disease. ⋯ Imaging is very useful to confirm the diagnosis, but also to assess the extent of the disorder, the potential surgical planning, and the detection of underlying etiologies. The presence of gas within the necrotized fasciae is characteristic, but may be lacking. The main finding is thickening of the deep fasciae due to fluid accumulation and reactive hyperemia, best seen on magnetic resonance imaging.