Accuracy of direct signs of tears of the anterior cruciate ligament.

OBJECTIVE: To evaluate the accuracy of direct magnetic resonance imaging (MRI) signs of tears of the anterior cruciate ligament. PATIENTS AND METHODS: Over the period April 1991 to February 1994, 92 consecutive MRI studies of the knee were obtained for which arthroscopic data were also available. The MRI studies were retrospectively evaluated for course, continuity, signal intensity, morphologic features, contour and visualization of the anterior cruciate ligament. Arthroscopic findings were correlated with individual primary signs and the overall MRI diagnosis. RESULTS: Among the cases studied were 4 partial and 32 complete tears of the anterior cruciate ligament (as determined by arthroscopy). Because of the low number of partial tears, it was not possible to draw any meaningful conclusions about the MRI diagnosis of this type of tear. For complete tears, the criteria with the highest accuracy were abnormal course of the ligament (96.0%) and high signal intensity (89.3%). The overall diagnostic accuracy of MRI was 98.8%. CONCLUSIONS: The most accurate direct MRI finding in patients with a complete tear of the anterior cruciate ligament was abnormal course of the ligament, followed by abnormally high signal intensity.

Rupture of the distal biceps tendon: evaluation with MR imaging.

PURPOSE: To assess the usefulness of magnetic resonance (MR) imaging in the diagnosis of distal biceps tendon ruptures. MATERIALS AND METHODS: MR images of the elbow in 20 patients with suspected distal biceps injury were retrospectively reviewed along with those of eight asymptomatic volunteers. Surgical confirmation was obtained in nine cases. RESULTS: MR imaging helped diagnose 10 complete ruptures with depiction of the absence of the tendon distally (n = 10), a fluid-filled tendon sheath (n = 9), an antecubital fossa mass (n = 3), muscle edema (n = 3), and atrophy (n = 2). Six partial tears were depicted with high signal intensity within the tendon (n = 6), fluid in the biceps tendon sheath (n = 6), and thinning (n = 3) or thickening (n = 3) of the distal tendon. Of the remaining patients, one each had tendinosis, tenosynovitis, a biceps hematoma, and a brachialis contusion. CONCLUSION: MR imaging helped confirm distal biceps tendon ruptures because it distinguished complete from partial ruptures and other entities that may mimic ruptures.

Magnetic resonance pathology of the rotator cuff.

This article reviews the current issues in imaging of the rotator cuff with magnetic resonance imaging (MRI). Important technical issues are discussed, including some of the newer pulse sequences, surface coils, and MR arthrography. Debate continues over what constitutes the normal appearance of the rotator cuff. Issues regarding studies of asymptomatic volunteers, pitfalls in imaging, and MR artifacts such as magic angle effects are discussed. The article also reviews the basic concepts of MR interpretation of pathologic lesions of the cuff, including tendinopathy, partial and complete tears, and the relationships to rotator cuff impingement.

CT of primary adrenal lymphoma.

We present a case of primary adrenal lymphoma with CT appearance of a cystic mass containing mural calcification. Sonographic findings are correlated. Comparison of imaging features is made with the few previously reported cases of this rare entity.