Distribution of intramuscular giant lipomas in the functional compartments of the forearm: a report of 12 cases

2019 ◽  
Vol 52 (04) ◽  
pp. 361-367
Author(s):  
Sercan Capkin ◽  
Ali Cavit ◽  
Kutay Yilmaz ◽  
Tufan Kaleli
Keyword(s):  
Average Diameter ◽  
Lateral Compartment ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Anatomical Features ◽  
Histopathological Features ◽  
Direct Radiography ◽  
Soft Tissue Masses ◽  
Neurovascular Structures

Abstract Purpose The aim of this study was to investigate the distribution of intramuscular giant lipomas in the functional compartments of the forearm and to compare their clinical, radiological and histopathological features with those reported in the current literature. Methods The study included 12 patients who were surgically treated for intramuscular lipomas > 5 cm in size located in the forearm that had been confirmed histopathologically between April 2006 and March 2017. Data about the patients with respect to age, sex, affected side, localisation of the lipomas in the forearm functional compartments, size, histopathological features and recurrence were collected. According to the clinical complaints, direct radiography and magnetic resonance imaging were applied. Results The average diameter was 6.5 cm (range: 5.5–9 cm). All lipomas had a well-defined border. All the patients presented with soft-tissue masses that were painless in seven patients. Five patients had nerve compression symptoms. When the lipomas were classified according to the functional compartments of the forearm, six of them were located in the superficial volar compartment, two in the deep volar compartment, two in the deep dorsal compartment and two in the lateral compartment. All lipomas were surgically removed by marginal excision. None had complications or recurrence at a mean of 6.5 years follow-up (range: 1–12 years) after surgery. Conclusions Intramuscular lipoma is a relatively uncommon tumour, especially in the forearm. Because of the proximity to the neurovascular structures in the forearm, excision of lipomas should be performed with care and include wide incisions. Additionally, knowing the anatomical features of the compartment where the lipoma is localised in the forearm is important in planning surgery to enable easier dissection of the lipoma and lessen the risk of damage to adjacent neurovascular structures. Level of evidence Level 4

Autologous Osteochondral Mosaicplasty for Centrally and Laterally Located, Advanced Capitellar Osteochondritis Dissecans in Teenage Athletes: Clinical Outcomes, Radiography, and Magnetic Resonance Imaging Findings

2018 ◽  
Vol 46 (8) ◽  
pp. 1943-1951 ◽  
Author(s):  
Tadanao Funakoshi ◽  
Daisuke Momma ◽  
Yuki Matsui ◽  
Tamotsu Kamishima ◽  
Yuichiro Matsui ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcomes ◽  
Osteochondritis Dissecans ◽  
Case Series ◽  
Return To Play ◽  
Joint Surface ◽  
Resonance Imaging ◽  
Level Of Evidence

Background: Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear. Purpose: To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. The secondary purpose was to compare the clinical outcomes with images of centrally and laterally located lesions. Study Design: Case series; Level of evidence, 4. Methods: This study analyzed 22 elbows (all male patients; mean age, 13.5 ± 1.2 years) with capitellar OCD managed with mosaicplasty. Patients were divided into 2 groups according to the location of the lesions: central (10 patients) and lateral (12 patients). Evaluation was performed through use of the clinical rating system of Timmerman and Andrews, plain radiographs, and magnetic resonance imaging (MRI; the cartilage repair monitoring system of Roberts). The mean follow-up period was 27.5 months (range, 24-48 months). Results: Lateral lesions were significantly larger than central lesions (147.1 ± 51.9 mm2 vs 95.5 ± 27.4 mm2, P = .01). No other significant differences were found between central and lateral lesions. Timmerman and Andrews scores for both central and lateral lesions improved significantly from 125.0 ± 30.1 points and 138.3 ± 34.5 points preoperatively to 193.5 ± 11.3 points and 186.7 ± 18.1 points, respectively, at final follow-up ( P < .0001, P < .0001). Radiography identified complete graft incorporation in all cases and the absence of severe osteoarthritic changes or displaced osteochondral fragments. In the lateral group, the radial head ratio at final follow-up (1.83 ± 0.23) was significantly larger than the preoperative findings (1.75 ± 0.14, P = .049). The quality of joint surface reconstruction was found to be acceptable for central and lateral lesions on MRI evaluation. Conclusion: Mosaicplasty resulted in satisfactory clinical outcomes and smooth cartilage surface integrity in teenage athletes with OCD on their return to competition-level sports activities irrespective of lesion location.

