Internal Derangement of the Knee

2019 ◽  
pp. 247-269
Author(s):  
Ankur Garg
Keyword(s):  
Articular Cartilage ◽  
Imaging Modality ◽  
Imaging Study ◽  
Internal Derangement ◽  
Collateral Ligaments ◽  
Musculoskeletal Mri ◽  
Knee Pathology ◽  
Excellent Tool ◽  
General Technical ◽  
Technical Considerations

Chapter 108 focuses on knee MRI, first discussing some general technical considerations of musculoskeletal MRI, and then discussing individual components, including the menisci, cruciate and collateral ligaments and articular cartilage, which often contribute to knee pathology. After initial radiographic assessment, MRI is the most helpful imaging modality to detect internal derangement of the knee, and the knee is the most commonly ordered extremity MRI examination. MRI is an extremely powerful tool for determining the source of the patient’s symptoms and directing future treatment, and it is the most sensitive imaging study to evaluate the menisci, ligaments, tendons, and muscles in the setting of knee pain or instability. Additionally, MRI is also an excellent tool to evaluate the bones and articular cartilage.

Area of cartilage accessible to curettage for subsequent arthrodesis of the equine proximal interphalangeal joint

2013 ◽  
Vol 26 (06) ◽  
pp. 489-492 ◽  
Author(s):  
S. Berchtold ◽  
J. M. Kuemmerle
Keyword(s):  
Articular Cartilage ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Disease ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Contralateral Limb ◽  
Conventional Procedure ◽  
Articular Cartilage Surface ◽  
The Difference

SummaryThis study compared the areas of cartilage accessible for curettage in arthrodesis of the equine proximal interphalangeal joint using the conventional and collateral ligament sparing approaches. For this purpose, forelimbs and hindlimbs of six equine cadavers without radiographic evidence of proximal interphalangeal joint disease were used. One limb of each pair of limbs was randomly assigned to a dissection using a standard approach to the proximal interphalangeal joint including transection of the collateral ligaments, while each contralateral limb was exposed using the same approach but leaving the collateral ligaments intact. Hohmann retractors and Spratt curettes were then used to remove as much articular cartilage as possible. Finally, proximal interphalangeal joints were photographed and image analysis was performed.Using the collateral ligament sparing procedure, the mean percentage of articular cartilage surface removed (41.2%) was significantly less than using the conventional procedure (79.6%) (p <0.01). The difference between forelimbs and hindlimbs was not significant.

scholarly journals A serial multiparametric quantitative magnetic resonance imaging study to assess proteoglycan depletion of human articular cartilage and its effects on functionality

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tobias Hafner ◽  
Justus Schock ◽  
Manuel Post ◽  
Daniel Benjamin Abrar ◽  
Philipp Sewerin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Articular Cartilage ◽  
Magnetic Resonance ◽  
Statistical Tests ◽  
T2 Mapping ◽  
Imaging Study ◽  
Proton Density ◽  
Human Articular Cartilage ◽  
Resonance Imaging ◽  
Condylar Cartilage

Abstract Water, collagen, and proteoglycans determine articular cartilage functionality. If altered, susceptibility to premature degeneration is increased. This study investigated the effects of enzymatic proteoglycan depletion on cartilage functionality as assessed by advanced Magnetic Resonance Imaging (MRI) techniques under standardized loading. Lateral femoral condylar cartilage-bone samples from patients undergoing knee replacement (n = 29) were serially imaged by Proton Density-weighted and T1, T1ρ, T2, and T2* mapping sequences on a clinical 3.0 T MRI scanner (Achieva, Philips). Using pressure-controlled indentation loading, samples were imaged unloaded and quasi-statically loaded to 15.1 N and 28.6 N, and both before and after exposure to low-concentrated (LT, 0.1 mg/mL, n = 10) or high-concentrated trypsin (HT, 1.0 mg/mL, n = 10). Controls were not treated (n = 9). Responses to loading were assessed for the entire sample and regionally, i.e. sub- and peri-pistonally, and zonally, i.e. upper and lower sample halves. Trypsin effects were quantified as relative changes (Δ), analysed using appropriate statistical tests, and referenced histologically. Histological proteoglycan depletion was reflected by significant sub-pistonal decreases in T1 (p = 0.003) and T2 (p = 0.008) after HT exposure. Loading-induced changes in T1ρ and T2* were not related. In conclusion, proteoglycan depletion alters cartilage functionality and may be assessed using serial T1 and T2 mapping under loading.

