MR imaging can help accurately define the location and limits of glomus tumors before excision.

The purpose of this study was to analyze the association between the severity of inflammatory endplate changes (Modic) on MRI and the clinical response to intradiscal injection of corticosteroids (IDIC) in chronic low back pain (LBP). A total of 74 patients with LBP and inflammatory Modic changes who showed no response to 3-month conservative treatment received lumbar IDIC. Two spine specialists and a radiologist assessed independently the endplate marrow changes of the injected discs. We classified patients with a pure edema endplate changes on MRI as Modic type I (n = 37); those with a mixture of Modic type I and type II changes but predominantly edema changes as Modic I-2 (n = 25) and those with predominantly fatty changes as Modic II-1 (n = 12). The primary outcome was the change in LBP intensity between baseline and 1 month after IDIC, as measured on a visual analog scale (range 0-100 mm). At 1 month, reduction in pain score was significantly higher in the Modic I and Modic I-2 groups than in the Modic II-1 group (30.2 +/- 26.6 and 29.4 +/- 21.5 vs 5.3 +/- 25.5; P = 0.009 and P = 0.017, respectively). At 3 and 6 months, IDIC tended to be more effective in the Modic I and Modic I-2 groups but not significantly. No complications such as infection or hematoma were reported. IDIC could be a short-term efficient treatment for patients with chronic LBP and predominantly inflammatory endplate changes when conservative treatments have failed.

Quantification of chondropathy with MR imaging is feasible and well correlated with anatomic cartilage breakdown.

Digital mucoid cysts may be polymorphic. MR imaging is helpful when cysts are in the nail bed.

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Intraarticular concentration of gadolinium tetraazacyclododecanetetraacetic acid (DOTA) after intravenous injection and the diagnostic contribution of the subsequent arthrographic effect were assessed for meniscal lesions in the knee. Kinetics were studied in three healthy volunteers. Passage of contrast material into the synovial fluid of the joint was evaluated in 53 knees by measuring the signal intensity on T1-weighted images before, immediately after, and 1 hour after injection. Synovial fluid enhancement was 1.46-fold greater than the unenhanced value after 10 minutes, plateaued after 30 minutes, and was 1.95-fold greater after 1 hour. In articular fluid samples from four patients 1 hour after intravenous injection, the average intraarticular concentration was 141 mumol +/- 47 (1 standard deviation) at atomic absorption spectrophotometry. Knee mobilization improved the passage of contrast material into the synovial fluid by approximately 120% at 10 minutes and 25% at 1 hour. In eight of 39 tears, unenhanced standard sequences were equivocal. In seven of these uncertain cases, delayed contrast-enhanced images permitted adequate interpretation. Intraarticular concentration of Gd-DOTA produces a sufficient arthrographic effect for meniscus evaluation.

The aim of this study was to compare the performance of CT and MRI in the diagnosis of longitudinal stress fracture of the tibia (LSFT). A retrospective study of imaging findings was performed in 15 patients with LSFT. The CT and MR images were compared for detection of fracture line, callus, bone marrow edema, and soft tissues changes. The CT and MRI techniques allowed the detection of the fracture line in 82 and 73 % of cases, respectively. The callus was always visualized with CT or MRI. The MRI technique had a markedly higher sensitivity than CT in the detection of bone marrow edema (73 vs 18 %) and soft tissue lesions (87 vs 9 %). This may cause a misleading aggressive appearance on MRI. Computed tomography remains the best imaging modality for diagnosis of LSFT. However, MRI findings should be known to obviate the performance of CT or bone biopsy.