CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures
ConclusionCT-guided bone marrow procedures were more likely to result in both adequate aspirate smears and biopsy samples and longer core lengths when compared with blind procedures. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Association of meniscal flounce in the knee with the pattern and location of meniscal tear, concomitant ligamentous injury, amount of knee joint effusion, and flexion and rotation angles: a magnetic resonance evaluation
ConclusionThe most significant factor associated with meniscal flounce is tear at the posterior horn of the medial meniscus, followed by tear at the meniscocapsular junction. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

High school male basketball athletes exhibit greater hamstring muscle stiffness than females as assessed with shear wave elastography
AbstractObjectiveThe purpose of this study was to characterize lower extremity passive muscle stiffness in a young, healthy, athletic population. It was hypothesized that males would exhibit greater stiffness than females and that hamstring stiffness would increase with increased passive hamstring stretch.MethodsMale (n = 52, age 16.0 ± 1.3 years, height 180.3 ± 7.9 cm, weight 73.1 ± 11.8 kg) and female (n = 89, age 15.6 ± 1.3 years, height 169.7 ± 8.1 cm, weight 65.2...
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Isolated septic facet joints: an underdiagnosed distinct clinical entity
ConclusionSeptic facet joints are not rare, but frequently overlooked as the origin of an epidural abscess. The majority of cases are hematogenously seeded and associated with bacteremia. Surgical decompression is frequently required secondary to the high incidence of associated epidural abscess. Iatrogenic septic facet joints are rare but associated with significant morbidity. From a clinical standpoint, it is helpful to delineate the origin of EDA as either secondary to spondylodiscitis or SFJ. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Anomalous signal intensity increase on out-of-phase chemical shift imaging: a manifestation of marrow mineralisation?
ConclusionWhen assessing focal marrow lesions with CSI, anomalous SI increase may be seen on the OOP sequence in approximately one-third of cases. In over 75% of such cases, CT or radiographs demonstrate either diffuse marrow sclerosis or matrix mineralisation. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Ultrasound-guided diagnostic deep peroneal nerve blocks prior to potential neurectomy: a retrospective review
ConclusionDiagnostic deep peroneal nerve blocks for patients considering deep peroneal neurectomy for denervation therapy should be performed in the anterior lower leg where the anterior tibial vessels serve as anatomic landmarks. Those who perform DPN blocks with ultrasound guidance should be aware of variable DPN position with respect to the vascular landmarks. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Deep convolutional neural network-based detection of meniscus tears: comparison with radiologists and surgery as standard of reference
ConclusionDCNN-based meniscus tear detection can be performed in a fully automated manner with a similar specificity but a lower sensitivity in comparison with musculoskeletal radiologists. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Osteochondral lesion of the talus in children: Are there MRI findings of instability?
ConclusionResults from our study suggest that previously published OCD criteria using conventional MRI are not sufficient for predicting stability of OLT in children. Regional skeletal maturity and older age were more predictive of unstable lesions. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Surgical techniques for management of acromioclavicular joint separations: review and update for radiologists
AbstractImaging plays a central role in the postoperative management of acromioclavicular (AC) joint separations. There are more than 150 described techniques for the surgical management of AC joint injuries. These procedures can be categorized as varying combinations of the following basic techniques: a) soft-tissue repair, b) trans-articular AC joint fixation, c) coracoclavicular (CC) fixation, d) non-anatomic reconstruction of the CC ligaments, e) anatomic reconstruction of the CC ligaments, f) distal clavicle resection, and g) dynamic muscle transfer. The goals of this article are to describe the basic techniques for t...
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Predicting osteomyelitis in patients whose initial MRI demonstrated bone marrow edema without corresponding T1 signal marrow replacement
AbstractPurposeWe endeavored to determine which characteristics of diabetic ulcers portend the strongest risk for osteomyelitis in patients whose initial T1-weighted imaging was normal. By determining which features have a greater risk for osteomyelitis, clinicians can treat patients more aggressively to reduce the sequela of inadequately treated osteomyelitis.Materials and methodsWe performed a retrospective analysis of MR imaging from 60 pedal ulcers with suspected osteomyelitis. Ulcer dimensions and depth were measured. Ratios of marrow ROI/joint fluid ROI on T2/STIR sequences were obtained. Progression to osteomyelitis...
