Thumb Injuries and Instabilities. Part 1: Anatomy, Kinesiology, and Imaging Techniques of the Thumb

2021 ◽  
Vol 25 (02) ◽  
pp. 346-354
Author(s):  
Alain G. Blum ◽  
Marnix T. van Holsbeeck ◽  
Stefano Bianchi

AbstractThe unique anatomical characteristics of the thumb offer a broad range of motion and the ability to oppose thumb and finger, an essential function for grasping. The motor function of the thumb and its orientation make it particularly vulnerable to trauma. Pathologic lesions encountered in this joint are varied, and imaging techniques play a crucial role in injury detection and characterization. Despite advances in diagnostic accuracy, acute thumb injuries pose a challenge for the radiologist. The complex and delicate anatomy requires meticulous and technically flawless image acquisition. Standard radiography and ultrasonography are currently the most frequently used imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations, and magnetic resonance imaging may be useful in equivocal cases. In this article, we present the relevant anatomy and imaging techniques of the thumb.

2001 ◽  
pp. 499-507 ◽  
Author(s):  
A Colao ◽  
A Faggiano ◽  
R Pivonello ◽  
FP Giraldi ◽  
F Cavagnini ◽  
...  

OBJECTIVE: To evaluate the diagnostic accuracy of inferior petrosal sinus sampling (IPSS) in the differential diagnosis of ACTH-dependent Cushing's syndrome as compared with pituitary imaging techniques. DESIGN AND METHODS: We retrospectively studied the diagnostic accuracy of basal and post corticotropin-releasing hormone (CRH) IPSS, magnetic resonance imaging and computed tomography in distinguishing pituitary from ectopic ACTH secretion in 97 Cushing's syndrome patients: 74 with Cushing's disease (CD) and 10 with ectopic ACTH secretion (EAS). Thirteen patients were excluded because of unconfirmed diagnosis. The difference between IPSS and pituitary imaging techniques in the correctly localized pituitary adenoma in the patients with CD was also investigated. RESULTS: The basal ACTH inferior petrosal sinus:periphery (IPS:P) ratio was > or = 2 in 63/74 patients with CD (85%), and in 1/10 EAS patients (10%); after stimulation with CRH, the ratio was > or = 3 in 60/68 patients with CD (88%) and < 3 in all patients with EAS. The basal and post-CRH ACTH IPS:P ratios had a diagnostic accuracy of 86% and 90% respectively. The diagnostic accuracy of IPSS with both ratios was significantly higher than magnetic resonance imaging (50%) and computed tomography (40%). The IPS:P ratio suggested by receiver-operator characteristic (ROC) analysis that better distinguished CD from EAS was 2.10 for the basal and 2.15 for the post-CRH ratios. Using these cut-offs, the specificity of basal ratio and the sensitivity of the post-CRH test rose to 100% and 93% respectively. Diagnostic accuracy remained substantially unchanged for the basal ratio (87% vs 86%), while it rose from 90% to 94% for the post-CRH ratio. The sensitivity of IPSS was significantly higher than that of magnetic resonance and computerized tomography. IPSS was less reliable in identifying the adenoma site found at surgery than magnetic resonance imaging or computed tomography (65% vs 75% and 79% respectively). CONCLUSION: In conclusion, IPSS improved the diagnostic performance of imaging techniques. It can help in excluding transsphenoidal surgery in EAS patients. More striking results were obtained when a > or = 2.1:1 basal ratio or a > or = 2.15:1 post-CRH ratio were considered as criteria to distinguish between patients with CD and EAS. To establish correctly the location of the pituitary adenoma, IPSS is less reliable than imaging techniques.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang Wha Kim ◽  
Adams Hei Long Yuen ◽  
Cherry Tsz Ching Poon ◽  
Joon Oh Hwang ◽  
Chang Jun Lee ◽  
...  

