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Category: Musculoskeletal Imaging

The advent of the multidetector CT (MDCT) scanner has increased the applicability of this imaging technique for the assessment of the musculoskeletal system. This technology allows for the acquisition of large data set in the axial plane that can be reconstructed in multiple planes of imaging with the use of multiplanar reconstruction (MPR) algorithm.

Other Knee Abnormalities

Other Knee Abnormalities

Patellar tendinitis (jumper’s knee) is demonstrated by MRI as an area of edema within the patellar ligament (i.e., tendon) at its patellar (Fig. 6-28) or tibial tuberosity attachment. There is also associated edema in the adjacent subcutaneous fat or the infrapatellar fat pad. FIGURE 6-28. Sagittal T2-weighted fat suppressed image of patellar tendinitis. The arrow points to the increased signal intensity within the proximal tendon fibers and the adjacent infrapatellar fat pad. . Ischemic necrosis about the knee most commonly…

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Collateral Ligament Injuries

Collateral Ligament Injuries

The collateral ligaments are best visualized by coronal MR images (Fig. 6-27). The medial collateral ligament appears as a narrow low–signal-intensity band extending from the medial epicondyle of the femur to an attachment on the anteromedial aspect of the tibia 5 to 6 cm below the joint line. It is overlaid at its tibial attachment by the tendons of the pes anserinus, which are separated from it by an intervening anserine bursa that is not visualized unless it is inflamed….

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Cruciate Ligament Injuries

Cruciate Ligament Injuries

The cruciate ligaments are best visualized by sagittal or oblique sagittal MR images that display the full length of the ligaments (Fig. 6-24A). On straight sagittal images, the slender nature of the anterior cruciate ligament and its oblique course cause a volume-averaging effect that averages fat signal intensity about the ligaments with the normal low signal intensity of the ligament so that the anterior cruciate ligament frequently does not appear as a complete signal void. Furthermore, straight sagittal images typically…

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Meniscal Injuries of the Knee

Meniscal Injuries of the Knee

All parts of both menisci are well visualized by MRI. Sagittal MR images provide good views of the anterior and posterior horns and a fair view of the body of both menisci. In more central sections, both horns of the menisci appear as wedge- shaped signal voids contrasted on their superior and inferior surfaces by the moderate signal intensity of the hyaline cartilage on the articular surfaces of the femur and tibia. In more peripheral sections, where the images are…

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Other Hip Abnormalities

Other Hip Abnormalities

Another hip region imaging application of potential interest to physiatrists involves the use of technetium bone scanning to evaluate recently described “thigh splints” caused by exaggerated stride length by short female basic trainees in the unisex-oriented military (34). Seven cases of thigh pain in female recruits at one military base were imaged after administration of technetium-99, with the expectation of finding stress fractures. Instead, the scans showed longitudinal linear accentuation sites in the upper or middle femur that were consistent…

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Femoroacetabular Impingement of the Hip

Femoroacetabular Impingement of the Hip

Femoroacetabular impingement is another cause of hip pain that may initially have a non–specific clinical presentation; however, a thorough physical evaluation should be able to identify this condition. Pain can be elicited on physical exam by passive movement of the thigh into full flexion, adduction, and internal rotation (34). Radiographs often help to identify anatomical variations such as dysplasia of the femoral neck (Fig. 6-19) or acetabular overcoverage. MR arthrography (Fig. 6-20) can be a helpful imaging study for evaluating…

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Ischemic Necrosis of the Hip

Ischemic Necrosis of the Hip

One of the common indications for MRI of the hip is to are the standard radiographs performed for the assessment determine the presence of ischemic necrosis. This is bone of hip joint abnormalities (26). The presence of osteoarthri death produced by a compromised blood supply. It also has tis, bone tumors, and soft-tissue calcifications can be assessed been called avascular necrosis, osteonecrosis, or aseptic necrosis. Predisposing factors that should raise the physician’s index of suspicion include corticosteroid therapy, alcoholism, known…

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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

MRI can serve as an adjunct diagnostic tool for CTS when the clinical or neurophysiologic findings are equivocal. The carpal tunnel is a fibro-osseous space with little fat that contains the flexor tendons and the median nerve. The flexor retinaculum composes the volar aspect of the tunnel and normally shows slight palmar bowing. The median nerve courses through the tunnel within its volar and radial aspect, and it can be differentiated from the adjacent tendons because it shows relative higher…

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Elbow Imaging

Elbow Imaging

Plain film radiographic examination of the elbows should be the initialevaluation forpatients withchronicelbowpain. Radiographs can be useful for the assessment of calcium within the joint compartment or periarticular soft tissues. Standard frontal and lateral radiographs are used for the routine evaluation of the elbow joint. Radiographic examination of the elbow has a minimal RRL. MRI has not been applied to the evaluation of elbow pathology as extensively as it has been to other large joints (17). However, improving imaging techniques…

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Tendinitis or Rupture of Other Shoulder Muscles

Tendinitis or Rupture of Other Shoulder Muscles

Tendinitis and rupture also can involve the subscapularis, infraspinatus, and teres minor, or biceps tendons, although far less commonly than the supraspinatus. Early tendinitis involves an increased signal intensity area within the tendon. This can progress to frank rupture of the tendon with a high–signalintensity area at the site of the tear on T2-weighted images and may be associated with joint effusion. A complete tear will eventually cause muscle retraction and later atrophy. Calcific tendinosis (Fig. 6-8) of the supraspinatus…

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