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  • 1
    ISSN: 1432-2161
    Keywords: Scaphoid ; Fracture ; Nonunion ; Grafting ; Radiographs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To determine how the appearance of fracture line bridging and graft incorporation changed on sequential plain films obtained during the healing of successful grafts for scaphoid nonunion. Patients We identified 50 patients who had healed Russe bone grafts for nonunited scaphoid fractures. These patients had 214 sets of wrist radiographs obtained 1–36 months after surgery. Each set of radiographs was reviewed in random order by two observers who were blinded as to the patient's name and the time interval since surgery. Closure of the fracture line and the presence of a linear lucency in each of six zones surrounding the graft were assessed using a three-point grading scale. Forty-six men and four women were included in the study. Their mean age was 30 years with a range from 21–43 years. Results and Conclusions With increasing time after surgery, there was progressive fracture line closing and disappearance of linear lucencies at the interfaces between the scaphoid and the graft. However, 20% of the patients had a well-defined lucency in at least one of the six zones around the graft on their last film. Even 1 year after surgery, the fracture line showed no bridging on the radial side in 22% of patients and on the ulnar side in 11%. We conclude that after grafting, most scaphoid nonunions show progressive fracture line closure and graft incorporation. However, the fracture line may not completely close and lucencies may persist in several zones around the graft for more than 1 year. These radiographic appearances should be recognized as part of the normal spectrum of healing.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2161
    Keywords: Shoulder injuries ; Tendon injuries ; Magnetic resonance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose. To determine the effect of decreasing the field of view (FOV) on the accuracy of MR for diagnosing rotator cuff tears. Material and methods. One hundred shoulder MR scans with surgical correlation were evaluated for the presence or absence of a cuff tear. The sensitivity and specificity of MR relative to the surgical results were determined for the 59 patients scanned with a 24-cm FOV, and the 41 patients scanned with an 18-cm FOV. All other imaging parameters including acquisition time were identical. The sensitivity and specificity of the two groups were compared using a t-test. Results. The specificity of MR for diagnosing a rotator cuff tear improved from 0.65 for the 24-cm FOV group to 0.89 for the 18-cm FOV group (P = 0.04). The sensitivity changed from 0.91 to 0.96 (P = 0.25). Conclusion. Reducing the FOV from 24 cm to 18 cm results in a statistically significant improvement in specificity of MR for diagnosing rotator cuff tears.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 24 (1995), S. 543-545 
    ISSN: 1432-2161
    Keywords: Meniscus ; Meniscal ossicle ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the MR appearance of a meniscal ossicle, which is an unusual etiology for knee pain. The role of MR in differentiating a meniscal ossicle from a loose body is presented. The MR images also demonstrated associated tibial cartilage thinning and a possible meniscal tear. These MR findings led to arthroscopic treatment rather than conservative management. A review of the literature on meniscal ossicles is also presented.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 24 (1995), S. 287-290 
    ISSN: 1432-2161
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 25 (1996), S. 739-741 
    ISSN: 1432-2161
    Keywords: Key words Shoulder ; Rotator cuff ; Magnetic resonance imaging ; Exercise
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To examine the effect of strenuous exercise on the magnetic resonance imaging (MRI) characteristics of the rotator cuff tendon. A second objective was to define an optimal time to image the rotator cuff and possibly eliminate exercise-induced false positives. Design and patients. Five male subjects from 24 to 38 years old with normal rotator cuffs by history, physical examination, and screening MRI underwent a rotator cuff exercise session on the Biodex System 2 (Biodex, Shirley, New York). The exercise sessions were followed by sequential MRI scans of the exercised shoulder. These were performed immediately and at 8 h and 24 h after exercise. Results and conclusions. The rotator cuff tendon and subacromial-subdeltoid bursal signal remained unchanged from the pre-exercise through the 24-h post-exercise scans. The rotator cuff muscle signal was increased in five of five subjects on the immediate post-exercise fat-suppressed T2-weighted images. This signal returned to baseline by the 8-h scan. Positive findings of rotator cuff pathology on MRI after strenuous athletic activity should not be discounted as normal exercise-induced changes. Also, diagnostic MRI scanning may take place after a practice session without an increased risk of false positives.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2161
    Keywords: Key words Magnetic resonance ; pulse sequences ; Shoulder ; MR imaging ; Shoulder ; abnormalities ; Shoulder ; dislocation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To compare the sensitivity, specificity, and accuracy of fat-suppressed fast spin-echo (FSE) mid-TE (TE[effective]=34) images with fat-suppressed FSE T2-weighted images for the diagnosis of labral abnormalities. Design and patients. The study included 27 consecutive patients who had axial fat-suppressed FSE T2-weighted and fat-suppressed FSE mid-TE MR images, and had labral abnormalities diagnosed at arthroscopy. The acquisition time was about 5 min for each sequence, but the mid-TE sequence allowed a higher spatial resolution than the T2-weighted images (256×256 versus 256×192). Twenty-eight age-matched patients with arthroscopically normal labra were included as a control group. The labrum was graded on the MR images as normal or abnormal separately by two musculoskeletal radiologists who were masked to the history and arthroscopic results. The surgical findings were used as the gold standard for calculating the sensitivity, specificity, and accuracy for interpreting the correct location of a labral abnormality. The sensitivity, specificity, and accuracy for the two sequences were compared with a McNemar test, and significance defined as P〈0.05. Results. For observer 1, the sensitivity for labral abnormalities was 0.59 on the T2-weighted images, and 0.78 on the mid-TE images (P=0.12). The specificity was 0.54 for the T2-weighted, and 0.64 for the mid-TE images (P=0.51). The accuracy was 0.56 for the T2-weighted, and 0.71 for the mid-TE images (P=0.08). For observer 2, the sensitivity/specificity/accuracy was 0.67/0.93/0.80 for the T2-weighted, and 0.70/0.86/0.78 for the mid-TE images (all P〉0.5). Conclusion. In this small study there is no statistically significant difference for demonstrating labral abnormalities between FSE T2-weighted images, and higher-resolution fat-suppressed FSE mid-TE (TE[effective]=34) images obtained with a similar acquisition time. Although there was a general trend toward higher sensitivity and accuracy with the mid-TE sequence, particularly for one of the two observers, a larger study is needed to determine whether this is the preferred single axial pulse sequence for conventional MR imaging of the labrum.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-2161
    Keywords: Rotator cuff ; Shoulder ; Magnetic resonance imaging ; Partial tear ; Gradient echo
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Most magnetic resonance (MR) studies evaluating the rotator cuff for tears have used T2-weighted imaging in the coronal oblique and sagittal oblique planes, T2*-weighted gradient echo imaging, however, has advantages over spin echo imaging, including contiguous slices without cross-talk, high contrast around the cuff, and intrinsically shorter imaging times which can be used to increase the number of signals averaged and thus improve the signal-to-noise ratio. We reviewed the shoulder MR scans of 87 consecutive patients who underwent both a MR scan and a shoulder arthroscopy during which the size of tears, if present, was graded. The reviewers were blinded as to the history and arthroscopic results. The MR scans included oblique coronal T2*-weighted gradient echo and oblique sagittal T2-weighted spin echo images. MR cuff grades were correlated with arthroscopic findings. For complete tears, the sensitivity of MR was 0.91 and the specificity 0.95. For partial tears, the sensitivity was 0.74 and the specificity 0.87. This accuracy is similar to two-plane T2-weighted imaging as previously reported in the literature. There was a statistically significant correlation (p 〈 0.0005) between the cuff grade as determined by MR and the arthroscopic findings.
    Type of Medium: Electronic Resource
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