Differentiating Subchondral Insufficiency Fracture from Osteonecrosis May Help Avoid Unnecessary Total Hip Arthroplasty

2018 ◽  
Vol 02 (01) ◽  
pp. 047-053
Author(s):  
Joaquin Moya-Angeler ◽  
R Haring ◽  
Angela Li ◽  
Harry Greditzer IV ◽  
Joseph Lane ◽  
...  
Keyword(s):  
Clinical Features ◽  
Nonoperative Management ◽  
Insufficiency Fracture ◽  
Resonance Imaging ◽  
Mineral Density ◽  
Mri Findings ◽  
Subchondral Insufficiency Fracture ◽  
X Ray ◽  
Magnetic Resonance Imaging Mri ◽  
Parallel Band

AbstractDifferentiation of subchondral insufficiency fracture (SIF) from osteonecrosis (ON) is clinically important. The purpose of this study is to correlate the X-ray and magnetic resonance imaging (MRI) findings in cases that have been diagnosed histopathologically as SIF or ON, define features on X-ray and MRI analysis, and identify clinical features that may aid in the diagnosis of SIF from ON. Two blinded radiologists evaluated 104 femoral heads that were diagnosed on histopathology as either ON or SIF. Radiographs and MRIs were evaluated for pertinent radiologic features. If a low signal intensity band was present on MRI, size/depth, shape (parallel/concave/serpentine), and consistency (fatty/edematous/fibrous/mixed) were characterized. About 48.1% of SIF cases were misdiagnosed on X-ray. On MRI, SIF was associated with the presence of a parallel band (p < 0.001), while ON was associated with a serpentine band (p < 0.001). Fifty-eight percent of SIF cases had low intensity signal bands that were fibrous (p < 0.001), while 86% of ON cases had mixed signal bands (p < 0.001). Mean depth for SIF and ON patients was 1.56 mm and 15.36 mm, respectively. Women with bone mineral density <  − 1, and age > 50 years had higher odds of SIF (p = 0.047, p = 0.014, p = 0.034, respectively). SIF is often misdiagnosed on X-ray, and the presence, shape, quality, and depth of the band on MRI can help distinguish SIF from ON. Patients with inconclusive X-ray findings with clinical features that match potential SIF should be considered for MRI. It is reasonable to allow for nonoperative management before recommending operative procedures in patients suspected of having SIF, as these fractures may be possibly managed conservatively.

scholarly journals A Clinical Prospective Observational Cohort Study on the Prevalence and Primary Diagnostic Accuracy of Occult Vertebral Fractures in Aged Women with Acute Lower Back Pain Using Magnetic Resonance Imaging

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Atsushi Terakado ◽  
Sumihisa Orita ◽  
Kazuhide Inage ◽  
Go Kubota ◽  
Tomohiro Kanzaki ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Back Pain ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Elderly Women ◽  
Resonance Imaging ◽  
Mineral Density ◽  
X Ray ◽  
Acute Low Back Pain ◽  
Magnetic Resonance Imaging Mri

Background.Elderly female patients complaints of acute low back pain (LBP) may involve vertebral fracture (VF), among which occult VF (OVF: early-stage VF without any morphological change) is often missed to be detected by primary X-ray examination. The current study aimed to investigate the prevalence of VF and OVF and the diagnostic accuracy of the initial X-ray in detecting OVF.Method.Subjects were elderly women (>70 years old) complaining of acute LBP with an accurate onset date. Subjects underwent lumbar X-ray, magnetic resonance imaging (MRI), and bone mineral density (BMD) measurement at their first visit. The distribution of radiological findings from X-ray and magnetic resonance imaging (MRI) as well as the calculation of the prevalence of VF and OVF are investigated.Results. The prevalence of VF among elderly women with LBP was 76.5% and L1 was the most commonly injured level. Among VF cases, the prevalence of OVF was 33.3%. Furthermore, osteoporotic patients tend to show increased prevalence of VF (87.5%). The predictive values in detecting VF on the initial plain X-ray were as follows: sensitivity, 51.3%; specificity, 75.0%; and accuracy rate, 56.7%.Conclusions.Acute LBP patients may suffer vertebral injury with almost no morphologic change in X-ray, which can be detected using MRI.

