Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

2021 ◽  
Vol 25 (02) ◽  
pp. 355-365
Author(s):  
Alain G. Blum ◽  
Marnix T. van Holsbeeck ◽  
Stefano Bianchi
Keyword(s):  
Soft Tissues ◽  
Imaging Techniques ◽  
Metacarpophalangeal Joint ◽  
Resonance Imaging ◽  
Ligament Injuries ◽  
First Line ◽  
Collateral Ligament ◽  
Traumatic Injuries ◽  
Line Imaging

AbstractThe motor function of the thumb and its alignment with regard to the hand make it particularly vulnerable to trauma. Pathology encountered in this joint is varied, and imaging techniques play a crucial role in the diagnosis and characterization of injury. Despite advances in imaging technology, acute thumb injuries remain a challenge for radiologists. Currently, standard radiography and ultrasonography are frequently used first-line imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations. Magnetic resonance imaging may be used to optimally characterize soft tissues and bone marrow. In this article, we cover the most common traumatic injuries: fractures, dislocations, collateral ligament injuries of the metacarpophalangeal joint, as well as soft tissue lesions.

scholarly journals Cross-sectional anatomy, computed tomography, and magnetic resonance imaging of the banded houndshark (Triakis scyllium)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang Wha Kim ◽  
Adams Hei Long Yuen ◽  
Cherry Tsz Ching Poon ◽  
Joon Oh Hwang ◽  
Chang Jun Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Imaging Techniques ◽  
Evolutionary Developmental Biology ◽  
Phylogenetic Position ◽  
Ct Scanner ◽  
Resonance Imaging ◽  
Cross Sectional

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.

Pulley, Flexor, and Extensor Tendon Injuries of the Hand

2021 ◽  
Vol 25 (02) ◽  
pp. 203-215
Author(s):  
Andrea B. Rosskopf ◽  
Mihra S. Taljanovic ◽  
Luca M. Sconfienza ◽  
Salvatore Gitto ◽  
Carlo Martinoli ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Resonance Imaging ◽  
First Line ◽  
A2 Pulley ◽  
Dynamic Examination ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Extensor Tendon Injuries

AbstractTendon injuries represent the second most common injury of the hand (after fractures) and are a common scanning indication in radiology. Pulley injuries are very frequent in rock climbers with the A2 pulley the most commonly affected. Tendon and pulley injuries can be reliably evaluated using ultrasound (US) and magnetic resonance imaging (MRI). US can be postulated as a first-line imaging modality, allowing dynamic examination. MRI is essential for cases with ongoing diagnostic doubt post-US and also for preoperative pulley reconstruction assessment.

scholarly journals Diagnostic value of four-dimensional computed tomography and four-dimensional magnetic resonance imaging in primary hyperparathyroidism when first-line imaging was inadequate

2020 ◽  
Vol 102 (4) ◽  
pp. 294-299
Author(s):  
N Acar ◽  
M Haciyanli ◽  
M Coskun ◽  
NK Erdogan ◽  
SC Celik ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Primary Hyperparathyroidism ◽  
Dynamic Imaging ◽  
Successful Outcome ◽  
Preoperative Imaging ◽  
Resonance Imaging ◽  
First Line ◽  
Line Imaging

Introduction Accurate localisation of the abnormal hyperfunctioning gland with preoperative imaging has a critical role in parathyroid surgery to obtain a successful outcome. This study aimed to evaluate the diagnostic performance of second-line imaging and their contribution to the treatment success in primary hyperparathyroidism when the first-line methods were negative or discordant. Methods Among the patients who underwent parathyroidectomy due to primary hyperparathyroidism, 33 who underwent four-dimensional computed tomography and/or four-dimensional magnetic resonance imaging because of negative or discordant first-line imaging results were included. Persistent and recurrent cases were excluded. Results The majority of the patients were female (84.8%) and the mean age was 59.2 years. Seventeen patients had four-dimensional computed tomography and 25 had four-dimensional magnetic resonance imaging, respectively. Four-dimensional computed tomography and four-dimensional magnetic resonance imaging localised the culprit gland successfully in 52.9% and 84%, respectively. Twenty-five patients in whom single adenoma was detected underwent focused parathyroidectomy. The culprit gland was solitary in 32 cases and one patient had double adenoma. Normocalcaemia was achieved in all cases. Among the 29 patients who completed their postoperative sixth month success rate was 100%. Conclusion Four-dimensional magnetic resonance imaging had high accuracy with fast dynamic imaging in detecting parathyroid adenomas. When the first-line imaging methods were negative or inconclusive, four-dimensional magnetic resonance imaging should be considered primarily since it is cost effective in Turkey and emits no radiation.

scholarly journals Characterization of Focal Liver Lesions using Contrast Enhanced Ultrasound as a First Line Method: a Large Monocentric Experience

2014 ◽  
Vol 23 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Ioan Sporea ◽  
Alina Martie ◽  
Simona Bota ◽  
Roxana Sirli ◽  
Alina Popescu ◽  
...  
Keyword(s):  
Focal Liver Lesions ◽  
Imaging Method ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
First Line ◽  
Clear Cut ◽  
Contrast Enhanced ◽  
Line Imaging ◽  
Conclusive Diagnosis

Aim: To present a large monocentric experience in the characterization of focal liver lesions (FLLs) using Contrast Enhanced Ultrasound (CEUS).Method: A retrospective study was performed in the Gastroenterology and Hepatology Department, Timisoara, including 1100 patients with 1329 FLLs evaluated between September 2009 and January 2013. A CEUS examination was considered conclusive if the FLL respected the typical enhancement pattern as described in the EFSUMB Guidelines.Results: From the 1329 FLLs, CEUS was conclusive for a specific pathology in 1102 cases (82.9%). For the differentiation of benign/malignant lesions, CEUS reached a conclusive diagnosis in 1196 (90%) cases. The percentage of conclusive CEUS examinations was significantly higher in patients without chronic liver disease as compared with those with chronic hepatopathies: 87.3% vs. 74.4% (p<0.0001).Conclusion: CEUS patterns of enhancement fell into clear cut specific diagnostic patterns in 83% of the FLLs discovered by US, and into clear cut benign versus malignant patterns in 90% of the cases. For this reason, we can strongly recommend CEUS as a first line imaging method to characterize FLLs found at US, at least in centers with a good experience in CEUS.

