Hydatid disease is an infectious disease caused by the larval stage of the parasitic tapeworm Echinococcosis granulosus. Its distribution is worldwide. Although hydatid disease can develop in almost any part of the body, it is most commonly found in the liver and lung. Musculoskeletal involvement is rare. The radiological appearance of the hydatid disease of musculoskeletal system mimics tumors and other inflammatory conditions. Therefore preoperative diagnosis of musculoskeletal hydatid disease is sometimes difficult clinically and radiologically. On radiography, different radiographic changes may occur. In cases of osteolytic and inflammatory changes, it may mimic any variant of nonspecific or specific osteomyelitis. Bone erosion and destruction may lead to almost complete osteolysis, bone may distort, and on occasion, its radiologic appearances may be confused with those of a malignant bone tumor. Computed tomography (CT) is more accurate in delineating the area of destruction. The primary role of CT and magnetic resonance imaging is in the recognition of extraosseous spread of the hydatid disease within the soft tissues. This article reviews the pathological basis and the clinical and imaging features of musculoskeletal hydatid disease.
Objective:The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). Materials and Methods: We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI. Knee MRI images were evaluated by a radiologist for chondromalacia staging. Patients were divided into two groups as early stage (stage 1-2) and advanced stage (stage 3-4) chondromalacia. Patients' demographical data (age, sex, and occupation), clinical features, physical examination findings and patellofemoral pain severity scale, kujala patellofemoral scoring system, and functional index questionnaire scores were obtained from their medical records. Trochlear sulcus angle, sulcus depth, lateral patellofemoral angle, patellar translation, and Insall-Salvati index were measured using the MRI images. Results: The mean patient age was higher in the advanced stage CMP group compared to the early stage CMP group (p=0.038). There was no statistically significant difference regarding other demographical data (p>0.05). MRI measurement parameters did not show difference between the groups (p>0.05). Patients in the advanced stage CMP group had higher patellofemoral pain severity score, lower kujala patellofemoral score, and lower functional index questionnaire score compared to the early stage CMP group. The differences were statistically significant (p=0.008, p=0.012, and p=0.026, respectively). Conclusion: As chondromalacia stage advances, the symptom severity worsens and knee functions decline; however, MRI measurements do not show difference between early and advanced stage CMP patients.
Brucellosis is a zoonosis of worldwide distribution caused by small gram-negative nonencapsulated coccobacilli of the genus Brucella. It is characterized by a granulomatous reaction in the reticuloendothelial system. Because it affects several organs and tissues, it may have various clinical manifestations. Musculoskeletal involvement is one of the most common locations, and the frequency of bone and joint (osteoarticular) involvement of brucellosis varies between 10% and 85%. Osteoarticular involvement includes spondylitis, sacroiliitis, osteomyelitis, peripheral arthritis, bursitis, and tenosynovitis. The most common osteoarticular finding in children is monoarticular arthritis, mostly located in the knees and hips; whereas in adults, sacroiliitis is the most frequent. Imaging studies, including radiography, computed tomography (CT), magnetic resonance (MR) imaging, and bone scintigraphy, have been used for diagnosis. Radiography is limited to evaluating the focal form of spinal brucellosis and advanced disease at the joints. CT and bone scintigraphy have limited value because of their inadequate soft tissue resolution. MR imaging is the method of choice to assess the extent of disease and follow up the treatment response. However, MR imaging has a low specificity to predict the exact cause of an osteoarticular lesion, and in case of arthralgia or symptoms of osteomyelitis or spondylodiscitis, the index of suspicion should be high in regions where the disease is endemic.
The purpose of this study was to report our experience of partial capitate shortening in seven patients with a median 38 months follow-up. Staging was made by the Lichtman classification system and stage II and III-A patients were included in the study. The mean age was 34 years (range 22-52). Patients were assessed for pain, range of motion, grip and pinch strength, and satisfaction was recorded using a scale between 0 and 4. All these parameters showed improvement after surgery. The Lichtman stage, lunate height index and carpal height index were determined radiographically. Magnetic resonance images of the wrist were studied for lunate revascularization at the final follow-up and occurred in all patients. According to our study, partial capitate shortening seems an effective treatment for Lichtman stage II and III-A patients.Level IV case series study.
Magnetic resonance imaging (MRI) of the internal acoustic canal is the standard diagnostic tool for a wide range of indications in patients. This study aims to investigate the vascular variations and compression of the cranial nerves (CNs) VII and VIII at the cerebellopontine angle in patients with neuro-otologic symptoms using 3D-fast imaging employing steady-state acquisition (FIESTA) MR imaging. One hundred and eighty-seven patients (374 temporal bones) were examined on a 1.5-T MRI. In addition to conventional MR sequences, a 3D-FIESTA MR imaging was acquired. Magnetic resonance images thus obtained were evaluated with special regard to the presence of vascular contact to the CNs VII and VIII, as well as the presence of the vascular variations of the anterior inferior cerebellar artery (AICA) causing the compression of CNs. The Chi-squared test was used for statistical analysis. No statistically significant differences were found between the presence and absence of the AICA loop and/or vascular contact for the clinical symptoms of patients (P > 0.05). The cisternal and canalicular segments of CNs VII and VIII and adjacent vascular variations are well identified using 3D-FIESTA, especially by determining the relationship of the AICA variations between CNs.
In patients with os trigonum, the posterior fibers of the PTFL were inserted herein. In the case of an os trigonum signal alterations of ligaments were more common, which may reflect chronic instability.
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