Gadopentetate-dimeglumine-enhanced MR imaging of osteonecrosis and osteochondritis dissecans of the elbow: initial experience

Abstract

Magnetic resonance imaging (MRI) was performed on seven patients with aseptic osteonecrosis (n = 4) and osteochondritis dissecans (OCD; n = 3) of the elbow. Precontrast MRI was superior to plain radiographs, which did not show any abnormality in three cases of osteonecrosis. On gadopentetate-dimeglumine-enhanced T1-weighted images, which were obtained in three patients with osteonecrosis and three patients with OCD, all cases of osteonecrosis demonstrated homogeneous enhancement of the lesions. All cases of OCD were diagnosed on plain radiographs. On MRI one showed significant enhancement of the loose body. In another case an incompletely enhancing loose body was surrounded by a diffusely enhancing region. In the third patient only a small marginal enhancement of the defect was observed. Our results suggest that MRI can improve the accuracy in diagnosis of aseptic osteonecrosis of the elbow. The use of gadopentetate dimeglumine allows the viability of the lesions or the loose bodies to be demonstrated and reparative tissue to be detected.

Contrast‐enhanced magnetic resonance imaging in a nontraumatic rabbit osteonecrosis model

“…Clinically, a comparison of some contrast-enhanced MRT studies with histological findings has shown that no enhancement area corresponded to necrotic lesions in paticnts with OsteonecroSis of the femoral head (5,27). On the other hand, Li and Hietle (10) reported that fat-suppression T1-weighted MRI enhanced with gadolinium-DTPA showed homogeneous or marginal enhancement in patients with osteonecrosis of the iemoral head, and Peiss et al (18) indicatcd that T1-weighted MRT enhanced with gadolinium-DTPA showed homogcneous enhancement in patients with osteonecrosis of the elbow. The differences in enhancement patterns may depend on the duration from onsct to the stage ofosteonecrosis of the temoral head.…”

“…There were two normal enhancement patterns on T1-weighted or fat-suppression T1 -weighted image5 cnhanccd with gadolinium-DTPA: no enhancement (three of 34 femora in group A and one of 25 in group B) and venous enhancement (three of 34 femora in group A and four of 25 in group B). There were also two abnormal enhancement patterns: focal homogeneous enhancement (22 of 34 temora in group A and 18 All femora wii ti lrohecular necroris (osteonecmsi?) had niarrow iicci-nsis.…”

Osteochondral Lesions of the Elbow

“…26,27,29,35 Furthermore, fragment enhancement implies presence of vascularity and viability. 7,18,36 Takamara and colleagues proposed a comprehensive classification system for OCD stability based on a combination of imaging and clinical features (►Table 4). In a 9-year review by Jars and colleagues, the prevalence and sensitivity of unstable osteochondral lesions in the elbow were reported.…”

Ligamentous reconstruction around the elbow using triceps tendon

“…MRI and CT are of no use in the evaluation of integrity of LUCL (OʼDriscoll et al 1991). MRI can be useful for detection of chondral damage to the capitellum secondary to the recurrent subluxation of the radial head (Peiss 1995).…”