Radiological and Magnetic Resonance Imaging Findings in the Sacroiliac Joints in Patients with early Spondylarthropathy

2008 ◽  
Vol 1 ◽  
pp. CMAMD.S917 ◽  
Author(s):  
Reijo Luukkainen ◽  
Kimmo O.J. Virtanen ◽  
Pekka Luukkainen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Low Back ◽  
Hla B27 ◽  
Resonance Imaging ◽  
Poor Agreement ◽  
Mri Findings ◽  
X Ray ◽  
Magnetic Resonance Imaging Mri ◽  
Posterior Anterior

Objective To compare the radiological (X-ray) and magnetic resonance imaging (MRI) findings in the sacroiliac (SI) joints in patients with early spondylarthropathy (SpA). Methods Forty consecutive HLA B27 antigen positive patients with early SpA and inflammatory low back pain (LBP) were studied. Their SI joints were investigated by posterior anterior plain X-ray and MRI. Results The X-ray and MRI examinations gave similar results in the SI joints in 24 patients, whereas they differed in 16, this difference being significant (p = 0.007). In those 16 patients, in whom the findings differed, the X-ray findings were normal but MRI showed sacroiliitis which was bilateral in 13 and unilateral in 3 patients. The kappa coefficient between these investigations was 0.346, showing poor agreement. Conclusion These results indicate that MRI may considerably improve the diagnosis of sacroiliitis in HLA B27 antigen positive patients with early SpA and inflammatory LBP.

scholarly journals Isolated calcific tendinitis at the posterosuperior labrum: a rare case study

2020 ◽  
Vol 23 (4) ◽  
pp. 194-197
Author(s):  
Dong-Hwan Suh ◽  
Jong-Hun Ji ◽  
Chang-Yeon Kim
Keyword(s):  
Shoulder Joint ◽  
Rare Case ◽  
Calcific Tendinitis ◽  
Resonance Imaging ◽  
Mri Findings ◽  
X Ray ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Calcific tendinitis of the shoulder joint, also known as chemical furuncle of the shoulder, causes intense shoulder pain and usually occurs within 1–2 cm from the insertion of the rotator cuff. We experienced a rare case of calcific tendinitis in the posterosuperior labrum of the shoulder joint in a 39-year-old male patient who presented with severe pain and weakness in the right shoulder. Radiographs and magnetic resonance imaging (MRI) findings showed calcific tendinitis in the posterosuperior labrum of the shoulder joint. A 1-week attempt at conservative treatment failed, so the calcified deposit in the posterosuperior labrum was arthroscopically removed. The patient’s symptoms were completely relieved, and satisfactory clinical outcomes were achieved. Postoperative follow-up X-ray and MRI showed no recurrence of calcific tendinitis.

Computed Tomography and Magnetic Resonance Imaging-aided Diagnosis of Primary Essential Cutis Verticis Gyrata: A Case Report with 5-year Follow-up and Review of the Literature

2019 ◽  
Vol 15 (9) ◽  
pp. 906-910
Author(s):  
Hongzhang Zhu ◽  
Shi-Ting Feng ◽  
Xingqi Zhang ◽  
Zunfu Ke ◽  
Ruixi Zeng ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Stable Condition ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Cutis Verticis Gyrata ◽  
Essential Form ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Background: Cutis Verticis Gyrata (CVG) is a rare skin disease caused by overgrowth of the scalp, presenting as cerebriform folds and wrinkles. CVG can be classified into two forms: primary (essential and non-essential) and secondary. The primary non-essential form is often associated with neurological and ophthalmological abnormalities, while the primary essential form occurs without associated comorbidities. Discussion: We report on a rare case of primary essential CVG with a 4-year history of normal-colored scalp skin mass in the parietal-occipital region without symptom in a 34-year-old male patient, retrospectively summarizing his pathological and Computer Tomography (CT) and magnetic resonance imaging (MRI) findings. The major clinical observations on the CT and MR sectional images include a thickened dermis and excessive growth of the scalp, forming the characteristic scalp folds. With the help of CT and MRI Three-dimensional (3D) reconstruction techniques, the characteristic skin changes could be displayed intuitively, providing more evidence for a diagnosis of CVG. At the 5-year followup, there were no obvious changes in the lesion. Conclusion: Based on our observations, we propose that not all patients with primary essential CVG need surgical intervention, and continuous clinical observation should be an appropriate therapy for those in stable condition.

