scholarly journals Accompanying Injuries of Ankle Joint Among the Fifth Metatarsal Basis Fractures

2020 ◽  
Author(s):  
Ali Turgut ◽  
Melikşah Uzakgider ◽  
Ozan Altun ◽  
Ercüment Egeli ◽  
Serkan Erkuş ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Ankle Joint ◽  
Bone Marrow Edema ◽  
Ankle Injuries ◽  
Common Finding ◽  
Common Mechanism ◽  
Ankle Sprains ◽  
Accompanying Injuries ◽  
Ligament Sprain ◽  
Marrow Edema

Background: Fifth metatarsal basis fractures are the most commonly seen fractures of the foot. Ankle sprains occur with inversion and plantar flexion mechanisms, like most of the fifth metatarsal basis fractures. Our aim was to investigate the possible accompanying ankle injuries about the fifth metatarsal basis fractures.Methods: Hospital's digital database was searched for the ICD 10 codes of the metatarsal bone fractures such as 'S92.30 and S92.35' between January 2015 and January 2018. Thirty nine patients with fifth metatarsal basis fracture who had an ankle magnetic resonance imaging (MRI) within 14 days of the injury were included in the study. MRI findings were evaluated and comparison was performed according to the fracture zones, gender and age.Results: The most common finding on MRI was talocrural joint effusion (TTJE) which was observed in 28 patients (71.8%). Bone marrow edema was observed in 16 patients (41%). Chondral injury at the medial dome of talus was observed in three patients (7.7%). Grade 1 ligament sprain was observed in 6 of the patients (15.4%). Lateral ligament sprain was observed only in two patients, while four of the sprains were about the deltoid ligament.Conclusions: Although most of the fifth metatarsal basis fractures and ankle sprains occur as a result of a common mechanism, physical examination and patients' complaints are very important. Routine MRI imaging should be unnecessary for most patients. If a patient with a fifth metatarsal basis fracture has complaints about his/her ankle joint, one should be aware of bone marrow edema which was observed in 41% of our study population.

Identification of bone marrow edema around the ankle joint in non-traumatic patients: Diagnostic accuracy of dual-energy computed tomography

2021 ◽  
Vol 69 ◽  
pp. 341-348
Author(s):  
Giovanni Foti ◽  
Massimo Guerriero ◽  
Niccolò Faccioli ◽  
Alessandro Fighera ◽  
Luigi Romano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Ankle Joint ◽  
Bone Marrow Edema ◽  
Dual Energy ◽  
Dual Energy Computed Tomography ◽  
Marrow Edema

scholarly journals How We Manage Bone Marrow Edema—An Interdisciplinary Approach

2020 ◽  
Vol 9 (2) ◽  
pp. 551 ◽  
Author(s):  
Sebastian F. Baumbach ◽  
Vanessa Pfahler ◽  
Susanne Bechtold-Dalla Pozza ◽  
Isa Feist-Pagenstert ◽  
Julian Fürmetz ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Task Force ◽  
Trauma Surgery ◽  
Interdisciplinary Approach ◽  
Underlying Disease ◽  
Common Finding ◽  
Diagnostic Measures ◽  
Practical Experiences ◽  
Marrow Edema

Bone marrow edema (BME) is a descriptive term for a common finding in magnetic resonance imaging (MRI). Although pain is the major symptom, BME differs in terms of its causal mechanisms, underlying disease, as well as treatment and prognosis. This complexity together with the lack of evidence-based guidelines, frequently makes the identification of underlying conditions and its management a major challenge. Unnecessary multiple consultations and delays in diagnosis as well as therapy indicate a need for interdisciplinary clinical recommendations. Therefore, an interdisciplinary task force was set up within our large osteology center consisting of specialists from internal medicine, endocrinology/diabetology, hematology/oncology, orthopedics, pediatrics, physical medicine, radiology, rheumatology, and trauma surgery to develop a consenus paper. After review of literature, review of practical experiences (expert opinion), and determination of consensus findings, an overview and an algorithm were developed with concise summaries of relevant aspects of the respective underlying disease including diagnostic measures, clinical features, differential diagnosis and treatment of BME. Together, our single-center consensus review on the management of BME may help improve the quality of care for these patients.