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Is the immediate effect of marathon running on novice runners ’ knee joints sustained within 6 months after the run? A follow-up 3.0 T MRI study
ConclusionThe knees of novice runners achieved sustained improvement, for at least 6  months post-marathon, in the condition of their bone marrow and articular cartilage. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

The prevalence of athletic pubalgia imaging findings on MRI in patients with femoroacetabular impingement
ConclusionSports participation, alpha angle ≥ 60°, and male sex predict a higher prevalence of athletic pubalgia imaging findings in patients with femoroacetabular impingement. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo
ConclusionsFPCT demonstrated better accuracy than did 1.5  T MR arthrography for cartilage defect detection in the ankle joint. Therefore, FPCT should be considered in patients scheduled for dedicated imaging of ankle articular cartilage. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Intraosseous gout mimicking giant cell tumor of the patella
We present a case of a patient with no known history of gout experiencing vague anterior knee pain and subtle but rapidly progressive findings of a patellar lucent lesion on radiographs. No other cause for the patient ’s pain was identified on imaging. No prominent involvement of surrounding tendinous structures on MRI, unipartite patellar morphology, normal serum uric acid levels, rapid growth, and nonspecific appearance of the lesion led to a working diagnosis of patellar giant cell tumor. Biopsy of the lesio n was performed to guide further management, which yielded the unexpected result of crystalline deposits co...
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Test yourself answer: supra-acetabular pelvis synthetic bone graft substitute (CERAMENT) with expected resorption of radiopaque graft material
(Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Browser's notes
(Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Skeletal Radiology: the year in review 2019
AbstractIn 2019, Skeletal Radiology published a total of 253 articles including 111 scientific articles, 36 review articles, 51 case reports, 16 Test-Yourself cases, 15 technical reports, as well as multiple browser notes, meeting abstracts, and meeting summaries. As we have done previously, in this review, we will highlight those articles that stimulated the most interest from our readers, as measured by their downloads, and those that stimulated other researchers and authors, as measured by their citations. The manuscripts highlighted herein were chosen from this list. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Correction to: Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo
The names of the following authors were inadvertently inverted in the original manuscript. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Test yourself question: routine follow up after revision right total hip arthroplasty
(Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Correction to: Deep convolutional neural network-based detection of meniscus tears: comparison with radiologists and surgery as standard of reference
The article “Deep convolutional neural network-based detection of meniscus tears: comparison with radiologists and surgery as standard of reference. (Source: Skeletal Radiology)
Source: Skeletal Radiology - June 18, 2020 Category: Radiology Source Type: research

Computed tomography (CT), X-ray, and MRI evaluation of two anterolateral knee reconstruction techniques: lateral extra-articular tenodesis (LET) and the anterolateral ligament (ALL) reconstruction
AbstractThe anterolateral ligament (ALL) and capsule of the knee are anatomical structures involved in rotational stability and pivot-shift control. As such, it has been demonstrated that the extra-articular anterolateral procedures improve clinical outcome when performed as an augmentation of the anterior cruciate ligament (ACL) reconstruction in specific groups of patients. This review describes the postoperative imaging findings of two techniques used to perform these procedures, using magnetic resonance imaging (MRI), computed tomography (CT), and radiography. The first technique described is the lateral extra-articula...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Pelvic bone tumor resection: what a radiologist needs to know
AbstractPelvic bone tumors present a diagnostic and therapeutic challenge. Due to the deep anatomic location and resultant late clinical presentation, pelvic bone tumors tend to be large and located in close proximity to pelvic viscera as well as vital neurovascular structures. Operative management of pelvic bone tumors is indicated for a variety of orthopedic oncologic conditions. In general, limb-sparing pelvic resection rather than hemipelvectomy with amputation of the ipsilateral limb is considered when a functional limb can be preserved without compromising the surgical margins. There are various options for pelvic re...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Prevalence and distribution of MRI abnormalities in the articular cartilage and supporting ligaments in patients with early clinical stage first carpometacarpal joint osteoarthritis
