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1.
Magn Reson Imaging Clin N Am ; 31(4): xiii, 2023 11.
Article in English | MEDLINE | ID: mdl-37741648
3.
AJR Am J Roentgenol ; 221(1): 137-138, 2023 07.
Article in English | MEDLINE | ID: mdl-36722760

ABSTRACT

Ageism is an increasingly recognized form of cognitive bias involving stereotypes, prejudice, and discrimination directed toward people on the basis of their age. Age-based bias influences how medicine is practiced and can result in profoundly negative but avoidable health outcomes. Awareness and education regarding ageism and its manifestations can improve the ability to identify and mitigate ageism. As this Viewpoint describes, radiologists are well situated to be part of the solution in addressing ageism.


Subject(s)
Ageism , Humans , Ageism/psychology , Stereotyping , Aging/psychology , Bias , Surveys and Questionnaires
4.
7.
Magn Reson Imaging Clin N Am ; 29(3): xv, 2021 08.
Article in English | MEDLINE | ID: mdl-34243930
8.
Magn Reson Imaging Clin N Am ; 28(2): xi, 2020 05.
Article in English | MEDLINE | ID: mdl-32241667
9.
Clin Imaging ; 58: 70-73, 2019.
Article in English | MEDLINE | ID: mdl-31252214

ABSTRACT

OBJECTIVE: Evaluate the MR distribution of inflammatory sacroiliac joint changes in axial spondyloarthritis phenotypes, including Ankylosing Spondylitis (AS) and non-radiographic Axial Spondyloarthritis (nrAxSpA). METHODS: A retrospective review of 94 patients seen for treatment of axial spondyloarthritis (SpA) who underwent sacroiliac joint MRI between January 2011 and December 2015 was performed. MR images from 68 patients (20 with AS and 48 with nrAxSpA) were reviewed independently by two radiologists. Images were scored on presence of active inflammatory and chronic structural lesions. These lesions were further categorized as unilateral, bilateral and asymmetric, or bilateral and symmetric. RESULTS: No statistically significant difference was found in the distribution (laterality or symmetry) of bone marrow edema or sclerosis between the AS and nr-axSpA groups. Osseous erosions were more commonly bilateral symmetric in AS than nr-axSpA (11/20 vs. 8/48, p = 0.01). No statistically significant difference was noted between bone marrow edema scores in the AS and nr-axSpA subgroups (2.6 vs 3.3, p = 0.514). Patients with AS had a significantly higher fat metaplasia score compared to patients with nr-axSpA (7.3 vs 1.1, p = 0.001). Patients with nr-axSpA had a higher mean score for erosions (11.6 vs 4.2, p = 0.001). Only patients classified as AS were found to have bony ankylosis. Inter-observer reliability was strong to excellent. CONCLUSION: Ankylosing spondylitis findings at the sacroiliac joints are classically described as bilateral and symmetric on radiographs. Our study demonstrates that distribution on MRI at an individual time point is variable. The variable distribution should be considered when radiologists evaluate MRI exams of AS patients.


Subject(s)
Sacroiliac Joint/pathology , Spondylarthritis/pathology , Spondylitis, Ankylosing/pathology , Adult , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Reproducibility of Results , Retrospective Studies
10.
Semin Musculoskelet Radiol ; 22(4): 386-397, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30134463

ABSTRACT

Anterior cruciate ligament (ACL) tears are common injuries that if left untreated can result in chronic instability, cartilage damage, meniscal tears, and ligamentous injuries, eventually leading to early osteoarthritis. ACL reconstruction surgeries are therefore increasingly being performed. Despite the fact that most patients achieve excellent postoperative results, patients can present with recurrent instability and pain. These patients often undergo imaging with radiographs, magnetic resonance imaging, and/or computed tomography. An understanding of the imaging appearance of the normal ACL reconstruction and common causes of failure is therefore essential for the interpreting radiologist. This article reviews surgical techniques for ACL reconstruction, highlighting recent technical advances, the normal imaging appearance after ACL reconstruction, etiologies for reconstruction failure, and the diagnosis of these with the aid of imaging.


Subject(s)
Anterior Cruciate Ligament Injuries/diagnostic imaging , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Postoperative Complications/diagnostic imaging , Cartilage, Articular/diagnostic imaging , Cartilage, Articular/injuries , Cartilage, Articular/surgery , Humans , Postoperative Period
11.
Skeletal Radiol ; 47(12): 1709-1715, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29785451

ABSTRACT

We present an uncommon imaging feature with fluid fat tracking within the tendon sheath of the flexor hallucis longus (FHL) after traumatic injury to the ankle joint. We propose a coined medical term "lipidus migrans" to define the presence of floating fat in a tendon sheath. This is due to lipohemarthrosis from intra-articular fracture of the ankle with leakage of fluid fat into the tendon sheath. Communication between the FHL tendon sheath and ankle joint can occur in up to 25% of patients. Radiologists should be aware of the presence of lipidus migrans as a potential posttraumatic complication after intra-articular ankle fracture and that fat in the tendon sheath may mimic fracture fragments or even a tendon sheath tumor.


