2015
Chang, Connie Y; Simeone, F Joseph; Huang, Ambrose J
Battery-powered bone drill: caution needed in densely blastic lesions Journal Article
In: Skeletal Radiol, vol. 44, no. 12, pp. 1845–1848, 2015, ISSN: 1432-2161.
@article{pmid26315889b,
title = {Battery-powered bone drill: caution needed in densely blastic lesions},
author = {Connie Y Chang and F Joseph Simeone and Ambrose J Huang},
doi = {10.1007/s00256-015-2241-2},
issn = {1432-2161},
year = {2015},
date = {2015-12-01},
journal = {Skeletal Radiol},
volume = {44},
number = {12},
pages = {1845--1848},
abstract = {Image-guided biopsies play an important role for pathologic diagnosis of bone tumors. Recently, motorized, battery powered bone marrow biopsy devices have been used to biopsy focal bone lesions with high accuracy. We present here two cases of densely blastic metastases where the biopsy sample could not be removed from the needle. These two cases suggest that if the lesion is densely blastic, then the sample should be small (<5 mm) to ensure that the biopsy specimen will not be stuck within the biopsy needle.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Image-guided biopsies play an important role for pathologic diagnosis of bone tumors. Recently, motorized, battery powered bone marrow biopsy devices have been used to biopsy focal bone lesions with high accuracy. We present here two cases of densely blastic metastases where the biopsy sample could not be removed from the needle. These two cases suggest that if the lesion is densely blastic, then the sample should be small (<5 mm) to ensure that the biopsy specimen will not be stuck within the biopsy needle.
Simeone, F Joseph; Bredella, Miriam A; Chang, Connie Y; Torriani, Martin; Huang, Ambrose J
MRI appearance of the superior transverse scapular ligament Journal Article
In: Skeletal Radiol, vol. 44, no. 11, pp. 1663–1669, 2015, ISSN: 1432-2161.
@article{pmid26210230,
title = {MRI appearance of the superior transverse scapular ligament},
author = {F Joseph Simeone and Miriam A Bredella and Connie Y Chang and Martin Torriani and Ambrose J Huang},
doi = {10.1007/s00256-015-2209-2},
issn = {1432-2161},
year = {2015},
date = {2015-11-01},
journal = {Skeletal Radiol},
volume = {44},
number = {11},
pages = {1663--1669},
abstract = {OBJECTIVE: The superior transverse scapular ligament (STSL) forms the roof of the suprascapular notch, which is the most common location of entrapment of the suprascapular nerve, a cause of shoulder pain and weakness. The purpose of this study is to determine the frequency of visualization of the STSL on routine shoulder MRIs, to identify the sequences and imaging planes on which it is visualized most frequently, and to describe its typical MRI appearance, none of which have been previously addressed in the radiologic literature.nnMATERIALS AND METHODS: One hundred twenty-one consecutive shoulder MRIs were reviewed for the presence or absence of the STSL, including the imaging plane and sequence that best depicted the ligament. Dimensions of the ligament were recorded.nnRESULTS: Fifty four of 121 shoulder MRIs were technically adequate for visualization of the STSL, and it was identified on 51 of these studies (94%). There was no statistically significant difference between 1.5-T and 3-T systems. The best individual sequence for visualizing the STSL was the sagittal T1-weighted sequence, in which the STSL was visible on 75/80 technically adequate sequences (94%). The sagittal plane was the best plane for visualizing the STSL, in which it was visible on 65/69 technically adequate studies (94%). The STSL on average measured 12.8 ± 1.5 mm in transverse dimension.nnCONCLUSIONS: The STSL can be visualized on the majority of shoulder MRIs and is best seen on sagittal T1-weighted images on our imaging protocol. Evaluation of the STSL can potentially help in identifying pathologic conditions affecting the suprascapular nerve.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: The superior transverse scapular ligament (STSL) forms the roof of the suprascapular notch, which is the most common location of entrapment of the suprascapular nerve, a cause of shoulder pain and weakness. The purpose of this study is to determine the frequency of visualization of the STSL on routine shoulder MRIs, to identify the sequences and imaging planes on which it is visualized most frequently, and to describe its typical MRI appearance, none of which have been previously addressed in the radiologic literature.nnMATERIALS AND METHODS: One hundred twenty-one consecutive shoulder MRIs were reviewed for the presence or absence of the STSL, including the imaging plane and sequence that best depicted the ligament. Dimensions of the ligament were recorded.nnRESULTS: Fifty four of 121 shoulder MRIs were technically adequate for visualization of the STSL, and it was identified on 51 of these studies (94%). There was no statistically significant difference between 1.5-T and 3-T systems. The best individual sequence for visualizing the STSL was the sagittal T1-weighted sequence, in which the STSL was visible on 75/80 technically adequate sequences (94%). The sagittal plane was the best plane for visualizing the STSL, in which it was visible on 65/69 technically adequate studies (94%). The STSL on average measured 12.8 ± 1.5 mm in transverse dimension.nnCONCLUSIONS: The STSL can be visualized on the majority of shoulder MRIs and is best seen on sagittal T1-weighted images on our imaging protocol. Evaluation of the STSL can potentially help in identifying pathologic conditions affecting the suprascapular nerve.
Chang, Connie Y; Simeone, F Joseph; Nelson, Sandra B; Taneja, Atul K; Huang, Ambrose J
In: AJR Am J Roentgenol, vol. 205, no. 1, pp. 123–129, 2015, ISSN: 1546-3141.
