scholarly journals Imaging of the B2 Glenoid: An Assessment of Glenoid Wear

2019 ◽  
Vol 3 ◽  
pp. 247154921986181 ◽  
Author(s):  
Jared M Mahylis ◽  
Vahid Entezari ◽  
Bong-Jae Jun ◽  
Joseph P Iannotti ◽  
Eric T Ricchetti

Background Glenohumeral osteoarthritis (OA) carries a spectrum of morphology and wear patterns of the glenoid surface exemplified by complex patterns such as glenoid biconcavity and acquired retroversion seen in the B2 glenoid. Multiple imaging methods are available for evaluation of the complex glenoid structure seen in B2 glenoids. The purpose of this article is to review imaging assessment of the type B2 glenoid. Methods The current literature on imaging of the B2 glenoid was reviewed to describe the unique anatomy of this OA variant and how to appropriately assess its characteristics. Results Plain radiographs, magnetic resonance imaging, and standard 2-dimensional computed tomography (CT) have all shown acceptable assessments of arthritic glenoids but lack the detailed and highly accurate evaluation of bone loss and retroversion seen with 3-dimensional CT. Conclusion Accurate preoperative identification of complex B2 pathology on imaging remains essential in planning and achieving precise implant placement at the time of shoulder arthroplasty.

Neurosurgery ◽  
2009 ◽  
Vol 64 (5) ◽  
pp. 945-954 ◽  
Author(s):  
Arnold H. Menezes ◽  
Kathleen A. Fenoy

Abstract OBJECTIVE Developmental remnants around the foramen magnum, or proatlas segmentation abnormalities, have been recorded in postmortem studies but very rarely in a clinical setting. Because of their rarity, the pathological anatomy has been misunderstood, and treatment has been fraught with failures. The objectives of this prospective study were to understand the correlative anatomy, pathology, and embryology and to recognize the clinical presentation and gain insights on the treatment and management. METHODS Our craniovertebral junction (CVJ) database started in 1977 and comprises 5200 cases. This prospective study has retrieval capabilities. Neurodiagnostic studies changed with the evolution of imaging. Seventy-two patients were recognized as having symptomatic proatlas segmentation abnormalities. RESULTS Ventral bony masses from the clivus or medial occipital condyle occurred in 66% (44/72), lateral or anterolateral compressive masses in 37% (27 of 72 patients), and dorsal bony compression in 17% (12 of 72 patients). Hindbrain herniation was associated in 33%. The age at presentation was 3 to 23 years. Motor symptoms occurred in 72% (52 of 72 patients); palsies in Cranial Nerves IX, X, and XII in 33% (24 of 72 patients); and vertebrobasilar symptoms in 25% (18 of 72 patients). Trauma precipitated symptoms in 55% (40 of 72 patients). The best definition of the abnormality was demonstrated by 3-dimensional computed tomography combined with magnetic resonance imaging. Treatment was aimed at decompression of the pathology and stabilization. CONCLUSION Remnants of the occipital vertebrae around the foramen magnum were recognized in 72 of 5200 CVJ cases (7.2%). Magnetic resonance imaging with 3-dimensional computed tomography of the CVJ provides the best definition and understanding of the lesions. Brainstem myelopathy and lower cranial nerve deficits are common clinical presentations in the first and second decades of life. Treatment is aimed at decompression of the pathology and CVJ stabilization.


2017 ◽  
Vol 21 (03) ◽  
pp. 218-239 ◽  
Author(s):  
Pantelis Kraniotis ◽  
Apostolos Karantanas ◽  
Ioannis Tsifountoudis

The spectrum of disorders in musculotendinous trauma (MTt) includes acute traumatic and subacute/chronic lesions caused by repetitive microtrauma. The imaging findings differ in the immature versus the mature skeleton in both categories. Sport-related MTt also depends on age, sex, and type of activity. Magnetic resonance imaging (MRI) is the modality of choice for exploring most MTt injuries and is invaluable for assessing severity and for planning management and return to activity. In some circumstances such as minimally displaced avulsion injuries, MRI findings need to be matched with plain radiographs or computed tomography. Ultrasonography is helpful in exploring superficial structures such as tendons, particularly if dynamic studies are required. Rarely, inflammatory or neoplastic disorders may simulate MTt in the hip and pelvis.


Neurosurgery ◽  
2013 ◽  
Vol 73 (2) ◽  
pp. 262-270 ◽  
Author(s):  
Anand Veeravagu ◽  
Ake Hansasuta ◽  
Bowen Jiang ◽  
Aftab S. Karim ◽  
Iris C. Gibbs ◽  
...  

Abstract BACKGROUND: Accurate target delineation has significant impact on brain arteriovenous malformation (AVM) obliteration, treatment success, and potential complications of stereotactic radiosurgery. OBJECTIVE: We compare the nidal contouring of AVMs using fused images of contrasted computed tomography (CT) and magnetic resonance imaging (MRI) with matched images of 3-dimensional (3-D) cerebral angiography for CyberKnife radiosurgery (CKRS) treatment planning. METHODS: Between May 2009 and April 2012, 3-D cerebral angiography was integrated into CKRS target planning for 30 consecutive patients. The AVM nidal target volumes were delineated using fused CT and MRI scans vs fused CT, MRI, and 3-D cerebral angiography for each patient. RESULTS: The mean volume of the AVM nidus contoured with the addition of 3-D cerebral angiography to the CT/MRI fusion (9.09 cm3, 95% confidence interval: 5.39 cm3-12.8 cm3) was statistically smaller than the mean volume contoured with CT/MRI fused scans alone (14.1 cm3, 95% confidence interval: 9.16 cm3-19.1 cm3), with a mean volume difference of δ = 5.01 cm3 (P = .001). Diffuse AVM nidus was associated with larger mean volume differences compared with a compact nidus (δ = 6.51 vs 2.11 cm3, P = .02). The mean volume difference was not statistically associated with the patient's sex (male δ = 5.61, female δ = 5.06, P = .84), previous hemorrhage status (yes δ = 5.69, no δ = 5.23, P = .86), or previous embolization status (yes δ = 6.80, no δ = 5.95, P = .11). CONCLUSION: For brain AVMs treated with CKRS, the addition of 3-D cerebral angiography to CT/MRI fusions for diagnostic accuracy results in a statistically significant reduction in contoured nidal volume compared with standard CT/MRI fusion-based contouring.


Sign in / Sign up

Export Citation Format

Share Document