Periosteal Reaction of Osteomyelitis: MRI Findings Compared with Plain Radiographs

Background. Stress fractures of the metacarpal bones are considered uncommon. We report on 11 adolescent athletes with these stress fractures, successfully treated with cessation of sports activities. Representative case presentation. In case 1, a 15-year-old male tennis player presented with right hand pain of 4-week duration without an acute trauma history. Tenderness existed on palpation along the dorsal and proximal second metacarpal bone. Plain radiographs demonstrated a periosteal reaction on the proximal shaft of the second metacarpal. Racket swinging was suspended. He returned to competitive tennis 2 months after the initial visit and continues to participate without symptoms. In case 2, a 16-year-old male boxer presented with right hand pain of 2-week duration that arose while punching. Acute trauma history was absent. Tenderness existed on palpation over the third metacarpal of the right hand. Plain radiographs demonstrated no periosteal reaction or fracture line. MRI showed a high signal on the third metatarsal bone on fat suppression and a low signal on T2-weighted images. Nonoperative treatment was initiated without external fixation, and punching was suspended. He returned to boxing 1 month after the initial visit without symptoms. Conclusions. The current case series of metacarpal stress fractures demonstrate that this condition is not as rare as previously reported. Metacarpal stress fractures are generally ignored since the clinical and radiological findings are mostly unclear. If an athlete experiences hand pain without acute onset during sports activities, especially in racket sports, the presence of a metacarpal stress fracture should be assessed by MRI.

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Hip and Pelvis: MRI of Musculotendinous Trauma and Mimickers

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0037-1602411 ◽

2017 ◽

Vol 21 (03) ◽

pp. 218-239 ◽

Cited By ~ 1

Author(s):

Pantelis Kraniotis ◽

Apostolos Karantanas ◽

Ioannis Tsifountoudis

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Imaging Findings ◽

Resonance Imaging ◽

Mri Findings ◽

Plain Radiographs ◽

Dynamic Studies ◽

Neoplastic Disorders ◽

Magnetic Resonance Imaging Mri ◽

Return To Activity

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.

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Patellar Tuberculosis presenting as an Osteolytic Lesion

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1089 ◽

2013 ◽

Vol 47 (4) ◽

pp. 221-222 ◽

Cited By ~ 1

Author(s):

Devendra K Chouhan

Keyword(s):

Ct Scan ◽

Osteolytic Lesion ◽

Clinical Findings ◽

Rare Entity ◽

Mri Findings ◽

Plain Radiographs ◽

Radiological Parameters ◽

Delays In Diagnosis

ABSTRACT Tuberculosis of the patella is a rare entity, and may present with nonspecific clinical findings and subtle changes on plain radiographs; the rarity and unusual nature of presentation lead to frequent delays in diagnosis. We present the radiological (roentgenograms, CT scan and MRI) findings of a case of patellar tuberculosis and discuss the pertinent radiological parameters. How to cite this article Chouhan DK, Dhillon MS, Prakash M, Sharma S. Patellar Tuberculosis Presenting as an Osteolytic Lesion. J Postgrad Med Edu Res 2013;47(4):221-222.

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BONE LESIONS OF THE HAND AND WRIST IN PATIENTS UNDERGOING HEMODIALYSIS FOR TEN YEARS

Hand Surgery ◽

10.1142/s0218810499000368 ◽

1999 ◽

Vol 04 (02) ◽

pp. 159-165 ◽

Cited By ~ 2

Author(s):

Eiji Ueno ◽

Moroe Beppu ◽

Hiroyuki Shimizu ◽

Miki Komurai

Keyword(s):

Bone Resorption ◽

Cystic Lesion ◽

Bone Lesion ◽

Quantitative Computed Tomography ◽

Lesion Group ◽

Bone Lesions ◽

Mri Findings ◽

Radiographic Findings ◽

Plain Radiographs ◽

Bone Atrophy

We investigated the chronological changes in the plain radiographs of the hands and wrists of 32 patients who underwent hemodialysis for ten years. Digital image processing (DIP)9 and quantitative computed tomography (QCT) were conducted to examine bone density. Fourteen patients underwent Magnetic Resonance Imaging (MRI) of the wrists, and the relationships between MRI findings and plain radiographic findings and association of carpal tunnel syndrome (CTS) were investigated. Twenty-one patients with bone lesions revealed by plain radiography were classified into four groups — cystic lesion, bone resorption, mixed, and no-lesion groups. Subperiosteal bone resorption was seen in 17 patients at ten years, of whom one showed a marked improvement of bone lesion observed at five years. Twelve patients had cystic lesions at ten years, most often observed in the middle phalanx and lunate. Seven of those 12 patients suffered from CTS, in contrast to only one case with CTS in each of the bone resorption and no-lesion groups. DIP and QCT revealed the most severe bone atrophy in the cystic lesion group. In six patients, MRI revealed bone lesions not detected by plain radiographs.