@article{pmid26102390,
title = {Is Biopsying the Paravertebral Soft Tissue as Effective as Biopsying the Disk or Vertebral Endplate? 10-Year Retrospective Review of CT-Guided Biopsy of Diskitis-Osteomyelitis},
author = {Connie Y Chang and F Joseph Simeone and Sandra B Nelson and Atul K Taneja and Ambrose J Huang},
doi = {10.2214/AJR.14.13545},
issn = {1546-3141},
year = {2015},
date = {2015-07-01},
journal = {AJR Am J Roentgenol},
volume = {205},
number = {1},
pages = {123--129},
abstract = {OBJECTIVE: The purpose of this study was to determine whether there is a difference in biopsying bone (endplate), disk, or paravertebral soft tissue to culture the pathogenic organism causing diskitis-osteomyelitis.nnMATERIALS AND METHODS: A retrospective review was conducted of 111 spinal biopsies performed between 2002 and 2011. Pathologic examination was used as the reference standard for detecting diskitis-osteomyelitis. Microbiologic yield, sensitivity, and specificity were calculated. The yields for different groups were compared by use of Fisher exact test. The analysis was repeated with biopsy samples from patients not being treated with antibiotics at the time of biopsy.nnRESULTS: A total of 122 biopsy specimens were obtained from 111 spinal biopsy procedures on 102 patients. Overall, 27 (22%) biopsies were performed on the endplate-disk, 61 (50%) on the disk only, and 34 (28%) on paravertebral soft tissue only. The microbiologic yield was 36% for all biopsies, 19% for endplate-disk biopsies, 39% for disk-only biopsies, and 44% for soft-tissue biopsies. The sensitivity and specificity of the microbiologic results for all specimens were 57% and 89%; endplate-disk, 38% and 86%; disk only, 57% and 89%; and paravertebral soft tissue, 68% and 92%. There was no statistically significant difference between the yields of the endplate-disk, disk-only, and paravertebral soft-tissue biopsies.nnCONCLUSION: Paravertebral soft-tissue changes, when present, may be considered a viable target for biopsy in cases of diskitis-osteomyelitis, even in the absence of a paravertebral abscess.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: The purpose of this study was to determine whether there is a difference in biopsying bone (endplate), disk, or paravertebral soft tissue to culture the pathogenic organism causing diskitis-osteomyelitis.nnMATERIALS AND METHODS: A retrospective review was conducted of 111 spinal biopsies performed between 2002 and 2011. Pathologic examination was used as the reference standard for detecting diskitis-osteomyelitis. Microbiologic yield, sensitivity, and specificity were calculated. The yields for different groups were compared by use of Fisher exact test. The analysis was repeated with biopsy samples from patients not being treated with antibiotics at the time of biopsy.nnRESULTS: A total of 122 biopsy specimens were obtained from 111 spinal biopsy procedures on 102 patients. Overall, 27 (22%) biopsies were performed on the endplate-disk, 61 (50%) on the disk only, and 34 (28%) on paravertebral soft tissue only. The microbiologic yield was 36% for all biopsies, 19% for endplate-disk biopsies, 39% for disk-only biopsies, and 44% for soft-tissue biopsies. The sensitivity and specificity of the microbiologic results for all specimens were 57% and 89%; endplate-disk, 38% and 86%; disk only, 57% and 89%; and paravertebral soft tissue, 68% and 92%. There was no statistically significant difference between the yields of the endplate-disk, disk-only, and paravertebral soft-tissue biopsies.nnCONCLUSION: Paravertebral soft-tissue changes, when present, may be considered a viable target for biopsy in cases of diskitis-osteomyelitis, even in the absence of a paravertebral abscess.
Huang, Ambrose J; Chang, Connie Y; Thomas, Bijoy J; MacMahon, Peter J; Palmer, William E
Using cone-beam CT as a low-dose 3D imaging technique for the extremities: initial experience in 50 subjects Journal Article
In: Skeletal Radiol, vol. 44, no. 6, pp. 797–809, 2015, ISSN: 1432-2161.
@article{pmid25652734,
title = {Using cone-beam CT as a low-dose 3D imaging technique for the extremities: initial experience in 50 subjects},
author = {Ambrose J Huang and Connie Y Chang and Bijoy J Thomas and Peter J MacMahon and William E Palmer},
doi = {10.1007/s00256-015-2105-9},
issn = {1432-2161},
year = {2015},
date = {2015-06-01},
journal = {Skeletal Radiol},
volume = {44},
number = {6},
pages = {797--809},
abstract = {PURPOSE: To prospectively evaluate a dedicated extremity cone-beam CT (CBCT) scanner in cases with and without orthopedic hardware by (1) comparing its imaging duration and image quality to those of radiography and multidetector CT (MDCT) and (2) comparing its radiation dose to that of MDCT.nnMATERIALS AND METHODS: Written informed consent was obtained for all subjects for this IRB-approved, HIPAA-compliant study. Fifty subjects with (1) fracture of small bones, (2) suspected intraarticular fracture, (3) fracture at the site of complex anatomy, or (4) a surgical site difficult to assess with radiography alone were recruited and scanned on an extremity CBCT scanner prior to FDA approval. Same-day radiographs were performed in all subjects. Some subjects also underwent MDCT within 1 month of CBCT. Imaging duration and image quality were compared between CBCT and radiographs. Imaging duration, effective radiation dose, and image quality were compared between CBCT and MDCT.nnRESULTS: Fifty-one CBCT scans were performed in 50 subjects. Average imaging duration was shorter for CBCT than radiographs (4.5 min vs. 6.6 min, P = 0.001, n = 51) and MDCT (7.6 min vs. 10.9 min, P = 0.01, n = 7). Average estimated effective radiation dose was less for CBCT than MDCT (0.04 mSv vs. 0.13 mSv, P = .02, n = 7). CBCT images yielded more diagnostic information than radiographs in 23/51 cases and more diagnostic information than MDCT in 1/7 cases, although radiographs were superior for detecting hardware complications.nnCONCLUSION: CBCT performs high-resolution imaging of the extremities using less imaging time than radiographs and MDCT and lower radiation dose than MDCT.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To prospectively evaluate a dedicated extremity cone-beam CT (CBCT) scanner in cases with and without orthopedic hardware by (1) comparing its imaging duration and image quality to those of radiography and multidetector CT (MDCT) and (2) comparing its radiation dose to that of MDCT.nnMATERIALS AND METHODS: Written informed consent was obtained for all subjects for this IRB-approved, HIPAA-compliant study. Fifty subjects with (1) fracture of small bones, (2) suspected intraarticular fracture, (3) fracture at the site of complex anatomy, or (4) a surgical site difficult to assess with radiography alone were recruited and scanned on an extremity CBCT scanner prior to FDA approval. Same-day radiographs were performed in all subjects. Some subjects also underwent MDCT within 1 month of CBCT. Imaging duration and image quality were compared between CBCT and radiographs. Imaging duration, effective radiation dose, and image quality were compared between CBCT and MDCT.nnRESULTS: Fifty-one CBCT scans were performed in 50 subjects. Average imaging duration was shorter for CBCT than radiographs (4.5 min vs. 6.6 min, P = 0.001, n = 51) and MDCT (7.6 min vs. 10.9 min, P = 0.01, n = 7). Average estimated effective radiation dose was less for CBCT than MDCT (0.04 mSv vs. 0.13 mSv, P = .02, n = 7). CBCT images yielded more diagnostic information than radiographs in 23/51 cases and more diagnostic information than MDCT in 1/7 cases, although radiographs were superior for detecting hardware complications.nnCONCLUSION: CBCT performs high-resolution imaging of the extremities using less imaging time than radiographs and MDCT and lower radiation dose than MDCT.
Simeone, F Joseph; Huang, Ambrose J; Chang, Connie Y; Smith, Maximilian; Gill, Thomas J; Bredella, Miriam A; Torriani, Martin
Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis Journal Article
In: Skeletal Radiol, vol. 44, no. 4, pp. 557–563, 2015, ISSN: 1432-2161.
@article{pmid25527466,
title = {Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis},
author = {F Joseph Simeone and Ambrose J Huang and Connie Y Chang and Maximilian Smith and Thomas J Gill and Miriam A Bredella and Martin Torriani},
doi = {10.1007/s00256-014-2081-5},
issn = {1432-2161},
year = {2015},
date = {2015-04-01},
journal = {Skeletal Radiol},
volume = {44},
number = {4},
pages = {557--563},
abstract = {OBJECTIVE: To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings.nnMETHODS: We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects.nnRESULTS: Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26).nnCONCLUSIONS: Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings.nnMETHODS: We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects.nnRESULTS: Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26).nnCONCLUSIONS: Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome.
