Purpose: To use proton magnetic resonance spectroscopy ( 1 H-MRS) to evaluate vertebral marrow fat, and to determine whether bone density correlates with fat content and fat unsaturation levels in postmenopausal women. Materials and Methods:Fifty-three women (mean age ϭ 70 years) underwent dual energy x-ray absorptiometry and 1 H-MRS, and 12 young female controls (mean age ϭ 28 years) underwent 1 H-MRS of the lumber spine. Water and lipid peak amplitudes were measured to calculate fat content and fat unsaturation index. Spearman's correlation tests and a t-test comparison of means were applied. Results:1 H-MRS was successful in 15 normal, 15 osteopenic, and 20 osteoporotic subjects, and in all controls. Marrow fat content was significantly elevated in osteoporotic (65.5% Ϯ 10%) and osteopenic (63.5% Ϯ 9.3%) subjects compared to normal subjects (56.3% Ϯ 11.2%) and young controls (29% Ϯ 9.6%). The fat unsaturation index was significantly decreased in osteoporotic (0.091 Ϯ 0.013) and osteopenic (0.097 Ϯ 0.014) subjects compared to normal subjects (0.114 Ϯ 0.016) and young controls (0.127 Ϯ 0.031). A good inverse correlation was observed between the fat content and the unsaturation index (r s ϭ -0.53, P Ͻ 0.0001). Conclusion:Osteoporosis is associated with increased marrow fat. As marrow fat increases, saturated lipids appear to increase preferentially to unsaturated lipids.

Subjects with osteoporosis have decreased vertebral marrow perfusion and increased marrow fat compared with these parameters in subjects with osteopenia. Similarly, subjects with osteopenia have decreased vertebral marrow perfusion and increased marrow fat compared with these parameters in subjects with normal bone density.

The subjects experienced a decrease in vertebral marrow maximum enhancement and enhancement slope and an increase in marrow fat content as bone density decreased. The reduction in perfusion indexes occurred only within the vertebral body and not in the paravertebral tissues supplied by the same artery.

Sonography is comparable to electrodiagnostic study in diagnosis of CTS and should be considered as initial test of choice for patients suspected of having CTS.

The modified Pfirrmann grading system is useful at discriminating severity of disc degeneration in elderly subjects. The system can be applied with good intra- and interobserver agreement.

Objective. Sonographic examination of the median nerve has been suggested as a useful alternative to electrophysiologic study in the diagnosis of carpal tunnel syndrome. To determine its usefulness and the best diagnostic criterion, sonograms of patients with the disease were compared with sonograms of healthy subjects in a case-control study.Methods. Patients with carpal tunnel syndrome and asymptomatic controls who were matched for age and sex were enrolled and underwent sonography of the wrists. Eight separate sonographic criteria were analyzed in each wrist. Data from the patient group and the control group were compared to establish optimal diagnostic criteria for carpal tunnel syndrome, using receiver operating characteristic analytic techniques.Results. Thirty-five patients with carpal tunnel syndrome and 35 asymptomatic controls were examined. Increased cross-sectional area of the median nerve was found to be the most predictive measure of carpal tunnel syndrome, proximal to the tunnel inlet, at the tunnel inlet, and at the tunnel outlet, with significant differences between patients and controls. Using a receiver operating characteristic curve, a cut-off value >0.098 cm 2 at the tunnel inlet provided a diagnostic sensitivity of 89% and a specificity of 83%.Conclusion. Sonographic measurement of the median nerve cross-sectional area is both sensitive and specific for the diagnosis of carpal tunnel syndrome.A diagnosis of carpal tunnel syndrome (CTS) is usually based on symptom characteristics and confirmatory neurophysiologic evaluation (1). Sonographic examination of the median nerve in CTS has been proposed as a useful alternative to neurophysiologic study in the diagnosis of CTS, and proposals for different criteria have been presented (2-7), as summarized in Table 1. The lack of consensus on the optimal criteria for CTS may be attributable to differences in equipment, patient populations, and sonographic techniques. These discrepancies underscore the need for each center to validate internally the criteria it uses to diagnose CTS with ultrasound.This study aimed to prospectively evaluate the characteristics of the median nerve in CTS patients against the findings in normal, healthy subjects, to elicit the optimal discriminatory sonographic criteria and relevant threshold values. PATIENTS AND METHODSCases and controls. This was a prospective, agematched case-control study of CTS in a cohort comprised solely of women, since women account for the majority of CTS patients in the local population (8). The study ethics were reviewed and approved, and patients gave their written informed consent. Consecutive CTS patients from our neurology and rheumatology clinics were invited to join the study. Patients were enrolled into the study after electrophysiologic examination, if the following criteria were fulfilled: 1) presence of sensory symptoms over the median nerve distribution, and 2) confirmatory neurophysiologic results (prolonged median nerve distal motor latencies Ͼ4 ms or a median-ulnar palmer sensory ...

Both intra- and extravascular events were found attributing to the steroid-associated ON based on our experimental protocol with a single low-dose LPS injection and subsequent three injections of high-dose MPS. Both high ON incidence and no mortality in rabbits treated with this inductive protocol suggested its effectiveness for future studies on evaluation of therapeutic efficacy of interventions developed for prevention of steroid-associated ON.

Purpose: To investigate vertebral bone marrow fat content in elderly subjects related to sex, age, and bone mineral density (BMD) and relate these findings to published data in younger subjects. Materials and Methods:A total of 259 healthy subjects (145 females, 114 males; age range, 62-90 years) underwent proton ( 1 H) MR spectroscopy of L3 vertebral body and BMD of the lumbar spine with results stratified according to age. Ninety age-and BMD-matched subjects were selected to determine sex differences in marrow fat content and BMD.Results: In females, vertebral marrow fat content rose sharply between 55 and 65 years of age while in males vertebral marrow fat content rose gradually throughout life. Vertebral marrow fat content in females more than 60 years was approximately 10% higher in females than males, i.e., a reversal of sex difference reported in marrow fat content for subjects less than 60 years. Conclusion:Marrow fat content increases sharply in female subjects between 55 and 65 years of age while male subjects continue to increase marrow fat at a more gradual steady rate. Females older than 60 years have a higher marrow fat content than males. This increased deposition in marrow fat concurs with recognized changes in extraosseous fat distribution in postmenopausal females.