MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture.

The objectives of this study were to use magnetic resonance (MR) imaging to evaluate the prevalence, size, location, and clinical relevance of tendon rerupture following complete repair of full-thickness rotator cuff tear (RCT). A total of 78 surgically proven full-thickness rotator cuff tears in 74 patients were retrospectively included in the study. Clinical assessment was performed using the University of California at Los Angeles score. Postoperative MR imaging was evaluated to determine prevalence, size, and location of tendon rerupture. At a mean 48.4 months' follow-up, 62 shoulders (79.5%) had favorable outcomes and 45 shoulders (57.6%) showed rerupture on MR imaging studies. Reruptures were significantly more prevalent among patients with intermediate-to-bad outcomes (81.3%), with surgically demonstrated two-tendon tears (78.9%) or three-tendon tears (100%), and with preoperative fatty degeneration of the supraspinatus muscle greater than 1 (91.6%). Reruptures were also significantly larger in those subgroups. Complete repair of RCT of all sizes may have favorable outcomes in a significant proportion of patients in spite of a high prevalence of reruptures. Preoperative tear size and degree of muscle fatty degeneration influence the prevalence and rerupture size. After repair of supraspinatus tears, reruptures tend to invade the posterior aspect of the tendon.

Surgically repaired massive rotator cuff tears: MRI of tendon integrity, muscle fatty degeneration, and muscle atrophy correlated with intraoperative and clinical findings.

OBJECTIVE: Our goal in this study was to evaluate by means of MRI the clinical significance of tendon integrity, muscle fatty degeneration, and muscle atrophy in surgically repaired massive rotator cuff tears and to correlate these and other prognostic factors with intraoperative and clinical findings. MATERIALS AND METHODS: Twenty-eight surgically proven massive rotator cuff tears were retrospectively included in the study. Twenty-two patients underwent complete repair, and six patients underwent partial repair. Preoperative and postoperative clinical assessment was performed by using the University of California at Los Angeles score. Preoperative and postoperative MRI studies were evaluated for the presence and extent of rotator cuff tear and for the degree of fatty degeneration and atrophy of the rotator cuff muscles. RESULTS: At a mean 44.4 months' follow-up, 20 patients (71.4%) had a favorable result. A total of 25 patients (89.2%) showed postoperative full-thickness rotator cuff tear, 19 of which were reruptures. A sagittal preoperative rotator cuff tear of less than or equal to 34 mm showed a specificity of 100% for predicting a favorable outcome. A coronal postoperative rotator cuff tear of less than or equal to 34 mm showed a specificity of 85.7% and a positive predictive value of 92.9% for predicting a favorable outcome. A postoperative fatty degeneration of infraspinatus muscle less than or equal to 2 had a specificity of 87.5% and a positive predictive value of 90.9% for predicting a favorable outcome. CONCLUSION: Open repair of massive rotator cuff tears may reach a favorable outcome in a significant proportion of patients, despite a high rate of recurrent or residual tears. Oblique coronal sizes of the recurrent or residual tear of less than or equal to 34 mm and postoperative fatty degenerations of infraspinatus muscle of less than or equal to 2 may allow a favorable outcome.

Cementoma of the fibula: imaging findings with histopathologic correlation and review of the literature.

Bone tumors containing fibrous tissue and cementum-like spherules are typically found in the maxilla and mandible. However, such lesions are extremely infrequent in the long bones. We report the complete radiologic assessment of a cementoma of the fibula in a 42-year-old man. We also correlate the findings with data provided by histopathologic analysis, and review the English-language literature on tumors of long bones that may contain cementum-like material.

MR imaging of spinal infection: atypical features, interpretive pitfalls and potential mimickers.

The wide variability of MR features in spinal infection reflects rare distribution of discovertebral involvement, unexpected soft-tissue and bone abnormalities, un-usual complications or uncommon pathogens. In addition, several de-generative and inflammatory entities can clinically and radiologically resemble spinal infection. In this pictorial review, we illustrate the various atypical features that may be found in MR imaging of spinal infection,with emphasis on interpretative pit-falls and common mimickers.

Long-standing Morel-Lavallée lesions of the trochanteric region and proximal thigh: MRI features in five patients.

OBJECTIVE: The purpose of this study was to review and describe the MRI features of long-standing Morel-Lavallée lesions of the trochanteric region and proximal thigh in five patients with a history of trauma. CONCLUSION: Long-standing Morel-Lavallée lesions of the trochanteric region and proximal thigh may present various MRI patterns that reflect their variable composition and stage of development. MRI may prove especially useful for characterizing these lesions when the trauma is remote and progressive growth or pain is present.

Ultrasonography and CT findings of a dermoid cyst of the cecum. A case report.

We report the US and CT findings of a dermoid cyst of the cecum, which is a very uncommon location for this entity. Pathological correlation and differential diagnosis are briefly discussed.

Muscle hernias of the lower leg: MRI findings.

Muscle hernias of the lower leg involving the tibialis anterior, peroneus brevis, and lateral head of the gastrocnemius were found in three different patients. MRI findings allowed recognition of herniated muscle in all cases and identification of fascial defect in two of them. MR imaging findings and the value of dynamic MR imaging is emphasized.