Chang, Connie Y; Gill, Corey M; Huang, Ambrose J; Simeone, Frank J; Torriani, Martin; McCarthy, Joseph C; Bredella, Miriam A
Use of MR arthrography in detecting tears of the ligamentum teres with arthroscopic correlation Journal Article
In: Skeletal Radiol, vol. 44, no. 3, pp. 361–367, 2015, ISSN: 1432-2161.
@article{pmid25527467,
title = {Use of MR arthrography in detecting tears of the ligamentum teres with arthroscopic correlation},
author = {Connie Y Chang and Corey M Gill and Ambrose J Huang and Frank J Simeone and Martin Torriani and Joseph C McCarthy and Miriam A Bredella},
doi = {10.1007/s00256-014-2082-4},
issn = {1432-2161},
year = {2015},
date = {2015-03-01},
journal = {Skeletal Radiol},
volume = {44},
number = {3},
pages = {361--367},
abstract = {OBJECTIVE: To demonstrate the normal appearance of the ligamentum teres on MR arthrography (MRA) and evaluate the accuracy of MRA in detecting ligamentum teres tears with arthroscopic correlation.nnMATERIALS AND METHODS: Institutional Review Board approval was obtained with a waiver for informed consent because of the retrospective study design. A total of 165 cases in 159 patients (111 females, 48 males; mean age 41 ± 12 years) who underwent both MRA and hip arthroscopy were evaluated for appearance of the ligamentum teres, including the size, number of bundles, and ligamentum teres tears. Marrow edema of the fovea capitis adjacent to the ligamentum teres insertion and the presence of hip plicae were also recorded.nnRESULTS: The mean thickness and length of the ligamentum teres were 3.5 ± 1.5 mm and 25.2 ± 3.8 mm, respectively. Sensitivity, specificity, positive and negative predictive value, and accuracy of MRA for the detection of ligamentum teres tears were 78, 97, 74, 97, and 95%, respectively.nnCONCLUSION: MRA is an accurate method to evaluate the normal morphology and to detect tears of the ligamentum teres.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To demonstrate the normal appearance of the ligamentum teres on MR arthrography (MRA) and evaluate the accuracy of MRA in detecting ligamentum teres tears with arthroscopic correlation.nnMATERIALS AND METHODS: Institutional Review Board approval was obtained with a waiver for informed consent because of the retrospective study design. A total of 165 cases in 159 patients (111 females, 48 males; mean age 41 ± 12 years) who underwent both MRA and hip arthroscopy were evaluated for appearance of the ligamentum teres, including the size, number of bundles, and ligamentum teres tears. Marrow edema of the fovea capitis adjacent to the ligamentum teres insertion and the presence of hip plicae were also recorded.nnRESULTS: The mean thickness and length of the ligamentum teres were 3.5 ± 1.5 mm and 25.2 ± 3.8 mm, respectively. Sensitivity, specificity, positive and negative predictive value, and accuracy of MRA for the detection of ligamentum teres tears were 78, 97, 74, 97, and 95%, respectively.nnCONCLUSION: MRA is an accurate method to evaluate the normal morphology and to detect tears of the ligamentum teres.
Bredella, Miriam A; Azevedo, Debora C; Oliveira, Adriana L; Simeone, Frank J; Chang, Connie Y; Stubbs, Allston J; Torriani, Martin
Pelvic morphology in ischiofemoral impingement Journal Article
In: Skeletal Radiol, vol. 44, no. 2, pp. 249–253, 2015, ISSN: 1432-2161.
@article{pmid25371087,
title = {Pelvic morphology in ischiofemoral impingement},
author = {Miriam A Bredella and Debora C Azevedo and Adriana L Oliveira and Frank J Simeone and Connie Y Chang and Allston J Stubbs and Martin Torriani},
doi = {10.1007/s00256-014-2041-0},
issn = {1432-2161},
year = {2015},
date = {2015-02-01},
journal = {Skeletal Radiol},
volume = {44},
number = {2},
pages = {249--253},
abstract = {OBJECTIVE: To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls.nnMATERIALS AND METHODS: The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender.nnRESULTS: The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15%) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender.nnCONCLUSION: Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To assess MRI measures to quantify pelvic morphology that may predispose to ischiofemoral impingement (IFI). We hypothesized that patients with IFI have a wider interischial distance and an increased femoral neck angle compared with normal controls.nnMATERIALS AND METHODS: The study was IRB-approved and complied with HIPAA guidelines. IFI was diagnosed based on clinical findings (hip or buttock pain) and ipsilateral edema of the quadratus femoris muscle on MRI. Control subjects did not report isolated hip/buttock pain and underwent MRI for surveillance of neoplasms or to exclude pelvic fractures. Two MSK radiologists measured the ischiofemoral (IF) and quadratus femoris (QF) distance, the ischial angle as a measure of inter-ischial distance, and the femoral neck angle. The quadratus femoris muscle was evaluated for edema. Groups were compared using ANOVA. Multivariate standard least-squares regression modeling was used to control for age and gender.nnRESULTS: The study group comprised 84 patients with IFI (53 ± 16 years, 73 female, 11 male) and 51 controls (52 ± 16 years, 33 female, 18 male). Thirteen out of 84 patients (15%) had bilateral IFI. Patients with IFI had decreased IF and QF distance (p < 0.0001), increased ischial angle (p = 0.004), and increased femoral neck angle (p = 0.02) compared with controls, independent of age and gender.nnCONCLUSION: Patients with IFI have increased ischial and femoral neck angles compared with controls. These anatomical variations in pelvic morphology may predispose to IFI. MRI is a useful method of not only assessing the osseous and soft-tissue abnormalities associated with IFI, but also of quantifying anatomical variations in pelvic morphology that can predispose to IFI.
Chang, Connie Y; Huang, Ambrose J; Palmer, William E
Radiographic evaluation of hip implants Journal Article
In: Semin Musculoskelet Radiol, vol. 19, no. 1, pp. 12–20, 2015, ISSN: 1098-898X.
@article{pmid25633021,
title = {Radiographic evaluation of hip implants},
author = {Connie Y Chang and Ambrose J Huang and William E Palmer},
doi = {10.1055/s-0034-1396763},
issn = {1098-898X},
year = {2015},
date = {2015-02-01},
journal = {Semin Musculoskelet Radiol},
volume = {19},
number = {1},
pages = {12--20},
abstract = {Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty.
Chang, Connie Y; Huang, Ambrose J; Palmer, William E
Radiographic evaluation of hip implants Journal Article
In: Semin Musculoskelet Radiol, vol. 19, no. 1, pp. 12–20, 2015, ISSN: 1098-898X.
@article{pmid25633021b,
title = {Radiographic evaluation of hip implants},
author = {Connie Y Chang and Ambrose J Huang and William E Palmer},
doi = {10.1055/s-0034-1396763},
issn = {1098-898X},
year = {2015},
date = {2015-02-01},
journal = {Semin Musculoskelet Radiol},
volume = {19},
number = {1},
pages = {12--20},
abstract = {Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty.