scholarly journals Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Management Strategies ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Demyelinating Lesions ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Regions

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.

scholarly journals Relationship between abnormalities detected by magnetic resonance imaging and knee symptoms in early knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Osteoarthritis ◽  
Cartilage Damage ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Radiographic Evidence ◽  
Cross Sectional ◽  
Meniscal Lesions ◽  
Magnetic Resonance Imaging Mri

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.

scholarly journals Canine Choroid Plexus Tumor with Intracranial Dissemination Presenting as Multiple Cystic Lesions

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Trisha J. Oura ◽  
Peter J. Early ◽  
Samuel H. Jennings ◽  
Melissa J. Lewis ◽  
Jeremy R. Tobias ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Brain Lesions ◽  
Behavioral Changes ◽  
Cystic Lesions ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Choroid Plexus Tumor ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Characteristics ◽  
Possible Cause

A Miniature Pinscher developed acute blindness and behavioral changes. On magnetic resonance imaging (MRI), there were multiple small intra-axial cystic lesions, and primary differential diagnoses included primary or metastatic neoplasia and neurocysticercosis. These cystic lesions were subsequently diagnosed histopathologically as disseminated choroid plexus carcinoma. This is only the second documented description of this diagnosis in a dog, but both patients had very similar MRI findings. This patient adds to the literature about the MRI characteristics of choroid plexus tumors and indicates that choroid plexus tumor should be considered as a possible cause of small multifocal intra-axial cystic brain lesions in dogs, regardless of whether a primary intraventricular lesion is visible.

Transperineal Ultrasonographic and Magnetic Resonance Imaging Findings of Vaginal Adenosis

2021 ◽  
Vol 17 ◽  
Author(s):  
Sebnem Karasu ◽  
Atilla Hikmet Cilengir ◽  
Irfan Ocal ◽  
Serpil Aydogmus
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Chronic Pelvic Pain ◽  
English Literature ◽  
Vaginal Wall ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Proven Case ◽  
Magnetic Resonance Imaging Mri

Background: Vaginal adenosis is a rare clinicopathological entity which refers to the presence of glandular endometrial tissue in the vaginal wall. Case report: A gravida 46-year-old woman was presented to the gynecology department with symptoms of chronic pelvic pain. Maternal Diethylstilbestrol (DES) usage has been proven effective in the development of vaginal adenosis. It can also be idiopathic. Its sonographic or magnetic resonance imaging (MRI) findings have not been described in English literature previously. Conclusion: Here, we report the clinical, transperineal ultrasonographic (US) and MRI findings of a pathologically proven case of vaginal adenosis.

scholarly journals Magnetic resonance imaging and pathological features of a mixed glioma in a dog: case report

2018 ◽  
Vol 70 (5) ◽  
pp. 1383-1387 ◽  
Author(s):  
T.M. Granato ◽  
L.P. Mesquita ◽  
R.C. Costa ◽  
J.P. Andrade Neto ◽  
P.C. Maiorka
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pathological Features ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Neoplastic Cells ◽  
Temporal Lobes ◽  
Mixed Glioma ◽  
Perilesional Edema ◽  
Magnetic Resonance Imaging Mri

ABSTRACT The aim of this report was to describe the magnetic resonance imaging (MRI) and pathological features of a canine mixed glioma. A 12-year-old boxer male dog was presented for necropsy along with data from an MRI evaluation conducted ante-mortem. The images were examined and showed a poorly demarcated prosencephalic lesion, hyperintense on T2W images, hypointense on T1W images and heterogeneously hyperintense on T2W FLAIR images. There was mild nonuniform contrast enhancement, apparent midline shift, moderate perilesional edema and marked distortion of the adjacent lateral ventricle. The brain was evaluated macroscopically, microscopically and immunohistochemically. Grossly, there was a poorly demarcated soft mass, with areas of hemorrhage, within the left parietal and temporal lobes. Histologically, there was a densely cellular mass composed of two geographically distinct populations of neoplastic cells. The first population was composed of small and round cells organized in a honeycomb pattern. The second population constituted of intermingled streams and bundles of neoplastic cells that were strongly immunolabeled for glial fibrillary acidic protein (GFAP). The diagnosis of a mixed glioma was based on MRI findings, and mainly on histological and immunohistochemical findings.

Sign in / Sign up

Export Citation Format

Share Document