MRI approach and findings in sport injuries and overuse syndromes involving of the elbow

MRI approach and findings in sport injuries and overuse syndromes involving of the elbowABSTTwenty-seven patients presenting with painful elbow attributed to acute or repetitive microtrauma were examined by MRI. The multiplanar capability and variable sensitivity of different MR pulse sequences clearly demonstrated radiographically occult osteochondral injuries as well as the wide spectrum of periarticular ligamentous, muscular tendinous and neuropathic injuries. Because positioning and scan planning are not straight forward as they are with other joints, the study tried to propose to the optimal imaging protocol providing a tailored approach for each entity as suspected by the mechanism of injury, clinical presentation and examination findings in order to limit the examination time and reduce the patient discomfort

Osteonecrosis: MR imaging versus plain radiography and nuclear scintigraphy

26 cases [23 males and 3 females] of a vascular necrosis [AVN] aged between 3 to 60 years diagnosed over two years were evaluated radiologically by plain radiography, nuclear isotopic scanning and MR imaging in the radiology department of Hamad General Hospital, Doha Qatar. 7 cases were around the hip joint, 9 knees, 7 ankles, 2 wrists and 1 shoulder. Radiological findings were compared and reviewed with the literatures regarding sensitivy and specificity of the technique used as well as MR appearance and staging. The plain radiography was either normal or non-specific in 12 cases [45%], while scintigrap[hy was normal in 8 and of non-specific increased radiotracer uptake in 18 cases [69%]. MR was positive for AVN in all cases. The hip cases of the study group showed different grades of MR staging based on the shape and both T1 and T2 signal characteristics of the involved aera using Kokubo and Lange et al., 92 classification, while knee and ankle cases showed mainly osteochondritis dessicans of different stages. We concludede that MRI is the most sensitive and specific radiological test and the modality of choice in the evaluation of avascular nercosis

Rectal foreign bodies: hazards, diagnosis and management

Over the past two years, 25 patients managed in Hamad Medical Corporation in Qatar were reviewed for retained foreign bodies in the rectum. The foreign bodies that were retrieved and the age, sex and marital status of each patient were recorded. The complications that arose from either the insertion or removal of the foreign bodies [F.B.] were discussed as were the methods of treatment involved. The diagnostic importance of radiology as well as its forensic aspect were also emphasized. The frequency of this increasing problem as well as the best method of its management was also discussed

Shoulder impingement syndrome: MRI imaging

Twenty five patients [21 males and 4 females] clinically diagnosed as rotator cuff impingement syndrome, were evaluated by MRI. Impinging structures were low acromion in 20 cases, subacromial spur in 9 cases and acromioclavicular osteoarthritis in 19 cases. Supraspinatous tendon was variably affected in 24 cases [96%] while subacromial bursa involvement was noticed in 22 cases [88%]. Surgical interference in 10 cases confirmed MRI findings. The rest of cases were treated either conservatively or with manipulations under anesthesia. Clinical improvement was excellent in 22 patients [88%], fair in 2 patients [8%], while only one patient showed no improvement. It is concluded that MRI can clearly delineate the soft tissue and bony abnormalities involved in shoulder impingement syndrome. This should offer a better understanding and treatment of such chronic painful condition

Correlation between magnetic resonance imaging and arthroscopy in diagnosis of anterior cruciate ligament[ACL] lesions

Forty five patients with enigmatic knee symptoms were selected for evaluation by both magnetic resonance imaging [MRI] and arthroscopy. Arthroscopy was performed in a standard examination room using a tourniquet under general anesthesia. All MRI scans were performed using 1.5-T superconductive magnet. A specifically designed protocol for imaging, producing T1 and T2 sagittal images and T1 coronal images interleaved at four millimeters, while the patient's foot was in 20 degrees of external rotation. Magnetic resonance imaging, yielded excellent visualization of the anterior cruciate ligament. During arthroscopy, one can usually treat abnormalities that are found, but as a diagnostic technique, arthgroscopy has the risks of an operative procedure. Compared to arthroscopy, the sensitivity, specificity, and accuracy of magnetic resonance imaging were respectively 100, 90, and 99.8%. The findings on magnetic resonance images were compared before to those of diagnostic arthroscopy. In series ranging in size from 28 to 86 knees [1, 2, 3, 4], the accuracy of imaging of the cruciate ligaments ranged from 90 to 100%. The MRI sequence can be performed in 30 min. It is totally noninvasive and requires no exposure to ionizing radiation. Magnetic resonance imaging can be a safe and valuable adjunct to the clinical evaluation of the knee and aid to efficient preoperative planning