Hassanzadeh, Elmira; Chang, Connie Y; Huang, Ambrose J; Shaqdan, Khalid; Mansouri, Mohammad; Aran, Shima; Abujudeh, Hani H
CT and MRI manifestations of luxatio erecta humeri and a review of the literature Journal Article
In: Clin Imaging, vol. 39, no. 5, pp. 876–879, 2015, ISSN: 1873-4499.
@article{pmid25979120,
title = {CT and MRI manifestations of luxatio erecta humeri and a review of the literature},
author = {Elmira Hassanzadeh and Connie Y Chang and Ambrose J Huang and Khalid Shaqdan and Mohammad Mansouri and Shima Aran and Hani H Abujudeh},
doi = {10.1016/j.clinimag.2015.04.009},
issn = {1873-4499},
year = {2015},
date = {2015-01-01},
journal = {Clin Imaging},
volume = {39},
number = {5},
pages = {876--879},
abstract = {AIM: We aimed to study luxatio erecta humeri using advanced imaging modalities.nnMETHOD: Patients with luxatio erecta humeri and a subsequent magnetic resonance imaging (MRI) and/or computed tomography (CT) scan were included in this study.nnRESULTS: Among 10 identified cases, we detected 2 rotator cuff, 4 labral, and 2 inferior glenohumeral ligament tears as well as 2 glenohumeral cartilage defects. We observed six comminuted displaced greater tuberosity fractures, four anterior inferior glenoid fractures, and four impaction fractures of humeral head.nnCONCLUSION: This study provides detailed radiologic findings associated with luxatio erecta humeri using MRI and CT.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
AIM: We aimed to study luxatio erecta humeri using advanced imaging modalities.nnMETHOD: Patients with luxatio erecta humeri and a subsequent magnetic resonance imaging (MRI) and/or computed tomography (CT) scan were included in this study.nnRESULTS: Among 10 identified cases, we detected 2 rotator cuff, 4 labral, and 2 inferior glenohumeral ligament tears as well as 2 glenohumeral cartilage defects. We observed six comminuted displaced greater tuberosity fractures, four anterior inferior glenoid fractures, and four impaction fractures of humeral head.nnCONCLUSION: This study provides detailed radiologic findings associated with luxatio erecta humeri using MRI and CT.
2014
Taneja, Atul K; Kattapuram, Susan V; Chang, Connie Y; Simeone, F Joseph; Bredella, Miriam A; Torriani, Martin
MRI findings of rotator cuff myotendinous junction injury Journal Article
In: AJR Am J Roentgenol, vol. 203, no. 2, pp. 406–411, 2014, ISSN: 1546-3141.
@article{pmid25055277,
title = {MRI findings of rotator cuff myotendinous junction injury},
author = {Atul K Taneja and Susan V Kattapuram and Connie Y Chang and F Joseph Simeone and Miriam A Bredella and Martin Torriani},
doi = {10.2214/AJR.13.11474},
issn = {1546-3141},
year = {2014},
date = {2014-08-01},
journal = {AJR Am J Roentgenol},
volume = {203},
number = {2},
pages = {406--411},
abstract = {OBJECTIVE: The purpose of this article is to describe the MRI features of rotator cuff myotendinous junction injuries.nnMATERIALS AND METHODS: We retrospectively identified MRI cases with myotendinous junction injury of the rotator cuff muscles and reviewed clinical, imaging, and surgical records. MR images were reviewed independently by two musculoskeletal radiologists to grade myotendinous junction injuries (strain, partial tear, or complete tear) and to assess for concurrent tendon tears (partial or full thickness) and bone changes (fracture or contusion).nnRESULTS: The final study group comprised 16 subjects. The mean age was 38 years, with a majority of men (56%). The left shoulder was affected in 56% of subjects, with the dominant upper limb affected in 50%. The mean time between symptoms and MRI was 19 days. Subjects reported heavy lifting (19%), landing on the arm after a fall (19%), or prior shoulder therapeutic injection (25%). Myotendinous junction injuries affected the infraspinatus muscle (50%), followed by the supraspinatus (31%), subscapularis (25%), and teres minor (19%) muscles. About one fifth of subjects presented with more than one muscle affected, and 94% did not present with tears of the corresponding tendons. Most myotendinous junction injuries were strains (80%), followed by partial tears (20%). No complete tears were identified. There was no correlation between myotendinous junction injury and the presence of bone changes or the presence of tendon tears (p > 0.05).nnCONCLUSION: Rotator cuff myotendinous junction injuries affect mostly the infra-spinatus and supraspinatus muscles, usually in a strain pattern and without tear of the corresponding tendon attachment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: The purpose of this article is to describe the MRI features of rotator cuff myotendinous junction injuries.nnMATERIALS AND METHODS: We retrospectively identified MRI cases with myotendinous junction injury of the rotator cuff muscles and reviewed clinical, imaging, and surgical records. MR images were reviewed independently by two musculoskeletal radiologists to grade myotendinous junction injuries (strain, partial tear, or complete tear) and to assess for concurrent tendon tears (partial or full thickness) and bone changes (fracture or contusion).nnRESULTS: The final study group comprised 16 subjects. The mean age was 38 years, with a majority of men (56%). The left shoulder was affected in 56% of subjects, with the dominant upper limb affected in 50%. The mean time between symptoms and MRI was 19 days. Subjects reported heavy lifting (19%), landing on the arm after a fall (19%), or prior shoulder therapeutic injection (25%). Myotendinous junction injuries affected the infraspinatus muscle (50%), followed by the supraspinatus (31%), subscapularis (25%), and teres minor (19%) muscles. About one fifth of subjects presented with more than one muscle affected, and 94% did not present with tears of the corresponding tendons. Most myotendinous junction injuries were strains (80%), followed by partial tears (20%). No complete tears were identified. There was no correlation between myotendinous junction injury and the presence of bone changes or the presence of tendon tears (p > 0.05).nnCONCLUSION: Rotator cuff myotendinous junction injuries affect mostly the infra-spinatus and supraspinatus muscles, usually in a strain pattern and without tear of the corresponding tendon attachment.
Chang, Connie Y; Huang, Ambrose J; Bredella, Miriam A; Kattapuram, Susan V; Torriani, Martin
Association between distal ulnar morphology and extensor carpi ulnaris tendon pathology Journal Article
In: Skeletal Radiol, vol. 43, no. 6, pp. 793–800, 2014, ISSN: 1432-2161.
