Skeletal radiology
-
When performing epidural steroid injections for the management of chronic back pain, imaging guidance and a limited epidurogram improve accuracy of needle placement and ensure appropriate delivery of the injectate into the epidural space. We describe our experience using a gadolinium chelate as an alternative contrast agent for limited epidurography in patients with a history of an iodinated contrast reaction. ⋯ Gadolinium chelate represents a safe and useful alternative contrast agent for confirmation of epidural needle placement in patients with an iodinated contrast allergy.
-
Sacral insufficiency fractures are a well recognised cause for low back, buttock and groin pain in the elderly. However, over a 4 year period, four patients have presented with symptoms of cauda equina syndrome, who were found on investigation to have acute sacral insufficiency fracture without any other aetiological spinal abnormality. ⋯ Sacral insufficiency fractures should be excluded in elderly or osteoporotic patients presenting with cauda equina syndrome who have no evidence of compression in the thoraco-lumbar MR studies.
-
Comparative Study
Magnetic resonance imaging findings in patients with peroneal tendinopathy and peroneal tenosynovitis.
To compare the magnetic resonance (MR) imaging findings of a group of patients with clinically diagnosed peroneal tendonopathy and peroneal tenosynovitis with the MR imaging findings of a control group of patients with no clinical evidence of peroneal tendon disorder. ⋯ The presence of predominantly or uniform intermediate signal intensity within the peroneal tendons on three consecutive axial proton density-weighted images is a highly sensitive and moderately specific indicator of symptomatic peroneal tendinopathy. The presence of intermediate T2 signal within the peroneal tendons, and the presence of circumferential fluid within the peroneal tendon sheath greater than 3 mm in maximal width, are highly specific indicators of peroneal tendinopathy and peroneal tenosynovitis respectively.
-
To investigate and illustrate a variation on the traditional percutaneous access to the vertebral body via a parapedicular approach. ⋯ The thoracic and lumbar vertebral bodies may be safely, reliably, and reproducibly accessed using a percutaneous parapedicular access technique. The technique presented represents a relatively avascular and aneural approach to vertebral body.
-
The diagnosis of ankle syndesmosis injuries is made by various imaging techniques. The present study was undertaken to examine whether the three-dimensional reconstruction of axial CT images and calculation of the volume of tibiofibular joint space enhances the sensitivity of diastases diagnoses or not. ⋯ Volume calculation using this method can be performed in cases of syndesmotic instability after ankle injuries and for preoperative and postoperative evaluation of the integrity of the tibiofibular syndesmosis.