Osteochondritis dissecans of the knee: correlation of magnetic resonance imaging and arthroscopy

Twenty-three patients with osteochondritis dissecans of the knee were examined with MR imaging and subsequently under went arthroscopy. The youngest patient was 15 years old, and the eldest 42 years with mean age of 20.2 years. MR imaging permitted direct visualization of the lesion as well as the overlying articular cartilage in all cases. Based on the MR imaging findings 4 lesions were classified as stable [14.7%], 5 loose in situ [21.7%], and 14 grossly loose [60.9%]. Arthroscopically 5 lesions were classified as stable [21.7%], 4 loose in situ [17.4%], and 14 grossly loose [60.9%]. Correlation of these findings revealed that the MR imaging was accurate in separating loose from stable lesions in 95.7% of the cases. MR imaging is the only non-invasive radiologic tool that can provide direct and conclusive evidence of loosening as well as displacement of the lesion. These informations have assisted in deciding whether surgery is likely to be needed, and how the lesion should be approached

Role of CT and MRI in diagnosing clinically obscure orthopedic cases

Seventeen patients with non-diagnostic clinical and radiographic findings were studied with CT scan. MR imaging was done in 12 cases. The preoperative diagnosis has been improved by using these imaging modalities. Accurate localization of the lesion has facilitated the surgical procedure in all cases. 7 lesions were osteoid osteoma, 6 Brodie's abscess, and 4 tuberculosis. CT scan results were found to be in agreement with the surgical and biopsy findings in 82% of the cases. MR imaging was found to be superior to CT scan in delineating the soft tissues and marrow space involvement. CT scan was superior to MR imaging in showing cortical involvement and calcifications within the lesion. These data lend strong support to use these imaging modalities when conventional methods fail to show up the lesion

AO/plating of diaphyseal fractures in children

109 diaphysical fractures in 108 child, have been treated by open reduction and plate fixation using the ASIF/AO principles. There were 58 fracture femur, 31 forearm, and 20 leg bone fractures. Children were able to move early without external support, No infection was recorded. The child bone can tolerate compression without undergoing pressure necrosis. Stripping of the periosteum did not affect the blood supply and the healing process. The overall results were satisfactory in 97.2% of the cases. it is concluded that diaphyseal fractures in chilren as a rule can be treated closed, but open reduction and internal fixation was found to be of great benefit and should be done if the remaining deformities are liekely to result in significant functional loss

Magnetic resonance imaging of the knee joint for the detection of meniscal lesions

Magnetic resonance imaging was done for 5 healthy volunteer control subjects and 91 patients suspected clinically of having meniscal lesions, using a surface coil. 61 menisci showed signal abnormalities, 8 of Grade 1, 23 Grade 2 and 30 Grade 3. Grades 1 and 2 were treated conservatively. Grade 3 was considered a definite meniscal tear indicating surgery. There was a good correlation of MR images with the clinical and surgical findings. It is concluded that MR imaging provides diagnostic information which can eliminate multiple invasive diagnostic procedures, helping to define the line of management

MR imaging in the diagnosis of osteomyelitis and soft tissue infection

29 patients with clinical findings consistent with osteomyelitis, soft tissue infection or both were studied with magnetic resonance imaging at 1.5 T. Soft tissue abscess, cellulitis and osteomyelitis were well depicted on MR imaging allowing the correct diagnosis of the presence and extent of infection. MR imaging can differentiate between cellulitis and abscess, which is not possible by any other imaging modalities. The MR imaging findings of osteomyelitis and abscesses agreed with the surgical findings in 96% of the cases. MRI has proved its high ability to detect the inflammatory changes earlier than other modalities