@article{pmid24595441,
title = {Association between distal ulnar morphology and extensor carpi ulnaris tendon pathology},
author = {Connie Y Chang and Ambrose J Huang and Miriam A Bredella and Susan V Kattapuram and Martin Torriani},
doi = {10.1007/s00256-014-1845-2},
issn = {1432-2161},
year = {2014},
date = {2014-06-01},
journal = {Skeletal Radiol},
volume = {43},
number = {6},
pages = {793--800},
abstract = {OBJECTIVE: The purpose of this study was to evaluate the association between distal ulnar morphology and extensor carpi ulnaris (ECU) tendon pathology.nnMATERIALS AND METHODS: We retrospectively reviewed 71 adult wrist MRI studies with ECU tendon pathology (tenosynovitis, tendinopathy, or tear), and/or ECU subluxation. Subjects did not have a history of trauma, surgery, infection, or inflammatory arthritis. MRI studies from 46 subjects without ECU tendon pathology or subluxation were used as controls. The following morphological parameters of the distal ulna were measured independently by two readers: ulnar variance relative to radius, ulnar styloid process length, ECU groove depth and length. Subjects and controls were compared using Student's t test. Inter-observer agreement (ICC) was calculated.nnRESULTS: There was a significant correlation between negative ulnar variance and ECU tendon pathology (reader 1 [R1], P = 0.01; reader 2 [R2], P < 0.0001; R1 and R2 averaged data, P < 0.0001) and ECU tendon subluxation (P = 0.001; P = 0.0001; P < 0.0001). In subjects with ECU tendon subluxation there was also a trend toward a shorter length (P = 0.3; P <0.0001; P = 0.001) and a shallower ECU groove (P = 0.01; P = 0.03; P = 0.01; R1 and R2 averaged data with Bonferroni correction, P = 0.08). ECU groove depth (P = 0.6; P = 0.8; P = 0.9) and groove length (P = 0.1; P = 0.4; P = 0.7) showed no significant correlation with ECU tendon pathology, and length of the ulnar styloid process showed no significant correlation with ECU tendon pathology (P = 0.2; P = 0.3; P = 0.2) or subluxation (P = 0.4; P = 0.5; P = 0.5). Inter-observer agreement (ICC) was >0.64 for all parameters.nnCONCLUSION: Distal ulnar morphology may be associated with ECU tendon abnormalities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: The purpose of this study was to evaluate the association between distal ulnar morphology and extensor carpi ulnaris (ECU) tendon pathology.nnMATERIALS AND METHODS: We retrospectively reviewed 71 adult wrist MRI studies with ECU tendon pathology (tenosynovitis, tendinopathy, or tear), and/or ECU subluxation. Subjects did not have a history of trauma, surgery, infection, or inflammatory arthritis. MRI studies from 46 subjects without ECU tendon pathology or subluxation were used as controls. The following morphological parameters of the distal ulna were measured independently by two readers: ulnar variance relative to radius, ulnar styloid process length, ECU groove depth and length. Subjects and controls were compared using Student's t test. Inter-observer agreement (ICC) was calculated.nnRESULTS: There was a significant correlation between negative ulnar variance and ECU tendon pathology (reader 1 [R1], P = 0.01; reader 2 [R2], P < 0.0001; R1 and R2 averaged data, P < 0.0001) and ECU tendon subluxation (P = 0.001; P = 0.0001; P < 0.0001). In subjects with ECU tendon subluxation there was also a trend toward a shorter length (P = 0.3; P <0.0001; P = 0.001) and a shallower ECU groove (P = 0.01; P = 0.03; P = 0.01; R1 and R2 averaged data with Bonferroni correction, P = 0.08). ECU groove depth (P = 0.6; P = 0.8; P = 0.9) and groove length (P = 0.1; P = 0.4; P = 0.7) showed no significant correlation with ECU tendon pathology, and length of the ulnar styloid process showed no significant correlation with ECU tendon pathology (P = 0.2; P = 0.3; P = 0.2) or subluxation (P = 0.4; P = 0.5; P = 0.5). Inter-observer agreement (ICC) was >0.64 for all parameters.nnCONCLUSION: Distal ulnar morphology may be associated with ECU tendon abnormalities.
2013
Taneja, Atul K; Simeone, F Joseph; Chang, Connie Y; Kumar, Vidhya; Daley, Scott; Bredella, Miriam A; Torriani, Martin
Peroneal tendon abnormalities in subjects with an enlarged peroneal tubercle Journal Article
In: Skeletal Radiol, vol. 42, no. 12, pp. 1703–1709, 2013, ISSN: 1432-2161.
@article{pmid24057440,
title = {Peroneal tendon abnormalities in subjects with an enlarged peroneal tubercle},
author = {Atul K Taneja and F Joseph Simeone and Connie Y Chang and Vidhya Kumar and Scott Daley and Miriam A Bredella and Martin Torriani},
doi = {10.1007/s00256-013-1725-1},
issn = {1432-2161},
year = {2013},
date = {2013-12-01},
journal = {Skeletal Radiol},
volume = {42},
number = {12},
pages = {1703--1709},
abstract = {OBJECTIVE: To examine the association between inframalleolar peroneal tendon abnormalities and an enlarged peroneal tubercle.nnMATERIALS AND METHODS: Two independent readers evaluated consecutive ankle MR imaging studies to classify inframalleolar peroneal tendon findings as normal, tenosynovitis, partial tear or complete tear. The size and morphology of the peroneal tubercle was also recorded. We performed statistical analyses for inter-observer agreement and to assess differences in peroneal tubercle size between groups with and without peroneal tendon abnormalities.nnRESULTS: The study group comprised 121 subjects (mean age, 45.5 years) of whom 28% (34 out of 121) had lateral ankle symptoms. The peroneal tubercle was absent in 56% of subjects (68 out of 121). In subjects with a peroneal tubercle (>0 mm), the mean size was 3.5 mm (37% triangular and 7% plateau-shaped). Male subjects had significantly larger mean peroneal tubercle size than female subjects (2.1 ± 2.5 vs 1.2 ± 1.9 mm, P = 0.04). Overall, 26% (32 out of 121) of subjects had some peroneal tendon abnormality: 17% (20 out of 121) had tenosynovitis and 17 % (20 out of 121) had partial thickness tears. The peroneal tubercle size was significantly larger in subjects with peroneal tendon partial tears (P = 0.036), tenosynovitis (P < 0.001), and when both abnormalities were present (P = 0.007). ROC statistic showed 73% sensitivity and 74% specificity for detection of partial tears for peroneal tubercle size ≥4.3 mm.nnCONCLUSION: Our study shows a significantly larger peroneal tubercle in subjects with inframalleolar peroneal tendon abnormalities. A cut-off of 4.3 mm showed good sensitivity and specificity for the presence of partial tears of the peroneal tendon.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To examine the association between inframalleolar peroneal tendon abnormalities and an enlarged peroneal tubercle.nnMATERIALS AND METHODS: Two independent readers evaluated consecutive ankle MR imaging studies to classify inframalleolar peroneal tendon findings as normal, tenosynovitis, partial tear or complete tear. The size and morphology of the peroneal tubercle was also recorded. We performed statistical analyses for inter-observer agreement and to assess differences in peroneal tubercle size between groups with and without peroneal tendon abnormalities.nnRESULTS: The study group comprised 121 subjects (mean age, 45.5 years) of whom 28% (34 out of 121) had lateral ankle symptoms. The peroneal tubercle was absent in 56% of subjects (68 out of 121). In subjects with a peroneal tubercle (>0 mm), the mean size was 3.5 mm (37% triangular and 7% plateau-shaped). Male subjects had significantly larger mean peroneal tubercle size than female subjects (2.1 ± 2.5 vs 1.2 ± 1.9 mm, P = 0.04). Overall, 26% (32 out of 121) of subjects had some peroneal tendon abnormality: 17% (20 out of 121) had tenosynovitis and 17 % (20 out of 121) had partial thickness tears. The peroneal tubercle size was significantly larger in subjects with peroneal tendon partial tears (P = 0.036), tenosynovitis (P < 0.001), and when both abnormalities were present (P = 0.007). ROC statistic showed 73% sensitivity and 74% specificity for detection of partial tears for peroneal tubercle size ≥4.3 mm.nnCONCLUSION: Our study shows a significantly larger peroneal tubercle in subjects with inframalleolar peroneal tendon abnormalities. A cut-off of 4.3 mm showed good sensitivity and specificity for the presence of partial tears of the peroneal tendon.
