Skeletal radiology
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We describe a patient with the rare autosomal dominant syndrome of congenital glenoid dysplasia. The severity of the findings resulted in an intense and effective radiological and clinical work-up including MRI, CT reconstruction, and fluoroscopy.
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Magnetic resonance imaging (MRI) is a sensitive method for the diagnosis of bone marrow abnormalities, but its usefulness in detecting active disseminated cancer in this tissue in treated patients has not been determined. We therefore examined 14 children who had been treated for disseminated bone marrow involvement by neuroblastoma (n = 6), lymphoma (n = 3), Ewing's sarcoma (n = 3), osteosarcoma (n = 1), and leukemia (n = 1). MRI studies were performed at 21 marrow sites to evaluate residual or recurrent tumor and were correlated with histologic material from the same site. ⋯ T1-weighted sequences showed enhancement of the lesion. However, abnormal signals were also observed on all T1-weighted, 6 of 8 T2-weighted, 11 of 12 STIR, and 5 of 8 Gd-DTPA-enhanced, T1-weighted images of the tumor-negative sites. In this clinical setting, MRI did not consistently differentiate changes associated with treatment from malignant disease.
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The relationship of the posterior aspects of the atlas and the axis were studied in 100 normal adult volunteers. The ratio of the height of the atlantal spinolaminar line to the atlantoaxial interspinous distance was found to be remarkably constant and was less than 2.0 in all men and women. This ratio should prove helpful in detecting hyperflexion injuries isolated to the atlantoaxial level.
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Magnetic resonance imaging of 24 symptomatic lower limb amputations revealed that postamputation neuromas were easily diagnosed in above-the-knee amputees. Visualization of nerve trunks in below-the-knee amputees was difficult due to greater compactness of calf muscles. Neuromas on magnetic resonance imaging appeared ovoid or rounded and were usually heterogenous and isointense with muscle. Magnetic resonance imaging also showed additional causes of stump pain such as scar formation, fat in atrophied muscles, soft tissue abscesses, osteomyelitis, and hematomas.