Greater trochanteric pain syndrome is commonly due to gluteus minimus or medius injury rather than trochanteric bursitis. Gluteal tendinopathy most frequently occurs in late-middle aged females. In this pictorial review the pertinent MRI and US anatomy of the gluteal tendon insertions on the greater trochanter and the adjacent bursae are reviewed. The direct (peritendinitis, tendinosis, partial and complete tear) and indirect (bursal fluid, bony changes and fatty atrophy) MRI signs of gluteal tendon injury are illustrated. The key sonographic findings of gluteal tendinopathy are also discussed.
Tibialis posterior dysfunction is a complex progressive condition caused primarily by injury to the tibialis posterior tendon, leading to acquired pes planus. The tibialis posterior is the most frequent ankle tendon to be injured, and the disorder commonly occurs in late middle-aged females. Degenerative, inflammatory, functional and post-traumatic aetiologies have all been proposed. Failure of the tibialis posterior tendon causes excessive load stress on the spring ligament and sinus tarsi ligaments. A wide spectrum of bony and soft-tissue abnormalities may be seen on plain radiographs, ultrasound and MRI, including malalignment, anatomical variants, and enthesopathic and tendinopathic changes. Knowledge of the anatomical and biomechanical considerations in tibialis posterior dysfunction allows the radiologist to diagnose injury to key structures and provide prognostic information that may assist with management options to prevent further flat foot deformity.
One hundred and eighty-two women undergoing dilatation and curettage were allocated randomly to receive premedication comprising temazepam, papaveretum-hyoscine or placebo. The temazepam recipients reported significantly fewer episodes of postoperative nausea. Movement was blamed by 66% of patients who identified a cause for nausea. These patients had higher scores on a motion sickness susceptibility questionnaire and were more likely to have been treated previously for nausea or vomiting. It may be possible to identify susceptible patients before surgery.
Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease characterized by the presence of osseous and cartilaginous submucosal nodules projecting into the tracheobronchial tree. Most cases are asymptomatic and discovered incidentally at post-mortem. We identified a case of TO on thoracic spiral CT and confirmed the diagnosis of bronchoscopy. This article reviews the imaging characteristics of TO, and shows the 3-D virtual bronchoscopic and multiplanar reconstruction appearances of TO.
Magnetic resonance imaging is an excellent technique for imaging the tendons and the ligaments of the ankle. Owing to the advantage of detailed demonstration of soft-tissue structures and capability for multiplanar demonstration of the ankle ligaments and tendons, MRI has been increasingly used in the evaluation of the ligamentous and the tendon injuries of the ankle. Knowledge of normal anatomy and of MRI appearances are essential to recognize pathological appearances. In this pictorial essay, the first of a three part series, we review the normal MRI appearances of the ankle tendons and ligaments. The anterior, lateral and medial tendon groups, the Achilles tendon and the lateral, the syndesmotic and the medial ligament groups are described and illustrated. Anatomy of the sinus tarsi is also described. Tendon and ligament pathology will be illustrated in the second part of the series, and imaging approach to ankle injuries will be outlined in the final part of this series.
The frequency and severity of hypoxaemia during induction of anaesthesia in neonates and small infants at the Norfolk and Norwich Hospital, a district general hospital, was compared, using pulse oximetry, with that of the nearest specialist hospital, the Queen Elizabeth Hospital for Sick Children in London. There were differences in stafing and the choice of anaesthetic techniques between the hospitals. One third of the patients in both hospitals experienced desaturation of more than 5% (moderate or severe hypoxaemia) at one or more recordings during induction. The highest incidence of hypoxaemia was associated with awake intubation. There was no statistical diyerence in the incidence or severity of hypoxaemia between the hospitals. In the district general hospital, moderate or severe hypoxaemia of greater than 30 s duration was more likely if an anaesthetist with a regular paediatric operating list was not present at induction ( p < 0.01).
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