Taneja, Atul K; Bierry, Guillaume; Simeone, F Joseph; Chang, Connie Y; Bredella, Miriam A; Torriani, Martin
Diagnostic yield of CT-guided sampling in suspected sternoclavicular joint infection Journal Article
In: Skeletal Radiol, vol. 42, no. 4, pp. 479–485, 2013, ISSN: 1432-2161.
@article{pmid23179735,
title = {Diagnostic yield of CT-guided sampling in suspected sternoclavicular joint infection},
author = {Atul K Taneja and Guillaume Bierry and F Joseph Simeone and Connie Y Chang and Miriam A Bredella and Martin Torriani},
doi = {10.1007/s00256-012-1535-x},
issn = {1432-2161},
year = {2013},
date = {2013-04-01},
journal = {Skeletal Radiol},
volume = {42},
number = {4},
pages = {479--485},
abstract = {OBJECTIVE: To determine the prevalence of infection diagnosed by percutaneous computed tomography (CT)-guided sternoclavicular (SC) sampling in cases of suspected joint infection.nnMATERIALS AND METHODS: A retrospective search was performed in reports of SC joint CT-guided biopsies in adults from July 1992 to July 2012. We reviewed medical records, radiology, microbiology, laboratory, and surgical reports. A positive result was defined as demonstration of a pathogenic organism, either by microscopy or growth in culture, confirming the diagnosis of SC joint infection. A negative result was defined as the absence of such findings. Patients in whom sampling was unsuccessful or not subjected to microbiology were excluded. In addition, CT images were reviewed by the consensus of two musculoskeletal radiologists.nnRESULTS: A total of 41 patients (mean age 57.1 years) underwent CT-guided SC joint sampling, 27 of whom underwent microbiology studies. Sampling was performed using core biopsy alone in 19%, fine needle aspiration alone in 44%, and aspiration combined with core biopsy in 37%. Positive results were found in 52% (14/27) of patients. Related diseases and predisposing conditions for infection were found in 79% of positive patients. Negative results were found in 48% (13/27) of patients. There were no procedure-related complications. The dominant CT findings were soft tissue swelling (negative group), and effusion and/or capsular hypertrophy/distension (positive group).nnCONCLUSIONS: CT-guided sampling is a safe procedure with positive microbiological cultures in slightly more than half of cases.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To determine the prevalence of infection diagnosed by percutaneous computed tomography (CT)-guided sternoclavicular (SC) sampling in cases of suspected joint infection.nnMATERIALS AND METHODS: A retrospective search was performed in reports of SC joint CT-guided biopsies in adults from July 1992 to July 2012. We reviewed medical records, radiology, microbiology, laboratory, and surgical reports. A positive result was defined as demonstration of a pathogenic organism, either by microscopy or growth in culture, confirming the diagnosis of SC joint infection. A negative result was defined as the absence of such findings. Patients in whom sampling was unsuccessful or not subjected to microbiology were excluded. In addition, CT images were reviewed by the consensus of two musculoskeletal radiologists.nnRESULTS: A total of 41 patients (mean age 57.1 years) underwent CT-guided SC joint sampling, 27 of whom underwent microbiology studies. Sampling was performed using core biopsy alone in 19%, fine needle aspiration alone in 44%, and aspiration combined with core biopsy in 37%. Positive results were found in 52% (14/27) of patients. Related diseases and predisposing conditions for infection were found in 79% of positive patients. Negative results were found in 48% (13/27) of patients. There were no procedure-related complications. The dominant CT findings were soft tissue swelling (negative group), and effusion and/or capsular hypertrophy/distension (positive group).nnCONCLUSIONS: CT-guided sampling is a safe procedure with positive microbiological cultures in slightly more than half of cases.
Chang, Connie Y; Huang, Ambrose J
MR imaging of normal hip anatomy Journal Article
In: Magn Reson Imaging Clin N Am, vol. 21, no. 1, pp. 1–19, 2013, ISSN: 1557-9786.
@article{pmid23168179,
title = {MR imaging of normal hip anatomy},
author = {Connie Y Chang and Ambrose J Huang},
doi = {10.1016/j.mric.2012.08.006},
issn = {1557-9786},
year = {2013},
date = {2013-02-01},
journal = {Magn Reson Imaging Clin N Am},
volume = {21},
number = {1},
pages = {1--19},
abstract = {Understanding normal anatomy of the hip is important for diagnosing its pathology. MR arthrography is more sensitive for the detection of intra-articular pathology than noncontrast MR imaging. Important elements of the osseous structures on MR imaging include the alignment and the marrow. Acetabular ossicles may be present. Normal variations involving the cartilage include the supra-acetabular fossa and the stellate lesion. Important muscles of the hip are the sartorius, rectus femoris, iliopsoas, gluteus minimus and medius, adductors, and hamstrings. The iliofemoral, ischiofemoral, and pubofemoral ligaments represent thickenings of the joint capsule that reinforce and stabilize the hip joint. Normal variations in the labrum include labral sulcus and absent labrum. The largest nerves in the hip and thigh are the sciatic nerve, the femoral nerve, and the obturator nerve.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Understanding normal anatomy of the hip is important for diagnosing its pathology. MR arthrography is more sensitive for the detection of intra-articular pathology than noncontrast MR imaging. Important elements of the osseous structures on MR imaging include the alignment and the marrow. Acetabular ossicles may be present. Normal variations involving the cartilage include the supra-acetabular fossa and the stellate lesion. Important muscles of the hip are the sartorius, rectus femoris, iliopsoas, gluteus minimus and medius, adductors, and hamstrings. The iliofemoral, ischiofemoral, and pubofemoral ligaments represent thickenings of the joint capsule that reinforce and stabilize the hip joint. Normal variations in the labrum include labral sulcus and absent labrum. The largest nerves in the hip and thigh are the sciatic nerve, the femoral nerve, and the obturator nerve.
Chang, Connie Y; Huang, Ambrose J
MR imaging of normal hip anatomy Journal Article
In: Magn Reson Imaging Clin N Am, vol. 21, no. 1, pp. 1–19, 2013, ISSN: 1557-9786.