Comparison of Bioabsorbable Pins and Nails in the Fixation of Adult Osteochondritis Dissecans Fragments of the Knee

2007 ◽  
Vol 35 (9) ◽  
pp. 1467-1476 ◽  
Author(s):  
Maria Weckström ◽  
Mickael Parviainen ◽  
Martti J. Kiuru ◽  
Ville M. Mattila ◽  
Harri K. Pihlajamäki
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Group Versus ◽  
Long Term Results ◽  
Adult Males ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Arthroscopic Fixation

Background The optimal device for the fixation of osteochondritis dissecans fragments of the knee remains controversial and lacks long-term results. Purpose To review a group of young adults with osteochondritis dissecans of the knee treated with arthroscopic fixation of the fragment using bioabsorbable pins and nails and to examine the medium-term outcome of the fixation via magnetic resonance imaging and clinical evaluation. Study Design Cohort study; Level of evidence, 3. Methods Twenty-eight patients (30 knees) with osteochondritis dissecans of the knee were treated with arthroscopic fixation using bioabsorbable, self-reinforced poly-L-lactide pins and nails. All patients were young adult males with closed physes. The average follow-up time was 5.4 years (range, 3-12). At follow-up, magnetic resonance imaging studies were used to evaluate subchondral bone healing, and the outcome was evaluated by the Kujala score. Results The functional results were excellent or good for 73% of the patients in the nail group versus 35% in the pin group. The lesions treated were large, with an average size of 447 mm2, affecting the weightbearing area in the majority of the patients. On magnetic resonance imaging, incomplete bone consolidation was predominant in the pin group. Conclusions Arthroscopic fixation with bioabsorbable nails seems to be a suitable method of repair for osteochondritis dissecans of the adult knee and appears to be superior to arthroscopic fixation with bioabsorbable pins.

Popliteomeniscal Fascicle Tears Causing Symptomatic Lateral Compartment Knee Pain

2005 ◽  
Vol 33 (8) ◽  
pp. 1231-1236 ◽  
Author(s):  
Robert F. LaPrade ◽  
Brian K. Konowalchuk
Keyword(s):  
Physical Examination ◽  
Knee Pain ◽  
Open Repair ◽  
Lateral Meniscus ◽  
Case Series ◽  
Lateral Compartment ◽  
Level Of Evidence ◽  
Arthroscopic Examination ◽  
Examination Techniques

Background Injuries to the popliteomeniscal fascicles of the lateral meniscus are difficult to identify from physical examination and magnetic resonance imaging scans. To our knowledge, there have been no described physical examination techniques to identify symptomatic isolated popliteomeniscal fascicle tears. The popliteomeniscal fascicles have been demonstrated to be important for lateral meniscus stability, and it has been reported that tears can lead to painful symptoms. Hypothesis Popliteomeniscal fascicle tears cause symptomatic lateral compartment knee pain and can be diagnosed by physical examination. Surgical repair can improve patient function. Study Design Case series; Level of evidence, 4. Methods Six patients with isolated tears of the popliteomeniscal fascicles, which caused lateral joint line knee pain, were identified by positive figure-4 test results. Results All patients were found to have replication of their symptoms while placing the affected knee in the figure-4 position and were found to have lateral meniscal hypermobility due to tears of the popliteomeniscal fascicles on arthroscopic examination. All patients had an open repair of the popliteomeniscal fascicles of the lateral meniscus with complete resolution of their symptoms at a mean follow-up of 3.8 years postoperatively. Conclusions The figure-4 test was found to be useful in identifying the source of lateral compartment knee pain due to popliteomeniscal fascicle tears. Open repair of isolated popliteomeniscal fascicle tears was also found to be effective in resolving lateral compartment knee pain due to popliteomeniscal fascicle tears.

Gorham–Stout disease of the temporal bone involving the temporomandibular joint

2018 ◽  
Vol 132 (3) ◽  
pp. 279-281 ◽  
Author(s):  
D Mulvihill ◽  
R S Kumar ◽  
J Muzaffar ◽  
R Irving
Keyword(s):  
Temporomandibular Joint ◽  
Temporal Bone ◽  
Symptomatic Treatment ◽  
Resonance Imaging ◽  
Joint Dislocation ◽  
Vascular Channels ◽  
Ear Symptoms ◽  
Temporomandibular Joint Dislocation ◽  
Neurovascular Structures

AbstractBackground:Gorham–Stout disease of the skull is a very rare entity. It presents with gradual bone resorption, and proliferation of lymphoid and vascular channels within the bony matrix. This is often a diagnosis of exclusion confirmed with serial imaging and based on radiological evidence.Case report:A case of Gorham–Stout disease of the temporal bone involving the temporomandibular joint, and presenting with sensorineural hearing loss and recurrent temporomandibular joint dislocation, is reported. The findings are presented and the literature on this condition is reviewed.Conclusion:ENT and maxillofacial surgeons should be aware of this extremely rare cause of temporomandibular joint dislocation and ear symptoms. Imaging comprising computed tomography and magnetic resonance imaging is crucial to achieving a diagnosis, which may only become evident after repeated imaging follow up. Symptomatic treatment is advised, with the option of anti-osteoclastic medication and radiotherapy indicated for advanced cases. Surgery is only recommended for complications including involvement of neurovascular structures.