ConclusionThe MRI findings of early clinical stage CMCJ-1 osteoarthritis commonly demonstrated cartilage lesions in the VU quadrant of the trapezium and ligament abnormalities in the AOL. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Blau syndrome: a rare cause of exuberant granulomatous synovitis of the knee
We describe a 38-year-old man with known BS who presented for orthopaedic review following right-sided patellar dislocation. MRI of the injured knee demonstrated diffuse synovitis and prominent fatty tissue resembling lipoma arborescens with evidence of recent patellar dislocation. Synovectomy was performed and confirmed granulomatous synovitis. Knee imaging findings are described for the first time. Combining distinct morphological bone changes with synovitis which resembles lipoma arborescens and histology which includes sarcoidal-type granulomatous synovitis should lead the radiologist and pathologist to consider the di...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Does MR arthrography cause intracranial gadolinium deposition?
ConclusionOur study found no MR evidence of intracranial gadolinium deposition following MRA. In addition, there was no association between intra-articular gadolinium dose and SI ratios in commonly affected regions of the brain. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Human T cell lymphotropic virus type-1 associated lymphoma presenting as an intramuscular mass of the calf
We present a rare case of ATLL manifesting as an intra-muscular calf mass in a 58-year-old man who immigrated to the USA from West Africa. While skeletal muscle involvement by lymphoma is uncommon, it remains important to consider within the differential diagnosis when there are suggestive imaging findings because it entails important technical biopsy considerations as well as treatment implications. This case report also raises awareness of ATLL presenting outside of typical HTLV-1 endemic areas, related to current population migration patterns. ATLL should therefore be considered in patients with appropriate risk factors...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Chondral tumours: discrepancy rate between needle biopsy and surgical histology
DiscussionIGCNB can achieve a diagnosis of a chondral tumour in a high proportion of cases when compared with final diagnosis from surgical resection specimens. However, correlation of tumour grade between IGCNB and resection histology is less reliable with discordance seen in almost one-quarter of cases, most commonly at non-appendicular sites. Therefore, IGCNB results should not be considered in isolation of imaging and clinical features when planning surgical management. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Sonographic evaluation of the lateral femoral cutaneous nerve in meralgia paresthetica
AbstractObjectiveIdentify sonographic features of the lateral femoral cutaneous nerve (LFCN) in meralgia paresthetica (MP) and report therapeutic outcomes in sonographically confirmed cases.Materials and methodsRetrospective review of 50 patients with clinically suspected MP and 20 controls. Ultrasounds were reviewed for characteristics of the LFCN and compared between groups. When available, MRIs were reviewed. In cases of sonographically pathologic LFCN, subsequent therapeutic interventions were recorded.ResultsThirty-five of the suspected MP cases (70%) had ultrasound findings suggestive of MP, 10 (20%) were negative, a...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Interchangeability of CT and 3D “pseudo-CT” MRI for preoperative planning in patients with femoroacetabular impingement
ConclusionPseudo-CT MRI was interchangeable with CT for measuring acetabular version and highly favorable for interchangeability for measuring alpha angle and for surgical planning, suggesting that MRI could replace CT in assessing patients with FAI. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Analysis of musculoskeletal radiology fellowship websites
ConclusionThere is lack of sufficient, useful information and standardization on the websites of MSK fellowship programs throughout the country. According to our review and analysis, addition of specific information regarding each fellowship program and implementing some type of standardization may optimize fellowship matching for both applicants and the programs. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0  T MRI