@article{pmid23168179b,
title = {MR imaging of normal hip anatomy},
author = {Connie Y Chang and Ambrose J Huang},
doi = {10.1016/j.mric.2012.08.006},
issn = {1557-9786},
year = {2013},
date = {2013-02-01},
journal = {Magn Reson Imaging Clin N Am},
volume = {21},
number = {1},
pages = {1--19},
abstract = {Understanding normal anatomy of the hip is important for diagnosing its pathology. MR arthrography is more sensitive for the detection of intra-articular pathology than noncontrast MR imaging. Important elements of the osseous structures on MR imaging include the alignment and the marrow. Acetabular ossicles may be present. Normal variations involving the cartilage include the supra-acetabular fossa and the stellate lesion. Important muscles of the hip are the sartorius, rectus femoris, iliopsoas, gluteus minimus and medius, adductors, and hamstrings. The iliofemoral, ischiofemoral, and pubofemoral ligaments represent thickenings of the joint capsule that reinforce and stabilize the hip joint. Normal variations in the labrum include labral sulcus and absent labrum. The largest nerves in the hip and thigh are the sciatic nerve, the femoral nerve, and the obturator nerve.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Understanding normal anatomy of the hip is important for diagnosing its pathology. MR arthrography is more sensitive for the detection of intra-articular pathology than noncontrast MR imaging. Important elements of the osseous structures on MR imaging include the alignment and the marrow. Acetabular ossicles may be present. Normal variations involving the cartilage include the supra-acetabular fossa and the stellate lesion. Important muscles of the hip are the sartorius, rectus femoris, iliopsoas, gluteus minimus and medius, adductors, and hamstrings. The iliofemoral, ischiofemoral, and pubofemoral ligaments represent thickenings of the joint capsule that reinforce and stabilize the hip joint. Normal variations in the labrum include labral sulcus and absent labrum. The largest nerves in the hip and thigh are the sciatic nerve, the femoral nerve, and the obturator nerve.
Hartman, Rebecca I; Chang, Connie Y; Wo, Jennifer Y; Eisenberg, Jonathan D; Hong, Theodore S; Harisinghani, Mukesh G; Gazelle, G Scott; Pandharipande, Pari V
Optimizing adjuvant treatment decisions for stage t2 rectal cancer based on mesorectal node size: a decision analysis Journal Article
In: Acad Radiol, vol. 20, no. 1, pp. 79–89, 2013, ISSN: 1878-4046.
@article{pmid22947271,
title = {Optimizing adjuvant treatment decisions for stage t2 rectal cancer based on mesorectal node size: a decision analysis},
author = {Rebecca I Hartman and Connie Y Chang and Jennifer Y Wo and Jonathan D Eisenberg and Theodore S Hong and Mukesh G Harisinghani and G Scott Gazelle and Pari V Pandharipande},
doi = {10.1016/j.acra.2012.07.010},
issn = {1878-4046},
year = {2013},
date = {2013-01-01},
journal = {Acad Radiol},
volume = {20},
number = {1},
pages = {79--89},
abstract = {RATIONALE AND OBJECTIVES: The aim of this study was to optimize treatment decisions for patients with suspected stage T2 rectal cancer on the basis of mesorectal lymph node size at magnetic resonance imaging.nnMATERIALS AND METHODS: A decision-analytic model was developed to predict outcomes for patients with stage T2 rectal cancer at magnetic resonance imaging. Node-positive patients were assumed to benefit from chemoradiation prior to surgery. Imperfect magnetic resonance imaging performance for primary cancer and mesorectal nodal staging was incorporated. Five triage strategies were considered for administering preoperative chemoradiation: treat all patients; treat for any mesorectal node >3, >5, and >7 mm in size; and treat no patients. If nodal metastases or unsuspected stage T3 disease went untreated preoperatively, postoperative chemoradiation was needed, resulting in poorer outcomes. For each strategy, rates of acute and long-term chemoradiation toxicity and of 5-year local recurrence were computed. Effects of input parameter uncertainty were evaluated in sensitivity analysis.nnRESULTS: The optimal strategy depended on the outcome prioritized. Acute and long-term chemoradiation toxicity rates were minimized by triaging only patients with nodes >7 mm to preoperative chemoradiation (18.9% and 10.8%, respectively). A treat-all strategy minimized the 5-year local recurrence rate (5.6%). A 7-mm nodal triage threshold increased the 5-year local recurrence rate to 8.0%; when no patients were treated preoperatively, the local recurrence rate was 10.1%. With improved primary tumor staging, all outcomes could be further optimized.nnCONCLUSIONS: Mesorectal nodal size thresholds for preoperative chemoradiation should depend on the outcome prioritized: higher size thresholds reduce chemoradiation toxicity but increase recurrence rates. Improvements in nodal staging will have greater impact if primary tumor staging can be improved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
RATIONALE AND OBJECTIVES: The aim of this study was to optimize treatment decisions for patients with suspected stage T2 rectal cancer on the basis of mesorectal lymph node size at magnetic resonance imaging.nnMATERIALS AND METHODS: A decision-analytic model was developed to predict outcomes for patients with stage T2 rectal cancer at magnetic resonance imaging. Node-positive patients were assumed to benefit from chemoradiation prior to surgery. Imperfect magnetic resonance imaging performance for primary cancer and mesorectal nodal staging was incorporated. Five triage strategies were considered for administering preoperative chemoradiation: treat all patients; treat for any mesorectal node >3, >5, and >7 mm in size; and treat no patients. If nodal metastases or unsuspected stage T3 disease went untreated preoperatively, postoperative chemoradiation was needed, resulting in poorer outcomes. For each strategy, rates of acute and long-term chemoradiation toxicity and of 5-year local recurrence were computed. Effects of input parameter uncertainty were evaluated in sensitivity analysis.nnRESULTS: The optimal strategy depended on the outcome prioritized. Acute and long-term chemoradiation toxicity rates were minimized by triaging only patients with nodes >7 mm to preoperative chemoradiation (18.9% and 10.8%, respectively). A treat-all strategy minimized the 5-year local recurrence rate (5.6%). A 7-mm nodal triage threshold increased the 5-year local recurrence rate to 8.0%; when no patients were treated preoperatively, the local recurrence rate was 10.1%. With improved primary tumor staging, all outcomes could be further optimized.nnCONCLUSIONS: Mesorectal nodal size thresholds for preoperative chemoradiation should depend on the outcome prioritized: higher size thresholds reduce chemoradiation toxicity but increase recurrence rates. Improvements in nodal staging will have greater impact if primary tumor staging can be improved.
Taneja, Atul K; Bredella, Miriam A; Chang, Connie Y; Simeone, F Joseph; Kattapuram, Susan V; Torriani, Martin
Extrinsic wrist ligaments: prevalence of injury by magnetic resonance imaging and association with intrinsic ligament tears Journal Article
In: J Comput Assist Tomogr, vol. 37, no. 5, pp. 783–789, 2013, ISSN: 1532-3145.
