Seminars in musculoskeletal radiology
-
Although the subject of entrapment and compressive neuropathies is huge, with dedicated textbooks on the subject, this article attempts to provide an up-to-date overview of the role of imaging in the diagnosis of nerve entrapment and compression syndromes. Entrapment and compressive neuropathies are a group of distinct syndromes secondary to physical constriction or irritation affecting peripheral nerves at specific anatomical sites in the body. Most nerve entrapment and compressive syndromes derive from an injury to the neurovascular components in a narrow anatomical passage. ⋯ Neuropathy can result in considerable morbidity. Although the mainstay of achieving diagnosis is with clinical acumen and electrophysiological investigations, the increasing use of modern high-resolution imaging studies is of particular value in confirming physical findings and enabling determination of the extent of injury. Knowledge and familiarity of pertinent anatomy and appropriate choice of imaging modality is important for the radiologist to allow accurate interpretation of site and etiology of nerve entrapment and compression as well as ascertaining possible alternative diagnoses.
-
Early diagnosis of musculoskeletal infections is the key to successful therapy and prevention of complications. Fluorine-18 (F-18) fluorodeoxyglucose-positron emission tomography (FDG-PET) is a promising modality for imaging musculoskeletal infection and might play an important role in the evaluation of chronic osteomyelitis and spinal infection. FDG-PET has shown promising results for diagnosing both acute and chronic infection of the axial and appendicular skeletons. ⋯ PET/CT with the combination of PET and a low-dose or full-dose diagnostic CT provides exact anatomical correlation of bone and joint lesions and increases the accuracy of the test compared with PET alone. The question of in which situations PET/CT becomes the preferred imaging method in suspected musculoskeletal infection depends on several factors, including cost and availability. This article reviews the currently available literature and addresses the use of FDG-PET/CT in the diagnosis of musculoskeletal infections.
-
Semin Musculoskelet Radiol · Sep 2007
ReviewOptimizing imaging techniques in the postoperative patient.
Postoperative patients may develop complications requiring imaging. Although any imaging technique can be used to investigate these patients, the presence of metal hardware in the region of interest may distort the image and interfere with diagnosis. It is important to understand why this distortion occurs and how to compensate for it. ⋯ Like CT, metal artifacts at MR imaging depend on the type of hardware alloy. Hardware-related artifacts at MR imaging can be reduced by using appropriate pulse sequences, such as fast or turbo spin echo and inversion recovery. Additionally, important pulse sequence modifications that are addressed here include manipulation of the receiver bandwidth and orientation of the frequency encode axis.
-
Myeloma is the most common primary bone malignancy and one of the most common hematologic malignancies. Research on myeloma constantly produces new information on genetic factors, imaging techniques, and treatment complications among others that is of use to patients, referring physicians, and radiologists. This update emphasizes new developments regarding imaging techniques for diagnosis, staging, and follow-up of myeloma patients. Advances in whole body radiography, whole body computed tomography, whole body magnetic resonance imaging, and whole body nuclear techniques (including sestamibi and positron emission tomography) are discussed.
-
Semin Musculoskelet Radiol · Dec 2006
ReviewMuscle edema: classification, mechanisms, and interpretation.
Muscle edema is commonly encountered in patients following extremity trauma. This article presents an overview of differential considerations in patients presenting with muscle edema, and while focusing on trauma outlines causes on the basis of mechanism, vasogenic, congestive, traumatic, and tumorigenic edema.