Subject(s)
Adipose Tissue/diagnostic imaging , Ankle Injuries/diagnostic imaging , Tendon Injuries/diagnostic imaging , Tibial Fractures/diagnostic imaging , Accidental Falls , Ankle Injuries/surgery , Arthroscopy , Debridement , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Pain Measurement , Spinal Fractures/diagnostic imaging , Tendon Injuries/surgery , Tibial Fractures/surgery , Tomography, X-Ray Computed
13.
Skeletal Radiol ; 46(11): 1507-1512, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28756567

ABSTRACT

PURPOSE: To assess the MRI features of growth plate injury at the base of the coracoid process. MATERIALS AND METHODS: Subjects were identified through retrospective search of our department imaging database and teaching files and the teaching files of two outside academic institutions. The coracoid base growth plate was examined with attention to widening, irregularity, abnormal signal intensity of the growth plate, and the presence of adjacent soft tissue edema. The apposing coracoid and scapular bony surfaces were examined for signal intensity and morphology. RESULTS: Shoulder MRIs in eight patients with coracoid base growth plate disturbances were retrospectively reviewed (7 males, 1 female, mean age 15 years). Growth plate injury manifested as widening, irregularity and increased signal, apposing bony marrow edema and hypertrophy, and surrounding soft tissue edema. Five subjects were athletes (football, archery, basketball, swimming, rugby), two had a history of neuromuscular disorders, and one subject presented after a fall. Clinical indications included: rule out labral tear (n = 3), rule out rotator cuff tear or fracture after fall (n = 1), nonspecific pain (n = 1), shoulder subluxation, rule out glenoid pathology (n = 1, patient with underlying neuromuscular disorder), muscular dystrophy with shoulder pain (n = 1), and impingement (n = 1). Coracoid growth plate injury was not suspected clinically in any of the patients. CONCLUSION: Awareness of the imaging appearance of coracoid base growth plate injury can aid in a more accurate diagnosis of shoulder MRI studies in young pediatric athletes. While uncommon, coracoid growth plate injury should be considered when assessing children with shoulder symptomatology.


Subject(s)
Growth Plate/diagnostic imaging , Magnetic Resonance Imaging/methods , Salter-Harris Fractures/diagnostic imaging , Shoulder Injuries , Shoulder Joint/diagnostic imaging , Accidental Falls , Adolescent , Athletic Injuries/diagnostic imaging , Female , Humans , Male , Retrospective Studies
14.
Skeletal Radiol ; 46(8): 1113-1115, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28405725

ABSTRACT

OBJECTIVE: To report a novel technique for tibiotalar joint injection that utilizes a posterolateral approach, including indications and technical considerations. METHODS: The posterolateral approach for tibiotalar injection is similar to that used in posterior subtalar joint injections. Using this technique, the tibiotalar joint space is accessed by directing the needle anterosuperiorly beneath the fibula until the posterior aspect of the talar dome has been reached. A retrospective review was conducted of all posterolateral approach tibiotalar joint injections at our institution. RESULTS: Eight patients underwent 12 technically successful therapeutic anesthetic/steroid tibiotalar joint injections using the posterolateral approach under fluoroscopic guidance. All eight patients had anterior predominant arthrosis with large osteophytes and tibiotalar joint space narrowing. The injections were well tolerated without evidence of complications. CONCLUSION: Posterolateral tibiotalar joint injection offers an alternative to the more commonly used anterior approach, particularly in cases of severe anterior predominant arthrosis. An additional advantage of this technique is that the ankle stays in the same position between the initial planning of the needle trajectory and the visualization of contrast flowing into the joint.


Subject(s)
Injections, Intra-Articular/methods , Subtalar Joint , Aged , Anesthetics, Local/administration & dosage , Female , Fluoroscopy , Humans , Male , Middle Aged , Osteophyte/diagnostic imaging , Osteophyte/drug therapy , Retrospective Studies , Steroids/administration & dosage , Subtalar Joint/diagnostic imaging , Treatment Outcome
15.
J Comput Assist Tomogr ; 41(1): 1-7, 2017 Jan.
Article in English | MEDLINE | ID: mdl-28081050

ABSTRACT

This is the third of a series of 4 white papers that represent Expert Consensus Documents developed by the Society of Computed Body Tomography and Magnetic Resonance through its Task Force on dual-energy computed tomography. This paper, part 3, describes computed tomography angiography and thoracic, cardiac, vascular, and musculoskeletal clinical applications. At the end of the discussion of each application category (vascular, cardiac, pulmonary, and musculoskeletal), we present our consensus opinions on the current clinical utility of the application and opportunities for further research.