AbstractDue to their important phylogenetic position among extant vertebrates, sharks are an invaluable group in evolutionary developmental biology studies. A thorough understanding of shark anatomy is essential to facilitate these studies and documentation of this iconic taxon. With the increasing availability of cross-sectional imaging techniques, the complicated anatomy of both cartilaginous and soft tissues can be analyzed non-invasively, quickly, and accurately. The aim of this study is to provide a detailed anatomical description of the normal banded houndshark (Triakis scyllium) using computed tomography (CT) and magnetic resonance imaging (MRI) along with cryosection images. Three banded houndsharks were scanned using a 64-detector row spiral CT scanner and a 3 T MRI scanner. All images were digitally stored and assessed using open-source Digital Imaging and Communications in Medicine viewer software in the transverse, sagittal, and dorsal dimensions. The banded houndshark cadavers were then cryosectioned at approximately 1-cm intervals. Corresponding transverse cryosection images were chosen to identify the best anatomical correlations for transverse CT and MRI images. The resulting images provided excellent detail of the major anatomical structures of the banded houndshark. The illustrations in the present study could be considered as a useful reference for interpretation of normal and pathological imaging studies of sharks.


2017 ◽  
Author(s):  
Gerald W. Staton Jr ◽  
Phuong-Anh T. Duong

Chest imaging techniques are evolving with recent advances in computed tomography, magnetic resonance imaging, and ultrasonography. While conventional radiography remains an important screening tool because of its low relative cost, ease of acquisition, general availability, and familiarity, physicians must understand all techniques so as to provide patients with the most appropriate diagnostic imaging. Consultation with radiologists, use of online clinical decision support, and adherence to national guidelines such as the American College of Radiology Appropriateness Criteria®, can help clinicians make imaging decisions, especially in light of medical imaging risks that are of concern in the medical community and the general population. Choosing appropriate imaging, including whether or not to image, requires careful consideration. This review contains 6 figures, 3 tables, and 6 references. Key Words: Chest Radiographs, Dual-Energy Chest Radiographs, Computed Tomography, High-Resolution Chest Computed Tomography, Multidetector Row Computed Tomography, Computed Tomographic Angiography for Pulmonary Embolism, Magnetic Resonance Imaging, Single-Photon Emission Tomography (SPECT), Ultrasonography 


2017 ◽  
Author(s):  
Emily Alanna Aherne ◽  
Sinchun Hwang

Medical imaging plays a pivotal role in the detection, diagnosis, and clinical management of primary soft tissue tumors. Various imaging modalities have been used, and each modality offers unique advantages in the workup of soft tissue tumors by localizing the lesions in different compartments of the body and characterizing macroscopic tissue composition of the lesions in a noninvasive and safe manner. We review the clinical role and technical aspects of the frequently used imaging modalities, including magnetic resonance imaging (MRI), computed tomography, ultrasonography, positron emission tomography, and plain radiography with an emphasis on MRI as a mainstay imaging modality and a brief discussion of advanced techniques. We also review imaging features of common soft tissue tumors that can be detected and characterized using current imaging techniques. This review contains 54 figures, 1 table and 37 references.   Key words: computed tomography, diffusion-weighted imaging, imaging, magnetic resonance imaging, positron emission tomography, soft tissue, technique, tumor, ultrasonography


Author(s):  
Hugh Markus ◽  
Anthony Pereira ◽  
Geoffrey Cloud

Imaging plays a key role in the investigation in stroke, both to confirm the diagnosis and rule out other causes, and also to determine the underlying aetiology. This chapter covers the different imaging techniques which are commonly used in stroke care. It discusses the use of computed tomography and magnetic resonance imaging in diagnosis of both ischaemic and haemorrhagic stroke. It also covers the various angiographic imaging techniques that can be used to identify the presence of extra- and intracranial stenoses.


2019 ◽  
Vol 36 (1) ◽  
pp. 37-44
Author(s):  
Jessica T. Prince

This review explores the classification and evaluation of suspicious renal lesions across several radiologic imaging modalities. Diagnostic medical sonography (DMS), computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS) are the primary modalities used to investigate questionable lesions found within the kidneys. Renal masses may range from completely benign to malignant. They are classified based on many different features and characteristics. These lesions may be simple cystic, complex cystic, or solid in nature. Masses may also exhibit varying degrees of vascularity, septations, and calcifications. The discussed imaging modalities have varying strengths, limitations, and implications for use. Imaging techniques may be used independently or in conjunction to best diagnose and treat a patient with a suspicious renal mass. The aim of this review was to describe the diagnostic value of the imaging modalities (DMS, CT, MRI, and CEUS) and their role in the evaluation of suspicious renal lesions.


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