ConclusionNearly all knees of asymptomatic adults showed abnormalities in at least one knee structure on MRI. Meniscal tears, cartilage and bone marrow lesions of the patellofemoral joint were the most common pathological findings. Bucket handle and complex meniscal tears were reported for the first time in asymptomatic knees. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Increased focal bone tracer uptake at the popliteus muscle origin in primary TKA compared with revision TKA
AbstractObjectiveThe purpose of the study was to investigate if the TKA design (cruciate retaining (CR), posterior stabilized (PS), revision prostheses) had an influence on the bone tracer uptake (BTU) pattern at the origin of the popliteus muscle.Materials and methodsA total of 92 knees (male:female  = 46:46) which had undergone prior TKA were included in this retrospective study, comprising the following 3 groups: (i) CR primary TKA (n = 45); (ii) PS primary TKA (n = 24); (iii) revision TKA (n = 23). All patients received a SPECT/CT after TKA surgery. SPECT/CT image...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Distal insertional anatomy of the triceps brachii muscle: MRI assessment in cadaveric specimens employing histologic correlation and Play-doh ® models of the anatomic findings
ConclusionAlthough MRI appeared to reveal separate and distinct attachments of the triceps brachii muscle into the olecranon, histologic analysis delineated complex but continuous tissue related to the attachments of the three heads of this muscle. The Play-doh® models were helpful for the comprehension of this complex anatomy and might serve as a valuable educational tool when applied to the analysis of other musculoskeletal regions. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Clinical and sonographic evaluation of Endobutton distal biceps brachii tendon repair: what constitutes normal post-operative appearances?
ConclusionNormal post-operative sonographic appearances of Endobutton DBBT repair comprise a hypoechoic tendon significantly increased in calibre compared with non-operated tendon ± intratendinous calcification. DBBT repair calibre varies greatly, but is not associated with any significant difference in strength/ROM. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Prevalence and frequency of subchondral bone marrow edema in the lumbar facet joints of asymptomatic and symptomatic individuals
AbstractObjectiveTo prospectively compare the prevalence and frequency of subchondral bone marrow edema (BME) in the lumbar facet joints of low back pain patients and healthy subjects.Materials and methodsLumbar magnetic resonance imaging (MRI) examinations were performed on 55 asymptomatic participants (18 men; age range 21 –63; mean 36 ± 12 years; body mass index (BMI) range 16–31; mean 22.6 ± 3.2 kg/m2) and 79 low back pain patients (36 men; age range 18 –77; mean 47 ± 14 years; BMI range 18–40; mean 27.8 ±...
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Dynamic ultrasound-guided trochanteric bursal injection
AbstractInjection of steroid and anesthetic into the greater trochanteric bursa is commonly performed for trochanteric bursitis, gluteus medius/minimus tendinopathy, or as a part of a barbotage procedure for gluteus medius or minimus calcific tendonosis. Trochanteric bursal injection is widely performed both with and without image guidance, and is typically viewed as low-difficulty; however optimum needle tip position can be challenging. We discuss a simple dynamic technique to aid the practitioner in optimal needle placement. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Diagnosis: subcutaneous myxopapillary ependymoma
(Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Browser ’s notes
(Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Correction to: Distal insertional anatomy of the triceps brachii muscle: MRI assessment in cadaveric specimens employing histologic correlation and Play-doh ® models of the anatomic findings
Figures 9, 10, 11, 12 and 15 corrected. (Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Diagnosis: Subcutaneous myxopapillary ependymoma
(Source: Skeletal Radiology)
Source: Skeletal Radiology - May 19, 2020 Category: Radiology Source Type: research

Correction to: Qualitative and quantitative analysis of glenoid bone stock and glenoid version: inter-reader analysis and correlation with rotator cuff tendinopathy and atrophy in patients with shoulder osteoarthritis
AbstractPurpose Glenoid bone stock and morphology and rotator cuff muscle quality and tendon integrity affect the outcome of total shoulder arthroplasty. We hypothesized that glenoid bone loss correlates with rotator cuff muscle fatty infiltration (FI), tendinopathy, and atrophy.Design Forty-three 3-D CT scans and MRIs of 43 patients (mean age 62  years; SD 13 years; range 22–77 years) referred for primary shoulder pain were evaluated. Measurements of glenoid bone stock, version, and posterior humeral subluxation index (HSI) were assessed on an axial CT image reconstructed in the true scapular plane. M...
