Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances.
ABSTRACT. The aim of this study was to evaluate the role of multidetector CT (MDCT) arthrography in the diagnosis of intra-articular hip pathology. A retrospective review of 96 patients who had undergone CT hip arthrography was performed. Data regarding the presence of a labral tear, paralabral cyst, chondral loss, acetabular version, femoral morphology and fibrocystic change were collected. We detected 28 labral tears (24 anterior, 2 anterolateral, 1 lateral and 1 posterolateral). An abnormal labral-chondral transitional zone was seen in 9 patients and 4 patients had surface labral fraying. We identified three paralabral cysts. Acetabular cartilage loss was detected in 45 and femoral cartilage loss in 9 patients. An abnormal anterior femoral head and neck junction was present in 18 hips and fibrocystic change in 8. Acetabular retroversion was present in 11 hips. 63 sets of patient notes were reviewed, of which 49 were in-patients with abnormal MDCT arthrogram findings. Surgical correlation was available in 27 patients. There was a discrepancy between the findings of a labral tear in one patient (false negative, 90% sensitivity and 100% specificity) and the presence of acetabular cartilage loss (88% sensitivity and 100% specificity) and femoral cartilage loss (94% sensitivity and 100% specificity) in three patients. MDCT arthrography affords accurate detection of intra-articular hip pathology. The investigation of suspected intra-articular hip pathology is challenging. Arthroscopy represents the gold standard but is invasive, necessitates a general anaesthetic and is best reserved for patients in whom concomitant therapeutic intervention is to be undertaken. Much of the radiology literature has focused on the use of MR arthrography of the hip to detect labral and cartilage pathology [1][2][3][4][5]. A number of groups have also studied the role of non-contrast MRI in the detection of labral tears associated with femoroacetabular impingement and acetabular dysplasia [6][7][8][9]. Both non-contrast MRI and MR arthrography have limitations in terms of spatial resolution, which can make the detection of subtle labral and cartilage pathology challenging [4].Modern spiral multidetector CT (MDCT) technology allows submillimetre spatial resolution and has revitalised interest in the role of CT arthrography in the wrist, shoulder, knee, elbow and ankle [10][11][12][13][14][15][16][17]. There are few published data on the utility of this technique in the investigation of intra-articular hip pathology. Several studies have investigated the ability of MDCT arthrography to assess cartilage loss in the hip and have demonstrated that its accuracy is equal to, or can outperform, MR arthrography [18][19][20]. There are limited reports regarding the ability of MDCT arthrography to assess labral pathology [9]. The aim of this study was to evaluate the role of MDCT arthrography in the diagnosis of intraarticular hip pathology in a consecutive group of patients.
Methods and materialsA retrospective review of 96 consecutive patients ...
Focused assessment with sonography for trauma or focused abdominal sonography for trauma -the FAST scan, has become a useful modality for the initial evaluation of patients with blunt abdominal trauma. The technique is used to identify free fluid in the abdomen and pelvis and to detect the presence of a pericardial effusion. FAST can be performed by any trained individual, not necessarily a sonographer or radiologist, aiding in the immediate availability of this technique in the emergency situation. We will discuss the applications and sensitivity of this technique in trauma and review the potential pitfalls and limitations which need to be understood if this technique is to be safely applied. The use of FAST for the detection of pneumothoraces in trauma and other advances in FAST scanning, such as scoring systems and paediatric FAST are also reviewed.
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