scholarly journals MRI features of and factors related to ankle injuries in asymptomatic amateur marathon runners

2020 ◽  
Vol 50 (1) ◽  
pp. 87-95
Author(s):  
Wanzhen Yao ◽  
Yanjing Zhang ◽  
Li Zhang ◽  
Jing Zhou ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Signal Intensity ◽  
Bone Marrow Edema ◽  
Lateral Collateral Ligament ◽  
Ankle Injuries ◽  
Ligament Injury ◽  
Marathon Runners ◽  
Mri Features ◽  
Marrow Edema

Abstract Objective To analyze the MRI manifestations of and factors related to ankle injuries in asymptomatic amateur marathon runners. Materials and methods A total of 113 amateur marathon runners without any ankle joint symptoms were recruited. Each participant was asked to complete a questionnaire at the beginning of the study and underwent MRI of the ankle. The MRI manifestations of ankle injuries were summarized, and binary logistic regression analysis was applied to analyze the factors related to ankle injuries. Results The main MRI features were bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. Others included Achilles tendinopathy, cyst-like lesions, osteochondral lesions, and subcutaneous soft tissue edema. The risk factor for bone marrow edema-like signal intensity in amateur marathon runners was a rearfoot strike pattern (p = 0.028, OR = 1.172); the risk factors for peritendinous effusion were a higher weekly running distance (p = 0.013, OR = 1.685) and increased running years (p = 0.039, OR = 1.113), whereas a rearfoot strike pattern (p = 0.005, OR = 0.831) was a protective factor for peritendinous effusion; the risk factor for Achilles tendinopathy was increased age (p = 0.008, OR = 1.412); the risk factors for anterior talofibular ligament injury were a rearfoot strike pattern (p = 0.017, OR = 1.346) and higher weekly running distance (p = 0.022, OR = 1.171); and the factors for calcaneofibular ligament injury were a higher weekly running distance (p = 0.029, OR = 1.570) and rearfoot strike pattern (p = 0.035, OR = 1.463). Conclusion The main MRI features of asymptomatic amateur marathon runners are bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. In addition, increased age, increased running years, higher weekly running distance, and different foot strike patterns are risk factors for ankle injuries.

Cortical and trabecular alterations in patients with bone marrow edema of the lower limb

2013 ◽  
Author(s):  
Afrodite Zendeli ◽  
Christian Muschitz ◽  
Roland Kocijan ◽  
Lukas Fischer ◽  
Daniela Suess ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Lower Limb ◽  
Bone Marrow Edema ◽  
Marrow Edema

Calcium-Suppressed Technique in Dual-Layer Detector Computed Tomography to Evaluate Knee Articular Cartilage

2020 ◽  
Vol 16 ◽  
Author(s):  
Qinglin Meng ◽  
Mengqi Liu ◽  
Weiwei Deng ◽  
Ke Chen ◽  
Botao Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Bone Marrow ◽  
Articular Cartilage ◽  
Bone Marrow Edema ◽  
Knee Joints ◽  
Infrapatellar Fat Pad ◽  
Proton Density ◽  
Knee Cartilage ◽  
Significant Difference ◽  
Marrow Edema