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Cervical myelopathy due to subaxial calcium pyrophosphate dihydrate (CPPD) deposition with simultaneous asymptomatic crowned dens syndrome: two case reports

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03736-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Dong-Gune Chang ◽

Jong-Beom Park ◽

Ho-Young Jung ◽

Kyung Jin Seo

Keyword(s):

Cervical Myelopathy ◽

Cord Compression ◽

Calcium Pyrophosphate ◽

Calcium Pyrophosphate Dihydrate ◽

Mri Findings ◽

Decompressive Laminectomy ◽

Plain Radiographs ◽

Calcified Lesion ◽

Crowned Dens Syndrome ◽

Pyrophosphate Dihydrate

Abstract Background There are few reports of cervical myelopathy caused by an attack of subaxial calcium pyrophosphate dihydrate (CPPD) deposition. Moreover, there has been no report on cervical myelopathy by subaxial CPPD deposition with simultaneous asymptomatic crowned dens syndrome (CDS) at the same time. Case presentation The first case was a 68-year-old male complaining of cervical myelopathic symptoms. Plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) findings revealed spinal cord compression by calcified round lesions at C4 as well as a calcified lesion behind the dens. The second case was a 77-year-old female complaining of cervical myelopathic symptoms. Plain radiographs, CT and MRI findings revealed spinal cord compression by calcified round lesions at C3 and C4 as well as a calcified lesion behind the dens. In both cases, we believed that the calcified lesion behind the dens was an asymptomatic lesion. Therefore, the first patient received decompressive laminectomy of C3 and C4, removal of calcified round lesions, and posterior fixation from C3 to C5 due to associated kyphosis. The second patient underwent decompressive laminectomy of C3 and C4 and removal of calcified round lesions. Microscopic examination under polarized light showed dark blue calcifications with rhomboid crystals that were positively birefringent. The findings were consistent with those of CPPD. Conclusions This is the first study to report cervical myelopathy caused by subaxial CPPD deposition with simultaneous asymptomatic CDS. Surgical removal of the subaxial CPPD deposition alone achieved a satisfactory surgical outcome without recurrence.

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Subchondral Insufficiency Fracture of the Femoral Head Caused by Excessive Lateralization of the Acetabular Rim

Case Reports in Orthopedics ◽

10.1155/2016/4371679 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Tetsuya Kimura ◽

Tomohiro Goto ◽

Daisuke Hamada ◽

Takahiko Tsutsui ◽

Keizo Wada ◽

...

Keyword(s):

Femoral Head ◽

Mechanical Stress ◽

Insufficiency Fracture ◽

Severe Osteoporosis ◽

Mri Findings ◽

Subchondral Insufficiency Fracture ◽

Plain Radiographs ◽

History Of ◽

Acetabular Rim ◽

Acetabular Overcoverage

We present a case of a 53-year-old woman with subchondral insufficiency fracture (SIF) of the femoral head without history of severe osteoporosis or overexertion. Plain radiographs showed acetabular overcoverage with excessive lateralization of the acetabular rim. A diagnosis of SIF was made by typical MRI findings of SIF. The lesion occurred at the antipodes of the extended rim. Increased mechanical stress over the femoral head due to impingement against the excess bone was suspected as a cause of SIF. The distinct femoral head deformity is consistent with this hypothesis. This is the first report of SIF associated with acetabular overcoverage.

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Recent developments in advanced imaging in gout

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x19844429 ◽

2019 ◽

Vol 11 ◽

pp. 1759720X1984442 ◽

Cited By ~ 10

Author(s):

Joseph Davies ◽

Philipp Riede ◽

Kirsten van Langevelde ◽

James Teh

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Disease Process ◽

Mri Findings ◽

Disease Extent ◽

Plain Radiographs ◽

Non Invasive ◽

Ultrasound Findings ◽

Recent Developments ◽

Magnetic Resonance Imaging Mri

The plain radiographic features of gout are well known; however, the sensitivity of plain radiographs alone for the detection of signs of gout is poor in acute disease. Radiographic abnormalities do not manifest until late in the disease process, after significant joint and soft tissue damage has already occurred. The advent of dual-energy computed tomography (DECT) has enabled the non-invasive diagnosis and quantification of gout by accurately confirming the presence and extent of urate crystals in joints and soft tissues, without the need for painful and often unreliable soft tissue biopsy or joint aspiration. Specific ultrasound findings have been identified and may also be used to aid diagnosis. Both ultrasound and magnetic resonance imaging (MRI) may be used for the measurement of disease extent, monitoring of disease activity or treatment response, although MRI findings are nonspecific. In this article we summarize the imaging findings and diagnostic utility of plain radiographs, ultrasound, DECT, MRI and nuclear medicine studies in the assessment as well as the implications and utility these tools have for measuring disease burden and therapeutic response.

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