Forefoot Pain in the Lesser Toes: Anatomical Considerations and Magnetic Resonance Imaging Findings

2019 ◽  
Vol 70 (4) ◽  
pp. 408-415 ◽  
Author(s):  
Tine Hulstaert ◽  
Maryam Shahabpour ◽  
Steven Provyn ◽  
Leon Lenchik ◽  
Philip Simons ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Subcutaneous Tissue ◽  
Accurate Assessment ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Anatomical Features ◽  
Forefoot Pain ◽  
Neurovascular Structures ◽  
Forefoot Disorders

Various conditions may result in forefoot pain. Magnetic resonance (MR) imaging allows accurate assessment of many of these conditions. We provide an overview of forefoot disorders divided into bones, capsule and plantar plate, musculotendinous structures, neurovascular structures, and subcutaneous tissue. We review normal anatomical features as well as MR imaging findings of common disorders.

scholarly journals Clinical and Radiological Outcomes After Autologous Matrix-Induced Chondrogenesis Versus Microfracture of the Knee: A Systematic Review and Meta-analysis With a Minimum 2-Year Follow-up

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712095928
Author(s):  
Jun-Ho Kim ◽  
Jae-Won Heo ◽  
Dae-Hee Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Magnetic Resonance ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Common Procedure ◽  
Subjective Score ◽  
The Mean

Background: Microfracture (MFx) is the most common procedure for treating chondral lesions in the knee; however, initial improvements decline after 2 years. Autologous matrix-induced chondrogenesis (AMIC) may overcome this shortcoming by combining MFx with collagen scaffolds. However, the outcomes of AMIC and MFx in the knee have not been compared. Purpose: To compare the clinical and radiological outcomes of AMIC and MFx over a minimum 2-year follow-up. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified studies of patients who underwent AMIC or MFx and that reported validated clinical outcome measure and/or radiological evaluation findings at a follow-up of ≥2 years. There were 2 reviewers who performed study selection, a risk of bias assessment, and data extraction. Results: Overall, 29 studies were included in this systematic review. The mean improvement on the Lysholm score, Tegner activity scale, and visual analog scale for pain did not differ significantly between the 2 procedures. The mean improvement on the International Knee Documentation Committee (IKDC) subjective score was significantly greater in the AMIC (45.9 [95% CI, 36.2-55.5]) than in the MFx (27.2 [95% CI, 23.3-31.1]) group ( P < .001). In addition, the mean magnetic resonance observation of cartilage repair tissue score was significantly higher in the AMIC (69.3 [95% CI, 55.1-83.5]) versus MFx (41.0 [95% CI, 27.3-54.7]) group ( P = .005), and the mean adequate defect filling rate on magnetic resonance imaging scans was significantly better in the AMIC (77.3% [95% CI, 66.7%-87.9%]) versus MFx (47.9% [95% CI, 29.2%-66.6%]) group ( P = .008) (odds ratio, 1.58 [95% CI, 1.07-2.33]). Conclusion: No significant differences in clinical outcomes, except for the IKDC subjective score, were found between the AMIC and MFx groups. Greater improvement in IKDC subjective scores and magnetic resonance imaging findings were seen in patients treated with AMIC compared with MFx at a minimum 2-year follow-up.

scholarly journals MENISCAL REPAIR RESULTS COMPARING MRI, ARTHRO-MRI, AND ARTHRO-CT

2018 ◽  
Vol 26 (3) ◽  
pp. 166-169
Author(s):  
ADRIANO MARQUES DE ALMEIDA ◽  
MARCELO BORDALO RODRIGUES ◽  
MARCIA UCHÔA DE REZENDE ◽  
ANDRÉ PEDRINELLI ◽  
ARNALDO JOSÉ HERNANDEZ
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Case Series ◽  
Meniscal Repair ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Meniscal Suture ◽  
Imaging Results ◽  
Magnetic Resonance Imaging Mri