Subject(s)
Cardiovascular Diseases/diagnostic imaging , Lung Diseases/diagnostic imaging , Musculoskeletal Diseases/diagnostic imaging , Practice Guidelines as Topic , Radiography, Dual-Energy Scanned Projection/standards , Tomography, X-Ray Computed/standards , Evidence-Based Medicine , Humans , United States
16.
Magn Reson Imaging Clin N Am ; 25(1): xv-xvi, 2017 Feb.
Article in English | MEDLINE | ID: mdl-27888855
17.
Eur Radiol ; 27(6): 2497-2506, 2017 Jun.
Article in English | MEDLINE | ID: mdl-27704199

ABSTRACT

OBJECTIVES: To evaluate the ability of different MRI sequences to detect chondrocalcinosis within knee cartilage and menisci, and to analyze the association with joint degeneration. METHODS: Subjects with radiographic knee chondrocalcinosis (n = 90, age 67.7 ± 7.3 years, 50 women) were selected from the Osteoarthritis Initiative and matched to controls without radiographic chondrocalcinosis (n = 90). Visualization of calcium-containing crystals (CaC) was compared between 3D T1-weighted gradient-echo (T1GE), 3D dual echo steady-state (DESS), 2D intermediate-weighted (IW), and proton density (PD)-weighted fast spin-echo (FSE) sequences obtained with 3T MRI and correlated with a semiquantitative CaC score obtained from radiographs. Structural abnormalities were assessed using Whole-Organ MRI Score (WORMS) and logistic regression models were used to compare cartilage compartments with and without CaC. RESULTS: Correlations between CaC counts of MRI sequences and degree of radiographic calcifications were highest for GE (rT1GE = 0.73, P < 0.001; rDESS = 0.68, P < 0.001) compared to other sequences (P > 0.05). Meniscus WORMS was significantly higher in subjects with chondrocalcinosis compared to controls (P = 0.005). Cartilage defects were significantly more frequent in compartments with CaC than without (patella: P = 0.006; lateral tibia: P < 0.001; lateral femur condyle: P = 0.017). CONCLUSIONS: Gradient-echo sequences were most useful for the detection of chondrocalcinosis and presence of CaC was associated with higher prevalence of cartilage and meniscal damage. KEY POINTS: • Magnetic resonance imaging is useful for assessing burden of calcium-containing crystals (CaC). • Gradient-echo sequences are superior to fast spin echo sequences for CaC imaging. • Presence of CaC is associated with meniscus and cartilage degradation.


Subject(s)
Cartilage Diseases/diagnosis , Chondrocalcinosis/complications , Chondrocalcinosis/diagnosis , Osteoarthritis, Knee/complications , Aged , Cartilage Diseases/complications , Cartilage Diseases/diagnostic imaging , Chondrocalcinosis/diagnostic imaging , Female , Humans , Knee Joint , Longitudinal Studies , Magnetic Resonance Imaging/methods , Male , Meniscus/diagnostic imaging , Observer Variation , Osteoarthritis, Knee/diagnostic imaging , Patella/diagnostic imaging , Radiography
18.
Radiology ; 280(1): 328, 2016 07.
Article in English | MEDLINE | ID: mdl-27322984
19.
Radiology ; 279(1): 12-28, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26989928

ABSTRACT

Elbow pain is a frequent presenting symptom in athletes, particularly athletes who throw. The elbow can be injured as a result of acute trauma, such as a direct blow or a fall onto an outstretched hand or from chronic microtrauma. In particular, valgus extension overload during the throwing motion can precipitate a cascade of chronic injuries that can be debilitating for both casual and high-performance athletes. Prompt imaging evaluation facilitates accurate diagnosis and appropriate targeted interventions.


Subject(s)
Athletic Injuries/diagnosis , Diagnostic Imaging , Elbow Injuries , Biomechanical Phenomena , Humans , Pain Measurement
20.
Skeletal Radiol ; 44(11): 1695-9, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26142538

ABSTRACT

We present the case of a 46-year-old woman with no significant past medical history who developed left mid-thigh pain and fullness. Imaging demonstrated a mineralized soft-tissue mass, which increased in size during a year of monitoring, but retained a circumscribed appearance. The mass was located in the medial soft tissues of the thigh, separate from the bone on imaging studies, and this finding was confirmed during excision. The mass showed gross and microscopic features of an aneurysmal bone cyst. This diagnosis was supported by cytogenetic analysis revealing a t(17;17)(p13;q21) translocation corresponding to the USP6 and COL1A1 loci. Soft-tissue aneurysmal bone cyst is a rare entity, with fewer than 25 reports in the literature. Limited cytogenetic information about these tumors is available. To our knowledge, the USP6 and COL1A1 rearrangement has only previously been described in a pediatric soft-tissue aneurysmal bone cyst. We also discuss the differential diagnosis of ossifying soft-tissue lesions.


Subject(s)
Bone Cysts, Aneurysmal/genetics , Collagen Type I/genetics , Soft Tissue Neoplasms/genetics , Translocation, Genetic/genetics , Ubiquitin-Specific Proteases/genetics , Bone Cysts, Aneurysmal/diagnosis , Bone Cysts, Aneurysmal/surgery , Collagen Type I, alpha 1 Chain , Diagnosis, Differential , Diagnostic Imaging , Female , Humans , Middle Aged , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/surgery , Thigh/surgery
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