Subject(s)
Aerospace Medicine , Arm Injuries/etiology , Magnetic Resonance Imaging , Military Personnel , Muscle, Skeletal/injuries , Occupational Diseases/etiology , Adult , Arm Injuries/diagnosis , Contusions/diagnosis , Contusions/etiology , Edema/diagnosis , Edema/etiology , Hematoma/diagnosis , Hematoma/etiology , Humans , Male , Muscle, Skeletal/pathology , Muscular Diseases/diagnosis , Muscular Diseases/etiology , Occupational Diseases/diagnosis , Pain/diagnosis , Pain/etiologyABSTRACT
Over the past decade, imaging evaluation of orthopedic conditions of the pelvis and hips has become increasingly complex. Although the conventional radiograph remains the initial examination of choice, the decision between secondary tests, such as computed tomography, MR imaging, or scintigraphy is far from clear. A thorough understanding of current imaging technology is necessary for the clinician to choose the most appropriate examination for a given situation. This article reviews the current status of orthopedic imaging in the areas of acute trauma, stress injuries, osteonecrosis, arthropathies, tumors, and interventional imaging.
Subject(s)
Bone Neoplasms/diagnosis , Femur Head Necrosis/diagnosis , Hip Joint/diagnostic imaging , Hip Joint/pathology , Pelvic Bones/diagnostic imaging , Pelvic Bones/pathology , Arthritis/diagnosis , Hip Injuries , Humans , Image Enhancement/methods , Magnetic Resonance Imaging , Pelvic Bones/injuries , Tomography, X-Ray ComputedSubject(s)
Contrast Media , Gadolinium , Joint Diseases/diagnosis , Magnetic Resonance Imaging , Organometallic Compounds , Pentetic Acid/analogs & derivatives , Contrast Media/administration & dosage , Drug Approval , Forensic Medicine , Gadolinium/administration & dosage , Gadolinium DTPA , Humans , Image Enhancement , Injections, Intra-Articular , Organometallic Compounds/administration & dosage , Pentetic Acid/administration & dosage , Safety , United States , United States Food and Drug AdministrationABSTRACT
We report an unusual case of Streptococcus pneumoniae sacroiliitis in a previously healthy 31-year-old woman. Six cases of pneumococcal sacroiliitis have been reported; the only two cases in adults occurred in young women in the preantibiotic era. Our patient had fever and a depressed level of consciousness, with subsequent right buttock and thigh pain. Blood cultures revealed S pneumoniae, and a bone scan showed increased tracer activity in the right sacroiliac joint. Although the cerebrospinal fluid white blood cell count was only 3/microL, culture of cerebrospinal fluid grew S pneumoniae. Our patient was successfully treated with a 6-week course of intravenous antibiotics (penicillin G after an initial week of ceftriaxone), followed by 2 weeks of oral penicillin therapy.
Subject(s)
Arthritis, Infectious/diagnosis , Pneumococcal Infections/diagnosis , Sacroiliac Joint/microbiology , Administration, Oral , Adult , Arthritis, Infectious/drug therapy , Bacteremia/microbiology , Buttocks , Ceftriaxone/administration & dosage , Ceftriaxone/therapeutic use , Cephalosporins/administration & dosage , Cephalosporins/therapeutic use , Consciousness , Drug Therapy, Combination/administration & dosage , Drug Therapy, Combination/therapeutic use , Female , Fever/microbiology , Humans , Injections, Intravenous , Pain/etiology , Penicillin G/administration & dosage , Penicillin G/therapeutic use , Penicillins/administration & dosage , Penicillins/therapeutic use , Pneumococcal Infections/drug therapy , Streptococcus pneumoniae/isolation & purification , ThighABSTRACT
"Vacuum" phenomena may occur within peripheral joints or in the spine. These phenomena are related to the accumulation of gas, principally nitrogen, under physiologic or pathologic circumstances. Within the spine, vacuums may occur within the intervertebral discs and are useful indicators of intervertebral osteochondrosis , spondylosis deformans, Schmorl's nodes, and limbus vertebrae. In addition, intraosseous vacuum may occur within the vertebral bodies usually related to osteonecrosis. Under physiologic conditions, naturally occurring peripheral vacuums cannot exist in the presence of joint fluid. This is often an easy, inexpensive, noninvasive means of excluding a joint effusion. In this review, the appearance, clinical importance, pathogenesis, and pitfalls of spinal and extra-spinal vacuums are discussed.
Subject(s)
Gases , Joint Diseases/diagnosis , Spinal Diseases/diagnosis , Arthrography , Humans , Joint Diseases/diagnostic imaging , Magnetic Resonance Imaging , Radiography , Spinal Diseases/diagnostic imagingABSTRACT
OBJECTIVE. The flexor tendon pulley system is often ruptured when a flexed finger is forcibly extended. In the acute phase, soft-tissue swelling and pain often make clinical evaluation difficult. These pulleys are not constantly visualized on MR imaging. Rupture of the pulley system can be inferred by observing bow stringing of the underlying flexor tendons when MR imaging is obtained with the finger in flexion. Our objective is to describe the flexor tendon pulley system and present our MR technique.
Subject(s)
Finger Injuries/diagnosis , Magnetic Resonance Imaging , Tendon Injuries/diagnosis , Humans , RuptureSubject(s)
Cathartics/administration & dosage , Fasting , Urography/methods , Contrast Media , Feces , HumansABSTRACT
Whether or not bowel preparation should be used before intravenous urography (IVU) remains a controversial issue. Despite strongly held views on both sides there is little scientific evidence to support either viewpoint. We have conducted a prospective randomized study designed to test the hypothesis that adequate bowel preparation before IVU facilitates better quality studies requiring fewer films and consequently less time and a lower radiation exposure. Data on 188 patients were analysed; 90 patients received bowel preparation and 98 received no bowel preparation. There was no difference between the groups in terms of the number of films taken, the duration of the procedure, the visibility of the renal tracts or the overall quality of the studies. The prepared group did have significantly less faecal residue than the unprepared group. However, the renal tract visibility was no greater, as the combination of gas and haustral folds seen after bowel preparation obscured fine detail of the urinary tract as effectively as faecal residue. The hypothesis that adequate bowel preparation before IVU facilitates better quality studies must therefore be rejected.