Head-to-head comparison of 68Ga-PSMA-11 PET/CT and mpMRI in the detection, intra-prostatic localization, and local extension of primary prostate cancer: A single-center imaging study with histopathology gold-standard.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 193-193
Author(s):  
Ida Sonni ◽  
Ely Felker ◽  
Andrew Thomas Lenis ◽  
Anthony E Sisk ◽  
Shadfar Bahri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Imaging Modality ◽  
Imaging Study ◽  
Imaging Modalities ◽  
Detection Rates ◽  
Local Extension ◽  
Primary Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
Local Staging

193 Background: The local staging of prostate cancer relies on systematic or targeted biopsies and multiparametric magnetic resonance imaging (mpMRI). The role of prostate-specific membrane antigen (PSMA)-targeted PET in the evaluation of intraprostatic cancer foci and T-staging assessment is not well defined. The goal of this analysis was to compare the diagnostic performance of PSMA PET/CT, mpMRI and the combination of the two (PSMA PET/CT+mpMRI) in the detection, intra-prostatic localization and local extension of primary prostate cancer with histopathology as the gold standard.Methods: Patients with intermediate- or high-risk prostate cancer underwent a PSMA PET/CT scan and mpMRI prior to intended radical prostatectomy. Each imaging modality was interpreted by 3 blinded independent readers. A majority rule was applied (2:1). A standardized approach was used to assess presence, location and size of prostate cancer foci within the prostate. The analysis was conducted on a lesion- and segment-level. Whole mount pathology was interpreted by a Genito-Urinary pathologist using the same standardized method described above. Accuracy in determining the location, extra-capsular extension (ECE) and seminal vesicle invasion (SVI) of prostate cancer foci were assessed using receiver operating characteristic (ROC) analysis. A “raw-stringent” and “neighboring” approach were used to define imaging/pathology correlation for the detection of individual prostate cancer foci. Results: The final analysis included 74 patients. Detection rate was 75%, 79% and 82% using the “raw-stringent” approach, 86%, 83% and 87% using the “neighboring” approach for PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI, respectively. Differences in detection rates between PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI were not statistically significant. The two imaging modalities performed similarly (AUC = 0.70 vs 0.73, p = 0.09; AUC = 0.77 for the two together) in localizing prostate cancer. ΔAUC between PSMA PET/CT+mpMRI and the two imaging modalities alone was statistically significant (p < 0.001), but not between PSMA PET/CT and mpMRI (p = 0.093). mpMRI performed better than PSMA PET/CT in the T-staging assessment: ECE (AUC = 0.79 vs 0.59, p = 0.002) and SVI (AUC = 0.84 vs 0.63, p = 0.001). Conclusions: PSMA PET/CT and mpMRI have similar diagnostic accuracy in the detection and intra-prostatic localization of prostate cancer foci while mpMRI performs better in the assessment of ECE and SVI. The combination of the two imaging modalities improves performance of the two modalities alone, but this does not reach statistically significant levels on a lesion-level and might not justify changes in the current practices for local staging of prostate cancer.

scholarly journals The role of [68 Ga]Ga-DOTATATE PET/CT in wild-type KIT/PDGFRA gastrointestinal stromal tumours (GIST)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Luigi Aloj ◽  
Olivier Giger ◽  
Iosif A. Mendichovszky ◽  
Ben G. Challis ◽  
Meytar Ronel ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Somatostatin Receptor ◽  
Imaging Study ◽  
Tracer Uptake ◽  
Receptor Subtype ◽  
Wild Type ◽  
Gastrointestinal Stromal Tumours ◽  
Molecular Features ◽  
Pet Ct

Abstract Background [68 Ga]Ga-DOTATATE PET/CT is now recognised as the most sensitive functional imaging modality for the diagnosis of well-differentiated neuroendocrine tumours (NET) and can inform treatment with peptide receptor radionuclide therapy with [177Lu]Lu-DOTATATE. However, somatostatin receptor (SSTR) expression is not unique to NET, and therefore, [68 Ga]Ga-DOTATATE PET/CT may have oncological application in other tumours. Molecular profiling of gastrointestinal stromal tumours that lack activating somatic mutations in KIT or PDGFRA or so-called ‘wild-type’ GIST (wtGIST) has demonstrated that wtGIST and NET have overlapping molecular features and has encouraged exploration of shared therapeutic targets, due to a lack of effective therapies currently available for metastatic wtGIST. Aims To investigate (i) the diagnostic role of [68 Ga]Ga-DOTATATE PET/CT; and, (ii) to investigate the potential of this imaging modality to guide treatment with [177Lu]Lu-DOTATATE in patients with wtGIST. Methods [68 Ga]Ga-DOTATATE PET/CT was performed on 11 patients with confirmed or metastatic wtGIST and one patient with a history of wtGIST and a mediastinal mass suspicious for metastatic wtGIST, who was subsequently diagnosed with a metachronous mediastinal paraganglioma. Tumour expression of somatostatin receptor subtype 2 (SSTR2) using immunohistochemistry was performed on 54 tumour samples including samples from 8/12 (66.6%) patients who took part in the imaging study and 46 tumour samples from individuals not included in the imaging study. Results [68 Ga]Ga-DOTATATE PET/CT imaging was negative, demonstrating that liver metastases had lower uptake than background liver for nine cases (9/12 cases, 75%) and heterogeneous uptake of somatostatin tracer was noted for two cases (16.6%) of wtGIST. However, [68 Ga]Ga-DOTATATE PET/CT demonstrated intense tracer uptake in a synchronous paraganglioma in one case and a metachronous paraganglioma in another case with wtGIST. Conclusions Our data suggest that SSTR2 is not a diagnostic or therapeutic target in wtGIST. [68 Ga]Ga-DOTATATE PET/CT may have specific diagnostic utility in differentiating wtGIST from other primary tumours such as paraganglioma in patients with sporadic and hereditary forms of wtGIST.

Sign in / Sign up

Export Citation Format

Share Document