Background: Calcium-suppressed (CaSupp) technique involving spectral-based images has been used to observe bone marrow edema by removing calcium components from the image. Objective: This study aimed to evaluate the knee articular cartilage using the CaSupp technique in dual-layer detector computed tomography (DLCT). Methods: Twenty-eight healthy participants and two patients with osteoarthritis were enrolled, who underwent DLCT and magnetic resonance imaging (MRI) examination. CaSupp images were reconstructed from spectral-based images using a calcium suppression algorithm and were overlaid conventional CT images for visual evaluation. The morphology of the knee cartilage was evaluated, and the thickness of the articular cartilage was measured on sagittal proton density– weighted and CaSupp images in the patellofemoral compartment. Results: No abnormal signal or density, cartilage defect, and subjacent bone ulceration were observed in the lateral and medial femorotibial compartments and the patellofemoral compartment on MRI images and CaSupp images for the 48 normal knee joints. CaSupp images could clearly identify cartilage thinning, defect, subjacent bone marrow edema, and edema of the infrapatellar fat pad in the same way as MRI images in the three knee joints with osteoarthritis. A significant difference was found in the mean thickness of the patellar cartilage between MRI images and CaSupp images, while the femoral cartilage presented no significant difference in thickness between MRI images and CaSupp images over all 48 knee joints. Conclusion: The present study demonstrated that CaSupp images could effectively be used to perform the visual and quantitative assessment of knee cartilage.

scholarly journals Detection of Bone Marrow Edema in Patients with Osteoid Osteoma Using Three-Material Decomposition with Dual-Layer Spectral CT

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 953
Author(s):  
Florian T. Gassert ◽  
Johannes Hammel ◽  
Felix C. Hofmann ◽  
Jan Neumann ◽  
Claudio E. von Schacky ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Osteoid Osteoma ◽  
Bone Marrow Edema ◽  
Volume Fraction ◽  
Imaging Findings ◽  
Spectral Ct ◽  
Material Decomposition ◽  
Negative Imaging ◽  
Interreader Agreement ◽  
Marrow Edema

The aim of this study is to assess whether perifocal bone marrow edema (BME) in patients with osteoid osteoma (OO) can be accurately detected on dual-layer spectral CT (DLCT) with three-material decomposition. To that end, 18 patients with OO (25.33 ± 12.44 years; 7 females) were pairwise-matched with 18 patients (26.72 ± 9.65 years; 9 females) admitted for suspected pathologies other than OO in the same anatomic location but negative imaging findings. All patients were examined with DLCT and MRI. DLCT data was decomposed into hydroxyapatite and water- and fat-equivalent volume fraction maps. Two radiologists assessed DLCT-based volume fraction maps for the presence of perifocal BME, using a Likert scale (1 = no edema; 2 = likely no edema; 3 = likely edema; 4 = edema). Accuracy, sensitivity, and specificity for the detection of BME on DLCT were analyzed using MR findings as standard of reference. For the detection of BME in patients with OO, DLCT showed a sensitivity of 0.92, a specificity of 0.94, and an accuracy of 0.92 for both radiologists. Interreader agreement for the assessment of BME with DLCT was substantial (weighted κ = 0.78; 95% CI, 0.59, 0.94). DLCT with material-specific volume fraction maps allowed accurate detection of BME in patients with OO. This may spare patients additional examinations and facilitate the diagnosis of OO.

scholarly journals THU0484 FIBROMYALGIA AND MULTIPLE SWITCHING OF BIOLOGICS IN SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 479.2-480
Author(s):  
A. Negm ◽  
J. Alsaleh
Keyword(s):  
Bone Marrow ◽  
Disease Activity ◽  
Bone Marrow Edema ◽  
Disease Duration ◽  
Hla B27 ◽  
Tender Points ◽  
Conventional Dmards ◽  
Likelihood Ratio Testing ◽  
Multiple Switching ◽  
Marrow Edema

