Seminars in musculoskeletal radiology
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Three bones and two joints comprise the pectoral girdle. These are the clavicle, scapula, proximal humerus, acromioclavicular joint, and shoulder joint. The pectoral girdle binds the upper extremity to the torso. ⋯ Whereas the former is a painful but self-limiting injury with minimal sequelae, the latter is life threatening. However, the severity of most pectoral girdle injuries lies between these two extremes. Fractures and dislocations are common in this region throughout life, and a clear understanding of the patterns of injury and their radiographic spectrum is essential for all radiologists who deal with trauma.
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Fractures and dislocations of the elbow usually occur secondary to indirect trauma. In the adult, fractures of the distal humerus almost always involve the condyles. Fractures of the radial head and neck may be subtle, and the appearance of secondary signs, such as the elevated fat pads from an elbow joint effusion, may be diagnostically useful. ⋯ Osteochondral injury may be difficult to identify without adjunctive imaging techniques, such as magnetic resonance (MR) imaging. Soft tissue injury at the elbow is also well characterized by MR imaging. Fractures of a single forearm bone may occur in isolation, usually due to a direct blow, but these are usually associated with fracture of displacement of the other bone in that forearm.
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Magnetic resonance (MR) imaging is an excellent technique for evaluating the postoperative spine when the patient has chronic or recurrent symptoms. Potential causes of pain following lumbar surgery include arachnoiditis, stenosis, epidural fibrosis and disc herniations, pseudomeningocele, and infection. The postoperative cervical spine may be complicated by hematoma, canal or foraminal stenosis, disc herniation, and cord abnormality. This article reviews standard imaging protocols, the normal postoperative appearance of the spine, and the characteristic imaging findings for each of the abnormal postoperative conditions.
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Benign cartilage lesions discussed in this article include osteochondroma (solitary, epiphyseal, and multiple), chondroblastoma, periosteal chondroma, and chondromyxoid fibroma. These lesions often demonstrate imaging appearances strongly suggesting the above diagnosis, particularly the "ring and arc" mineralization characteristic of cartilage lesions, which reflects their underlying pathology. This article emphasizes the imaging spectrum of these lesions with a multimodality approach.
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Semin Musculoskelet Radiol · Jan 2000
ReviewEvaluation of the postoperative spine: spinal instrumentation and fusion.
Spinal instrumentation is used in a variety of clinical settings ranging from degenerative spine disease to tumors and infection. The primary goal is to provide internal fixation in a region of the spine to facilitate development of an osseous fusion. Hardware is often used to improve alignment and reduce deformities. ⋯ This article will review the basic components of hardware used in the cervical, thoracic, and lumbar spine for anterior and/or posterior fusion. It will not review specific hardware in detail but will discuss general concepts applicable to the various types and strengths and weaknesses of the components. Evaluation of fusion mass will be considered, including some of the current controversies and the current accepted practices.