Seminars in musculoskeletal radiology
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Semin Musculoskelet Radiol · Feb 2011
ReviewImaging in the assessment and management of overuse injuries in the foot and ankle.
Overuse injuries of the ankle and foot are common in the general and athletic populations. The wide spectrum of overuse injuries includes ligamentous injuries, soft tissue and osseous impingement, osteochondral lesions, tendon injuries, and stress fractures. ⋯ With the increasing participation in sports, health-care professionals involved in the care of athletes at all levels must have a thorough understanding of overuse conditions of the foot and ankle, and the use of imaging in the management of these conditions. This article covers the clinical presentation, pertinent anatomy, imaging features, and management of overuse injuries of the foot and ankle.
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Semin Musculoskelet Radiol · Feb 2011
ReviewImaging in the assessment and management of Achilles tendinopathy and paratendinitis.
Achilles tendinopathy is a common overuse injury in patients engaged in athletic activities. Tendon degeneration is often accompanied by paratendinitis. Radiologists are frequently asked to use imaging techniques to evaluate patients with problems at or around the Achilles tendon. ⋯ In recent years, ultrasound has also been used to guide minimally invasive local treatments for Achilles tendinopathy, which may prevent the need for surgery if conservative treatments have failed. In this article, we review the imaging features of Achilles tendinopathy and consider the relative strengths and weaknesses of the various imaging techniques. The role of imaging in directing patient management is also discussed, with particular focus on ultrasound-guided treatments.
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Semin Musculoskelet Radiol · Feb 2011
ReviewRadiology and management of multiligament injuries of the knee.
Multiligament injury of the knee, which may include joint dislocation, is a severe injury that can devastate knee function. It usually results in rupture of three of the four major stabilizing ligaments of the knee, but occasionally only two of the ligaments are torn. ⋯ What is considered best treatment is often varied and controversial. This article discusses the diagnosis and management of multiligament knee injury and the role of imaging in the context of the published literature and our own experience.
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The diagnosis of a peripheral nerve tumor can often be suggested on imaging. Direct continuity with a neural structure or location along a typical nerve distribution, shape, and intrinsic magnetic resonance (MR) signal characteristics represent the most important signs in this regard. ⋯ This article reviews the MR imaging appearance, clinical and pathological features of schwannoma, localized neurofibroma, plexiform neurofibroma, intraneural perineurioma, fibrolipomatous hamartoma, nerve sheath ganglion, traumatic neuroma, malignant peripheral nerve sheath tumor, and secondary malignant neoplasms of peripheral nerves. Typical findings are illustrated on the basis of histologically confirmed cases.
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Semin Musculoskelet Radiol · Nov 2010
ReviewEntrapment neuropathies I: upper limb (carpal tunnel excluded).
Several entrapment neuropathies of the upper extremity can cause hypoechoic swelling and nerve compression as seen at ultrasound. The ulnar nerve can be compressed at the cubital tunnel of the elbow and Guyon's canal at the wrist. ⋯ In addition to compression at the carpal tunnel, the median nerve may be compressed at the elbow, related to a supracondylar process or by the pronator teres. Knowledge of these key anatomical sites of potential nerve compression is essential for accurate diagnosis of entrapment neuropathies.