Background:Fibromyalgia (FM) is a condition characterized by chronic widespread pain, tender points, fatigue and disturbed sleep rhythm. Some of these symptoms such as fatigue, tender points and diffuse pain seen in patients with spondylarthritis (SpA). Moreover, FM and SpA can coexist creating a diagnostic challenge, particularly in early disease course and influence clinical disease activity assessment.Objectives:With this cross-sectional study, we aim to estimate the prevalence of FM in SpA and to elaborate its effect on biological treatments.Methods:FM was identified according to the ACR 2010 diagnostic criteria. SpA patients identified according to rheumatologist using various SpA subsets criteria. A review of the electronic medical files for SpA patients attending the rheumatology outpatient clinic and infusion unit at a major tertiary hospital during the period from June to December 2018 were included. Patients’ demographics, socioeconomics, disease characteristics, activity, HLA status and abnormal MRI sacroiliac were explored. Regarding SpA medications, number, frequency and dose of DMARDs and biological agents were obtained.Continuous variables were reported by their mean and standard deviation (SD) and qualitative variables by frequency and percentage. Statistical significance was set at p <0.05. Statistical analysis was performed using SPSS version 23.Results:Of the 305 enrolled SpA patients, 43 (14.1%) had FM. Females represents 57.4% of the patients, mean age was 44.07 ± 11.85 years. Arab ethnicity represents most of our cohort 84.9%, the majority were Emirati 64.6%. Smokers were 8.2% and ex-smokers were 3.3%. Axial SpA represents 38.4% while peripheral SpA 61.6% of our cohort according to ASAS classification.HLA B27 tested in a sample of 180 patients; it was positive in only 17.8%. CRP found to be elevated in 20.3% of the patients at baseline. Abnormal MRI SIJ bone marrow edema changes were found in 10.8%, while other SIJ changes was seen in additional 20.6%. The prevalence of FM showed no statistically significant difference between axial and peripheral SpA. Patients SpA and FM have longer disease duration than SpA alone, P= 0.034. Table.1 show demographics, socioeconomics and clinical data of our cohort.Regarding medication, the use of biologics among SpA patients with FM is more frequent than SpA patients without FM (74.4% vs 51.5 % respectively), P= 0.005. Interestingly, the likelihood ratio testing showed that SpA patient with Fibromyalgia switch more frequently to another biologics than SpA without fibromyalgia, P= 0.015.Cramer’s V test showed that there is a high statistically significant (P= 0.002) and very strong association (> 0.25) between presence of Fibromyalgia and multiple switching of biologics in SpA.There was no difference in the exposure to prednisolone nor conventional DMARDs between SpA patients with or without FM, P= 0.64 & 1 respectively.Gender, Female, n (%)175 (57.4)Age, mean ± SD (min- max), years44.07 ± 11.85 (18- 78)Type of A, n (%)AxialPeripheral117 (38.4)188 (61.6)Fibromyalgia, n (%)FM in axial SpAFM in Peripheral SpA43 (14.1)18 (41.9)25 (58.1)SpA Disease duration (months)FM+, mean ±SDFM-, mean ±SD107.7± 50.486± 57.9Elevated CRP, n (%)62 (20.3)HLA B27 in180 patients, n (%)PositiveNegative32 (17.8)148 (82.2)Abnormal MRI SIJ, n (%)Bone marrow edemaSubchondral sclerosisFatty transformation of bone marrowErosion92 (30.2)33 (10.8)21 (6.9)5 (1.6)2 (0.7)Number of conventional DMARDs ever tired, n (%)NoneOneTwoThree81 (26.6)166 (54.4)46 (15.1)12 (3.9)Frequency of DMARDs usage, n, (%)Conventional DMARDsPrednisoloneBiologic DNARDs224 (73.4)56 (18.4)164 (53.8)Conclusion:FM coexistence with SpA might impact clinical evaluation of disease activity and possibly negatively affect self-measurement of treatment response. In our study, SPA patients exposed to more biologics if they have coexisting FM; Moreover, they are more frequent switchers among biologics including TNFi and IL17i.Acknowledgments:N Elsidig, A Al Marzooqi, N Zamani, A HossainiDisclosure of Interests: :None declared

MR Imaging of Bone Marrow Edema and Joint Effusion in Patients with Osteonecrosis of the Femoral Head: Relationship to Pain

2003 ◽  
Vol 181 (2) ◽  
pp. 545-549 ◽  
Author(s):  
Guo-Shu Huang ◽  
Wing P. Chan ◽  
Yue-Cune Chang ◽  
Cheng-Yen Chang ◽  
Cheng-Yu Chen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Femoral Head ◽  
Mr Imaging ◽  
Bone Marrow Edema ◽  
Joint Effusion ◽  
Marrow Edema
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