ABSTRACT Objective To clinically and radiologically evaluate patients who received meniscal suture using the outside-in technique, comparing magnetic resonance imaging (MRI), arthro-magnetic resonance imaging (arthro-MRI), and arthro-computed tomography (arthro-CT) to evaluate the healing of meniscal sutures. Methods We evaluated eight patients with an average follow-up of 15 months. The evaluation analyzed clinical parameters using the Lysholm and IKDC scores as well as MRI, arthro-MRI, and arthro-CT imaging. Results At the end of the follow-up period, mean Lysholm score was 89.5 and mean IKDC score was 78.6. In the MRI, signs of meniscal healing were observed in 50% of the cases. The arthro-MRI and arthro-CT showed signs of healing in 75% of cases. There was a positive correlation between arthro-MRI and arthro-CT results in all the cases studied (kappa correlation index=1). Conclusion Meniscal suture using the outside-in technique presented good or excellent results in 87.5% of our patients. The arthro-CT and arthro-MRI showed the same level of accuracy in detecting healing of the sutured region of the meniscus. Level of Evidence IV; Case series.

Clinical Consequences of Posttraumatic Bone Bruise in the Knee

2007 ◽  
Vol 35 (6) ◽  
pp. 990-995 ◽  
Author(s):  
Simone S. Boks ◽  
Dammis Vroegindeweij ◽  
Bart W. Koes ◽  
Roos M. D. Bernsen ◽  
M.G. Myriam Hunink ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rating Scale ◽  
Repeated Measurements ◽  
Pain Severity ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Knee Trauma

Background Bone bruise is often seen in posttraumatic knees, but the clinical relevance is unclear. Hypothesis The presence of bone bruise is associated with increased pain severity in patients with sustained knee trauma. Study Design Cohort study; Level of evidence, 2. Methods We collected prospective data of 132 patients visiting their general practitioner after sustained knee trauma. Patients with bone bruise underwent a magnetic resonance imaging follow-up study that was discontinued when the bone bruise could no longer be discerned or after 1 year of follow-up. Bone bruise was assessed on magnetic resonance imaging, and pain severity was scored on a numeric rating scale (0-10) at baseline, and at 3, 6, and 12 months after trauma. The presence of bone bruise and pain severity (over time) were compared using linear regression analyses for repeated measurements. Adjustment was made for possible confounders: presence of meniscal tears, cruciate or collateral ligament ruptures, severe effusion, osteoarthritis, obesity, age, gender, work load, and sports load. Results At baseline as well as during follow-up, bone bruise was associated with a slightly higher pain score. The differences, however, were very small (adjusted difference in pain severity 0.34 or less) and not statistically significant nor clinically relevant. Conclusion There is no statistically significant relationship, nor a clinically relevant relationship, between the presence of bone bruise and pain severity in patients with sustained knee injury in general practice.

scholarly journals Femoral Avulsion of the Medial Patellofemoral Ligament after Primary Traumatic Patellar Dislocation Predicts Subsequent Instability in Men

2009 ◽  
Vol 37 (8) ◽  
pp. 1513-1521 ◽  
Author(s):  
Petri J Sillanpää ◽  
Erno Peltola ◽  
Ville M. Mattila ◽  
Martti Kiuru ◽  
Tuomo Visuri ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Patellar Dislocation ◽  
Medial Patellofemoral Ligament ◽  
Activity Level ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Cartilage Lesions

Background The clinical relevance of medial patellofemoral ligament (MPFL) injury location in primary patellar dislocation has not been studied. Hypothesis Prognosis after primary traumatic patellar dislocation may vary by MPFL injury location. Study Design Cohort study; Level of evidence, 3. Methods The initial magnetic resonance imaging (MRI) findings in 53 patients with identical nonoperative management were retrospectively analyzed for medial restraint injuries. The MPFL injury sites were classified as follows: femoral, midsubstance, and patellar. Magnetic resonance imaging was used to assess initial and control articular cartilage lesions in the patellofemoral joint. After a mean follow-up of 7 years, 42 patients were evaluated for redislocations, subjective symptoms, and functional limitations. Results Based on the initial MRIs, MPFL rupture was classified as femoral in 35 patients, midsubstance in 11, and patellar in 7. At follow-up, 15 patients reported an unstable patella (13 femoral, 1 patellar, 1 midsubstance; P =. 01) and 9 reported patellar redislocations (8 femoral, 1 midsubstance; P =. 05). The proportion of patients who regained their preinjury activity level was significantly smaller among those with femoral MPFL injury than among those with midsubstance or patellar MPFL injury (P =. 05). The median Kujala score was as follows: 90 for femoral, 91 for patellar, and 96 for midsubstance (P =. 76). Control MRI showed full-thickness patellofemoral cartilage lesions in 50% of the patients, unrelated to MPFL injury location. Conclusion An MPFL avulsion at the femoral attachment in primary traumatic patellar dislocations predicts subsequent patellar instability. The authors suggest that MPFL injury location be taken into account when planning treatment of primary traumatic patellar dislocation.

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