Magnetic resonance imaging–based classification for ulnar collateral ligament injuries of the elbow

2016 ◽  
Vol 25 (10) ◽  
pp. 1710-1716 ◽  
Author(s):  
Patrick W. Joyner ◽  
Jeremy Bruce ◽  
Ryan Hess ◽  
Arron Mates ◽  
Frederic Baker Mills ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Ulnar Collateral Ligament ◽  
Resonance Imaging ◽  
Ligament Injuries ◽  
Collateral Ligament

A Cyclooxygenase-2 Inhibitor Impairs Ligament Healing in the Rat

2001 ◽  
Vol 29 (6) ◽  
pp. 801-805 ◽  
Author(s):  
Christopher L. Elder ◽  
Laurence E. Dahners ◽  
Paul S. Weinhold
Keyword(s):  
Medial Collateral Ligament ◽  
Soft Tissues ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Cyclooxygenase 2 ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Antiinflammatory Drugs ◽  
Increased Risk ◽  
Ligament Healing ◽  
Specific Inhibitors

Celecoxib was the first of a new class of nonsteroidal antiinflammatory drugs, the cyclooxygenase-2 (COX-2) specific inhibitors, marketed as having the same antiinflammatory efficacy as other nonsteroidal antiinflammatory drugs without their increased risk of gastrointestinal ulceration. Among the widest uses of nonsteroidal antiinflammatory drugs is in the treatment of acute soft tissue injuries. Although the benefits of celecoxib have been shown when used for rheumatoid arthritis and osteoarthritis, we are unaware of any studies concerning its effect on soft tissues. We used the surgically incised medial collateral ligament of male Sprague-Dawley rats as an experimental model for acute ligament injuries to investigate the effects of celecoxib on ligament healing. Fifty rats underwent surgical transection of the right medial collateral ligament. Postoperatively, half were given celecoxib for the first 6 days of recovery, the other half were not. The animals were sacrificed 14 days after the operation, and both the injured and uninjured medial collateral ligaments were mechanically tested to failure in tension. Celecoxib-treated/injured ligaments were found to have a 32% lower load to failure than untreated/ injured ligaments. The results of this study do not support use of cyclooxygenase-2 specific inhibitors in the treatment of ligament injuries.

scholarly journals Efficiency of magnetic resonance imaging for diagnosing unstable ligament injuries around the thumb metacarpophalangeal joint: A comparison to arthroscopy

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902097830
Author(s):  
Yong-Eun Shin ◽  
Sung-Joon Kim ◽  
Jeong-Sang Kim ◽  
Kwon-Young Kwak ◽  
Ji-Hyo Kim ◽  
...  
Keyword(s):  
Metacarpophalangeal Joint ◽  
Complete Agreement ◽  
Ligament Injuries ◽  
Collateral Ligament ◽  
Mri Findings ◽  
3.0 Tesla ◽  
Acute Injuries ◽  
Diagnostic Arthroscopy ◽  
Arthroscopic Findings ◽  
Sensitivity Specificity

Purpose: This study aimed to assess the accuracy of MRI in identifying ulnar collateral ligament (UCL), radial collateral ligament (RCL), and volar plate (VP) injuries of the metacarpophalangeal joint (MCPJ) of the thumb by comparing with diagnostic arthroscopy. Methods: A total of 56 consecutive patients (56 thumbs) who underwent arthroscopy of MCPJ of thumb were enrolled. MRI findings reviewed by consensus reading of two blinded radiologists were compared with arthroscopic examination. Statistical data, including sensitivity, specificity, accuracy, were analyzed. Additionally, the performance characteristics between 3.0-tesla (39 thumbs) and 1.5-tesla (17 thumbs) MRI and acute (≤4 weeks after injury) and chronic (>4 weeks) injuries were compared. Results: Of the 56 thumbs, 38 thumbs (67.9%) showed complete correspondence between MRI and arthroscopic findings. The sensitivity, specificity and accuracy of MRI for detecting UCL injuries were 78.8%, 87.0%, and 82.1%, respectively. The sensitivity, specificity and accuracy of MRI for detecting RCL injuries were 85.7%, 91.4%, and 85.7%, respectively. The sensitivity, specificity, and accuracy of MRI for detecting VP injuries were 89.5%, 89.2%, and 81.0%, respectively. 3.0-tesla MRI showed higher correspondence with arthroscopic observation (76.9%) than 1.5-tesla MRI (47.1%) (p = 0.028). For acute injuries, 78.4% showed complete correspondence between MRI and arthroscopic findings, whereas 47.4% with chronic injuries revealed complete agreement (p = 0.019). Conclusion: Overall, MRI is moderately effective in evaluating ligamentous lesions around MCPJ of thumb, but MRI is more sensitive in diagnosing acute injuries. Furthermore, 3.0-tesla MRI can provide results with better accuracy for diagnosing ligamentous lesions around MCPJ of thumb. However, the sensitivity and the specificity are not applicable to all ligament injuries, but only the severe one which would agree for surgical options.

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