@article{pmid24045257,
title = {Extrinsic wrist ligaments: prevalence of injury by magnetic resonance imaging and association with intrinsic ligament tears},
author = {Atul K Taneja and Miriam A Bredella and Connie Y Chang and F Joseph Simeone and Susan V Kattapuram and Martin Torriani},
doi = {10.1097/RCT.0b013e318298aa2a},
issn = {1532-3145},
year = {2013},
date = {2013-01-01},
journal = {J Comput Assist Tomogr},
volume = {37},
number = {5},
pages = {783--789},
abstract = {OBJECTIVE: The objective of this study was to determine the prevalence of extrinsic wrist ligament injury by magnetic resonance imaging and its association with intrinsic ligament tears.nnMETHODS: We reviewed conventional magnetic resonance images performed over a 5-year period from adult patients in the setting of wrist trauma. Two musculoskeletal radiologists examined the integrity of wrist ligaments and presence of bone abnormalities.nnRESULTS: In a cohort of 75 subjects, extrinsic ligament injury was present in 75%, with radiolunotriquetral being most frequently affected (45%). Intrinsic ligament injury was present in 60%. Almost half of subjects had combined intrinsic and extrinsic ligament injury. Bone abnormalities were seen in 69%. The rate of extrinsic injury was higher in subjects with bone injury (P = 0.008).nnCONCLUSIONS: There is high prevalence of extrinsic ligament injury in the setting of wrist trauma, especially in the presence of bone abnormalities, with combined injury of intrinsic and extrinsic ligaments in about half of cases.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: The objective of this study was to determine the prevalence of extrinsic wrist ligament injury by magnetic resonance imaging and its association with intrinsic ligament tears.nnMETHODS: We reviewed conventional magnetic resonance images performed over a 5-year period from adult patients in the setting of wrist trauma. Two musculoskeletal radiologists examined the integrity of wrist ligaments and presence of bone abnormalities.nnRESULTS: In a cohort of 75 subjects, extrinsic ligament injury was present in 75%, with radiolunotriquetral being most frequently affected (45%). Intrinsic ligament injury was present in 60%. Almost half of subjects had combined intrinsic and extrinsic ligament injury. Bone abnormalities were seen in 69%. The rate of extrinsic injury was higher in subjects with bone injury (P = 0.008).nnCONCLUSIONS: There is high prevalence of extrinsic ligament injury in the setting of wrist trauma, especially in the presence of bone abnormalities, with combined injury of intrinsic and extrinsic ligaments in about half of cases.
2012
Bierry, Guillaume; Huang, Ambrose J; Chang, Connie Y; Torriani, Martin; Bredella, Miriam A
MRI findings of treated bacterial septic arthritis Journal Article
In: Skeletal Radiol, vol. 41, no. 12, pp. 1509–1516, 2012, ISSN: 1432-2161.
@article{pmid22430565,
title = {MRI findings of treated bacterial septic arthritis},
author = {Guillaume Bierry and Ambrose J Huang and Connie Y Chang and Martin Torriani and Miriam A Bredella},
doi = {10.1007/s00256-012-1397-2},
issn = {1432-2161},
year = {2012},
date = {2012-12-01},
journal = {Skeletal Radiol},
volume = {41},
number = {12},
pages = {1509--1516},
abstract = {INTRODUCTION: The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis.nnMATERIALS AND METHODS: The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings.nnRESULTS: Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases.nnCONCLUSION: The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
INTRODUCTION: The purpose of this study was to report the MRI findings that can be encountered in successfully treated bacterial septic arthritis.nnMATERIALS AND METHODS: The study included 12 patients (8 male and 4 female; mean age 38 years, range 9-85) with 13 proven cases of bacterial septic arthritis. The joints involved were hip (n = 3), knee (n = 3), shoulder (n = 2), sacroiliac (n = 2), ankle (n = 1), wrist (n = 1), and elbow (n = 1). MRI examinations following surgical debridement and at initiation of antibiotic therapy and after successful treatment were compared for changes in effusion, synovium, bone, and periarticular soft tissues. Imaging findings were correlated with microbiological and clinical findings.nnRESULTS: Joint effusions were present in all joints at baseline and regressed significantly at follow-up MRI (p = 0.001). Abscesses were present in 5 cases (38 %), and their sizes decreased significantly at follow-up (p = 0.001). Synovial enhancement and thickening were observed in all joints at both baseline and follow-up MRI. Myositis/cellulitis was present in 10 cases (77 %) at baseline and in 8 cases (62 %) at follow-up MRI. Bone marrow edema was present in 10 joints (77 %) at baseline and persisted in 8 joints (62 %). Bone erosions were found in 8 joints (62 %) and persisted at follow-up MRI in all cases.nnCONCLUSION: The sizes of joint effusions and abscesses appear to be the factors with the most potential for monitoring therapy for septic arthritis, since both decreased significantly following successful treatment. Synovial thickening and enhancement, periarticular myositis/cellulitis, and bone marrow edema can persist even after resolution of the infection.
2010
Chang, Connie Y; Peck, Kyung K; Brennan, Nicole M; Hou, Bob L; Gutin, Philip H; Holodny, Andrei I
Functional MRI in the presurgical evaluation of patients with brain tumors: characterization of the statistical threshold Journal Article
In: Stereotact Funct Neurosurg, vol. 88, no. 1, pp. 35–41, 2010, ISSN: 1423-0372.
@article{pmid20051708,
title = {Functional MRI in the presurgical evaluation of patients with brain tumors: characterization of the statistical threshold},
author = {Connie Y Chang and Kyung K Peck and Nicole M Brennan and Bob L Hou and Philip H Gutin and Andrei I Holodny},
doi = {10.1159/000268740},
issn = {1423-0372},
year = {2010},
date = {2010-01-01},
journal = {Stereotact Funct Neurosurg},
volume = {88},
number = {1},
pages = {35--41},
abstract = {We investigated whether an optimal statistical threshold could be obtained in healthy controls and patients with brain tumors undergoing presurgical functional MRI assessment. The volumes of activation of the primary motor cortex (PMC) and the lateral prefrontal cortex (PFC) were measured for the tumor and nontumor sides in 24 patients and 8 controls using four parameters; p values ranged between 10(-2) and 10(-31). The mean r value for first activation in the PMC was higher in controls than for both the tumor and nontumor sides in patients. The mean r value for 'first activation in the noise area' and 'PMC and PFC ratio' in controls was significantly different from the mean r value for the tumor and nontumor sides in patients (p < 0.05). The magnitude of the range of r values for the nontumor side was closer to the tumor side data than to the control data. It is imperative to evaluate functional MRI data with a wide range of statistical parameters, especially in the assessment of tumor patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
We investigated whether an optimal statistical threshold could be obtained in healthy controls and patients with brain tumors undergoing presurgical functional MRI assessment. The volumes of activation of the primary motor cortex (PMC) and the lateral prefrontal cortex (PFC) were measured for the tumor and nontumor sides in 24 patients and 8 controls using four parameters; p values ranged between 10(-2) and 10(-31). The mean r value for first activation in the PMC was higher in controls than for both the tumor and nontumor sides in patients. The mean r value for 'first activation in the noise area' and 'PMC and PFC ratio' in controls was significantly different from the mean r value for the tumor and nontumor sides in patients (p < 0.05). The magnitude of the range of r values for the nontumor side was closer to the tumor side data than to the control data. It is imperative to evaluate functional MRI data with a wide range of statistical parameters, especially in the assessment of tumor patients.