Magnetic resonance imaging (MRI) is the mainstay of diagnosis, staging and follow-up of much musculoskeletal pathology. Diffusion-weighted magnetic resonance imaging (DWI) is a recent addition to the MR sequences conventionally employed. DWI provides qualitative and quantitative functional information concerning the microscopic movements of water at the cellular level. A number of musculoskeletal disorders have been evaluated by DWI, including vertebral fractures, bone marrow infection, bone marrow malignancy, primary bone and soft tissue tumours; post-treatment follow-up has also been assessed. Differentiation between benign and malignant vertebral fractures by DWI and monitoring of therapy response have shown excellent results. However, in other pathologies, such as primary soft tissue tumours, DWI data have been inconclusive in some cases, contributing little additional information beyond that gained from conventional MR sequences. The aim of this article is to critically review the current literature on the contribution of DWI to musculoskeletal MRI.
Myositis ossificans (MO) is characterized by abnormal heterotopic bone formation involving striated muscle, tendons, ligaments, fasciae, and aponeuroses. Myocardium, the diaphragm, tongue, larynx, smooth muscle, and sphincters are all spared. Several subtypes of myositis ossificans exist: posttraumatic myositis ossificans (PTMO), nontraumatic/pseudomalignant myositis ossificans, and myositis ossificans progressiva (MOP). This article reviews the clinical features and differential diagnoses of each subtype of MO and illustrates the typical imaging features demonstrated by plain radiography, ultrasound, radionuclide bone scans, computed tomography, and magnetic resonance imaging.
U/S highly agrees with radiography when measuring MCGR length. It has a high inter- and intra-observer reliability and does not require radiation exposure. Although U/S allows accurate MCGR measurement and soft tissue assessment, patients will still need occasional radiographs to assess spine bony elements, overall spinal balance and scoliosis correction. Combining radiography and U/S allows patient monitoring and accurate MCGR measurement whilst decreasing patients' radiation exposure.
OBJECTIVEWe conducted a retrospective cohort study assessing the prevalence and clinical and radiological outcome of remote areas of bone marrow edema on magnetic resonance imaging (MRI) in the feet of subjects with diabetes and neuropathic foot ulceration.RESEARCH DESIGN AND METHODSMRIs performed over 6 years looking for osteomyelitis associated with neuropathic lesions were assessed for remote areas of signal change.RESULTSSeventy MRI studies were assessed. Remote areas of signal change were present in 21 (30%) subjects, involved midfoot or hindfoot in 20 subjects, were associated with younger age and renal replacement therapy, and did not predict future Charcot neuroarthropathy or infection at that site. Repeat MRIs in 11 subjects with such areas found that none had progressed, six had improved, and two had resolved; in 29 subjects without such areas, five had developed new areas.CONCLUSIONSBone marrow edema in the midfoot and hindfoot of subjects with diabetes and neuropathic lesions is common, often transient, and of unknown significance.
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