MR arthrography was superior to conventional MRI for detecting labral tears and acetabular cartilage defects and showed a higher interobserver agreement. For femoral cartilage lesions, both modalities yielded comparable results.
Hindfoot alignment measurements should be performed on hindfoot alignment view radiographs using the medial or lateral calcaneal contour or on long axial view radiographs using the calcaneal axis. Interreader agreement of hindfoot alignment measurements is slightly better on long axial view radiographs than on hindfoot alignment view radiographs.
Objective The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Methods Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Results Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n=20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n=19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p=0.032 and p= 0.021, respectively). Conclusion Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities.
OBJECTIVE: To investigate the ability of coronal non-weight-bearing MR images to discriminate between normal and abnormal hindfoot alignment. METHODS: Three different measurement techniques (calcaneal axis, medial/lateral calcaneal contour) based on weight-bearing hindfoot alignment radiographs were applied in 49 patients (mean, 48 years; range 21-76 years). Three groups of subjects were enrolled: (1) normal hindfoot alignment (0°-10°valgus); (2) abnormal valgus (>10°); (3) any degree of varus hindfoot alignment. Hindfoot alignment was then measured on coronal MR images using four different measurement techniques (calcaneal axis, medial/lateral calcaneal contour, sustentaculum tangent). ROC analysis was performed to find the MR measurement with the greatest sensitivity and specificity for discrimination between normal and abnormal hindfoot alignment. RESULTS: The most accurate measurement on MR images to detect abnormal hindfoot valgus was the one using the medial calcaneal contour, reaching a sensitivity/specificity of 86 %/75 % using a cutoff value of >11°valgus. The most accurate measurement on MR images to detect abnormal hindfoot varus was the sustentaculum tangent, reaching a sensitivity/specificity of 91 %/71 % using a cutoff value of <12°valgus. CONCLU-SION: It is possible to suspect abnormal hindfoot alignment on coronal non-weight-bearing MR images. KEY POINTS : • Abnormal hindfoot alignment can be identified on coronal non-weight-bearing MR images.• The sustentaculum tangent was the best predictor of an abnormally varus hindfoot.• The medial calcaneal contour was the best predictor of a valgus hindfoot.
AbstractObjective To investigate the ability of coronal non-weightbearing MR images to discriminate between normal and abnormal hindfoot alignment. Methods Three different measurement techniques (calcaneal axis, medial/lateral calcaneal contour) based on weightbearing hindfoot alignment radiographs were applied in 49 patients (mean, 48 years; range 21-76 years). Three groups of subjects were enrolled: (1) normal hindfoot alignment (0°-10°v algus); (2) abnormal valgus (>10°); (3) any degree of varus hindfoot alignment. Hindfoot alignment was then measured on coronal MR images using four different measurement techniques (calcaneal axis, medial/lateral calcaneal contour, sustentaculum tangent). ROC analysis was performed to find the MR measurement with the greatest sensitivity and specificity for discrimination between normal and abnormal hindfoot alignment.Results The most accurate measurement on MR images to detect abnormal hindfoot valgus was the one using the medial calcaneal contour, reaching a sensitivity/specificity of 86 %/75 % using a cutoff value of >11°valgus.The most accurate measurement on MR images to detect abnormal hindfoot varus was the sustentaculum tangent, reaching a sensitivity/specificity of 91 %/71 % using a cutoff value of <12°valgus. Conclusion It is possible to suspect abnormal hindfoot alignment on coronal non-weight-bearing MR images.
Focal myositis of the iliopsoas muscle is a rare entity which may mimic a tumoural lesion. Imaging findings may not be conclusive, and US-guided biopsy is recommended to rule out a malignant mass. Ultrasound seems to be the most cost-effective method for diagnosis, image guided biopsy and follow-up.
Bladder cancer is the fourth most common malignancy among men in the Western world. Bone metastasis occurs in 27 % of the cases. Usually, the location is the spine. The present report describes the first case of a proven distant bone metastasis to the acromion from a urinary bladder carcinoma in a patient with shoulder pain.
We report the observation of a child born at 38 5/7 weeks’ gestation, who presented with marked microcephaly and suffered from persistent intractable epilepsy up to his death at the age of 5 days. Magnetic resonance imaging suggested lissencephaly. But interestingly no submicroscopical deletion in LIS-1 gene could be detected and true lissencephaly could not be confirmed histologically. Instead, primary degenerative process was considered the most probable cause of congenital pontocerebellar hypoplasia II in this case, which may be associated with a maturation delay of the cerebral hemispheres. The present case points to possible pitfalls in neuroradiological interpretation of simplified cerebral gyration and to the necessity to take into account cerebral pathologies leading to slowing or arrest of intrauterine cerebral development and delay of cerebral gyration.
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