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Performance of a rapid two-sequence screening protocol for osteomyelitis of the foot
AbstractObjectiveCompare a two sequence protocol to a standard protocol in the detection of pedal osteomyelitis (OM) and abscesses and to identify patients that benefit from a full protocol.Materials and methodsOne hundred thirty-two foot MRIs ordered to assess for OM were enrolled, and the following items were extracted from the clinical reports: use of IV contrast, the presence of OM, reactive osteitis, and a soft tissue abscess. Using only one T1 nonfat-suppressed and one fluid sensitive fat-suppressed sequences, two experienced musculoskeletal radiologists reviewed each case for the presence of OM, reactive osteitis, o...
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Magnetic resonance imaging of impingement and friction syndromes around the knee
AbstractThe knee is a complex joint with its function dependent on a combination of osseous and soft tissue structures. Alteration in the relationship of these tissues, due to either acute or chronic repetitive injury with possible underlying congenital predisposing factors, can result in impingement between the structures resulting in pain, particularly on activity. The purpose of this article is to provide a comprehensive review of the MRI features of various impingement syndromes around the knee. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

The incidence of skip metastases on whole bone MRI in high-grade bone sarcomas
ConclusionThe current study has documented the incidence of skip metastases in common types of high-grade primary bone sarcoma. The possibility of false positive skip metastases has also been highlighted. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Value of multidetector computed tomography for the differentiation of delayed aseptic and septic complications after total hip arthroplasty
ConclusionMultidetector CT findings are useful to differentiate between aseptic and septic complications before revision surgery. The presence of osteolysis with expansile periosteal reaction appeared to be a time-dependent variable. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Intramuscular peripheral nerve sheath tumors: schwannoma, ancient schwannoma, and neurofibroma
ConclusionsIntramuscular schwannomas were easily diagnosed based on MRI. In the case of intramuscular ancient schwannoma and neurofibroma with only split fat sign among the classic MRI findings, they might be distinguished from other intramuscular soft tissue tumors based on muscle denervation change or typical crescent split fat sign. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Magnetic resonance imaging characteristics in patients with histopathologically proven fibrous dysplasia —a systematic review
ConclusionCurrent knowledge of the MRI findings in patients with FD is based mainly on case reports. SI in patients with FD is variable and contrast enhancement is common. FD may explain etiology of spinal bone tumor in some patients. FD with malignant transformation should be considered also in patients without prior radiotherapy. Further studies are needed to clarify if FD displays specific characteristics allowing it to be distinguished from other bone tumors. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

The sensitivity, specificity, and diagnostic accuracy of whole-bone MRI for identifying skip metastases in appendicular osteosarcoma and Ewing sarcoma
ConclusionWhole-bone MRI has a high sensitivity, specificity, and diagnostic accuracy for the identification of skip metastases in osteosarcoma and Ewing sarcoma. The possibility of false positive skip lesions and late local osseous recurrence is also highlighted. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Image quality of hip MR arthrography with intra-articular injection of hyaluronic acid versus gadolinium-based contrast agent in patients with femoroacetabular impingement
ConclusionsHA-MRA provided an image quality not significantly different from that of Gd-MRA. This may open the possibility of combining MRA and viscosupplementation in one single procedure. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research

Evaluation of baseline fracture risk in younger postmenopausal women with breast cancer using different risk assessment methods
ConclusionPostmenopausal women younger than 60  years with breast cancer do not show any differences in baseline BMD, TBS, or TBS adjusted FRAX in comparison to controls. (Source: Skeletal Radiology)
Source: Skeletal Radiology - April 21, 2020 Category: Radiology Source Type: research