Acute calcific tendinitis of the gluteus medius: a case report with serial magnetic resonance imaging findings.

A case of calcific tendinitis of the gluteus medius is presented. Calcification was evident in the soft tissue adjacent to the greater trochanter on plain radiographs. On the initial magnetic resonance images (MRI), inflammatory edematous change was detected not only in the gluteus medius but also in the bone marrow of the greater trochanter, corresponding to the painful area. Three months later, calcification disappeared on plain radiographs and the femur showed normal signal intensity on MRI. Initial MRI excluded other diseases' including infection and bone tumor, and serial MRI confirmed that the change in extraosseous and intraosseous findings were in accordance with self-limiting clinical symptoms.

Pulsatile cerebrospinal fluid flow measurement using phase-contrast magnetic resonance imaging in patients with cervical myelopathy.

STUDY DESIGN: A technical report is presented. OBJECTIVE: To investigate the relation between the severity of myelopathy and the degree of cerebrospinal fluid flow disturbance by using magnetic resonance imaging to measure the velocity of the cerebrospinal fluid flow in patients with cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA: Analyses of pulsatile cerebrospinal fluid flow measured by phase-contrast magnetic resonance imaging in healthy subjects and patients with Arnold-Chiari syndrome have been reported. Few studies have evaluated the change of pulsatile cerebrospinal fluid flow velocity and the waveform of the plotted velocity in patients with cervical spondylotic myelopathy. METHODS: Study 1: Pulsatile cerebrospinal fluid flow was measured at C7, positioned with cervical spine flexion and extension, to investigate the influence of cervical alignment on the pulsatile cerebrospinal fluid flow in five patients with cervical spondylotic myelopathy. Study 2: In 31 patients with cervical spondylotic myelopathy, pulsatile cerebrospinal fluid flow was measured at C3 and C7, with the neck set centrally. The relevance of cerebrospinal fluid flow disturbance and the severity of myelopathy evaluated by the Japanese Orthopedic Association scoring system also were studied. RESULTS: Study 1: The waveform of plotted pulsatile cerebrospinal fluid flow velocity showed no change resulting from the position of the cervical spine. Study 2: A high correlation between the Japanese Orthopedic Association score and the cerebrospinal fluid pulsatile flow amplitude at C7 was demonstrated (r = 0.75; P < 0.0001). The average Japanese Orthopedic Association score of 14 patients whose cerebrospinal fluid flow velocity waveforms were absent was significantly lower (P < 0.0001) than that of 17 patients whose waveforms were present. CONCLUSIONS: The disturbance of pulsatile cerebrospinal fluid flow demonstrated high correlation with the severity of myelopathy. Measurement of cerebrospinal fluid flow disturbance can quantify the degree of dural sac and spinal cord compression.