Seminars in musculoskeletal radiology
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MR imaging of peripheral nerves, typically referred to as MR neurography, is a rapidly evolving technique that currently is drawing huge attention, both in research and in clinical settings. Both training and experience are necessary to detect the sometimes subtle findings and to avoid misinterpretation of abnormalities. This review article is intended to help radiologists with image evaluation and interpretation. Typical pitfalls are discussed as well as strategies to avoid them.
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Semin Musculoskelet Radiol · Sep 2014
ReviewCurrent concepts on imaging diagnosis of rotator cuff disease.
Rotator cuff disease is common and may be clinically silent or a cause of shoulder pain. Evaluation of the rotator cuff before and after surgery is challenging for the orthopedic surgeon, but the radiologist can make an accurate diagnosis and facilitate appropriate management. This article reviews the current concepts on imaging diagnosis of rotator cuff disease, beginning with a discussion of the complex anatomy of the rotator cuff, continuing into the normal and pathologic MR imaging appearances of the rotator cuff including tendinosis and tearing, and concluding with a review of the postoperative cuff after various surgical repair techniques.
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The glenohumeral ligaments (GHLs) are the most important passive stabilizers of the shoulder joint. Recognition of acute and chronic glenohumeral ligamentous lesions is very important in the preoperative work-up of shoulder instability and trauma. This article describes and depicts the normal anatomy of the GHLs and their appearance during arthroscopy and on MR and computed tomography arthrography (CTA). ⋯ Although CTA is reputed to better depict associated bony and cartilage lesions, CTA allows only indirect evaluation of the GHLs by outlining their contour or showing contrast penetration. Normal variants may create pitfalls that one should be aware of. Signs of GHL pathology on imaging include: discontinuity, nonvisualization, changes in signal intensity (on MRA), contrast extravasation, contour irregularity, thickening, or waviness.
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Different interventional procedures performed under imaging guidance permit the diagnosis and treatment of the many causes of back pain. Sources of pain amenable to be treated include facet joints, vertebral body, intervertebral disk, and paraspinal structures including nerves and ganglion roots. These procedures may be merely diagnostic, therapeutic, or intended for both purposes. We review the main indications, advantages, and complications of these techniques.