Seminars in musculoskeletal radiology
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Postoperative neurological complications following foot and ankle surgery are common. This article reviews the structural architecture of peripheral nerves and innervation patterns around the foot and ankle; describes the pathophysiology of surgery-related nerve injury; and illustrates the postoperative neurological complications using specific case examples.
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Semin Musculoskelet Radiol · Apr 2012
ReviewImaging and treatment of scaphoid fractures and their complications.
The scaphoid is the most commonly fractured carpal bone, with frequent complications that are predisposed by its anatomical location, anatomical configuration (shape and length), and vascular supply. The most common mechanism of injury is a fall onto an outstretched hand. Imaging plays a significant role in the initial evaluation and treatment of scaphoid fractures and their complications. ⋯ Magnetic resonance imaging without contrast is the imaging modality of choice for depiction of radiographically occult scaphoid fracture, bone contusion, and associated soft tissue injury; contrast-enhanced imaging aids assessment of scaphoid fracture nonunion, osteonecrosis, fracture healing after bone grafting, and revitalization of the necrotic bone after bone grafting. Proper identification and classification of scaphoid fracture and its complications is necessary for appropriate treatment. This article describes the normal anatomy, mechanism of injury, and classification of stable and unstable fractures, together with the imaging and treatment algorithm of scaphoid fractures and their complications with an emphasis on magnetic resonance imaging.
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Brucellosis is a zoonosis of worldwide distribution caused by small gram-negative nonencapsulated coccobacilli of the genus Brucella. It is characterized by a granulomatous reaction in the reticuloendothelial system. Because it affects several organs and tissues, it may have various clinical manifestations. ⋯ CT and bone scintigraphy have limited value because of their inadequate soft tissue resolution. MR imaging is the method of choice to assess the extent of disease and follow up the treatment response. However, MR imaging has a low specificity to predict the exact cause of an osteoarticular lesion, and in case of arthralgia or symptoms of osteomyelitis or spondylodiscitis, the index of suspicion should be high in regions where the disease is endemic.
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Hydatid disease is an infectious disease caused by the larval stage of the parasitic tapeworm Echinococcosis granulosus. Its distribution is worldwide. Although hydatid disease can develop in almost any part of the body, it is most commonly found in the liver and lung. ⋯ Computed tomography (CT) is more accurate in delineating the area of destruction. The primary role of CT and magnetic resonance imaging is in the recognition of extraosseous spread of the hydatid disease within the soft tissues. This article reviews the pathological basis and the clinical and imaging features of musculoskeletal hydatid disease.
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Semin Musculoskelet Radiol · Sep 2011
ReviewManaging postoperative artifacts on computed tomography and magnetic resonance imaging.
Orthopedic hardware should not be considered a contraindication to computed tomography (CT) or magnetic resonance (MR) imaging. The hardware alloy, the geometry of the hardware, and the orientation of the hardware all affect the magnitude of image artifacts. For commonly encountered alloys, the severity of image artifacts is similar for CT and MR. ⋯ A turbo spin-echo sequence yields the best results. The use of larger image matrices, thinner slices, and a wide receiver bandwidth are recommended parameter adjustments when imaging patients with hardware. This article discusses how hardware-related artifacts can be minimized by altering scan technique and image reconstruction.