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Hur Y, Ahn JM, Kim HJ, Jeon Y, Kang Y, Gong HS. Peripheral tear of the triangular fibrocartilage complex: diagnostic accuracy of magnetic resonance imaging and diagnostic performance of the primary and secondary signs. Skeletal Radiol 2024; 53:1153-1163. [PMID: 38127153 DOI: 10.1007/s00256-023-04517-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study is to assess the diagnostic performance of magnetic resonance imaging (MRI) findings for type 1B triangular fibrocartilage complex (TFCC) tear of the wrist. MATERIALS AND METHODS This study retrospectively enrolled 78 patients to examine the diagnostic performance of preoperative MRI examinations in patients with type 1B TFCC tears. Thirty-nine participants had confirmed type 1B TFCC tear. The control group included 39 patients who were randomly selected from 1157 patients who underwent MRI for wrist pain. Both groups underwent a review of 19 MRI findings by two independent radiologists, and the correlation between each diagnostic finding and type 1B TFCC tear was assessed using the chi-squared test. The 19 MRI findings comprised eight primary signs of abnormalities in the distal or proximal lamina, in conjunction with 11 secondary signs suggestive of abnormalities in the surrounding structures. RESULTS The TFCC tear group demonstrated a significantly higher incidence of two primary MRI signs, i.e., fiber discontinuity and signal alteration in the distal lamina, as observed by both readers (R1, 74.4% vs. 38.5%, p = 0.003, and 87.2% vs. 43.6%, p < 0.001; R2, 74.4% vs. 35.9%, p = 0.001, and 87.2% vs. 53.8%, p < 0.003, respectively). Reader 2 identified a higher prevalence of two additional primary MRI signs: fiber discontinuity and signal alteration in the proximal lamina (all p < 0.05). None of the 11 secondary MRI signs demonstrated statistically significant associations with type 1B TFCC. CONCLUSION MRI manifestations of fiber discontinuity and signal alteration in the distal lamina may provide predictive markers for type 1B TFCC wrist tear.
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Affiliation(s)
- Youngjun Hur
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Joong Mo Ahn
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea.
| | - Hyo Jin Kim
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Yejin Jeon
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Yusuhn Kang
- Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
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Flores DV, Umpire DF, Rakhra KS, Jibri Z, Belmar GAS. Distal Radioulnar Joint: Normal Anatomy, Imaging of Common Disorders, and Injury Classification. Radiographics 2023; 43:e220109. [DOI: 10.1148/rg.220109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Dyan V. Flores
- From the Department of Medical Imaging, Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6 (D.V.F., K.S.R., Z.J.); Department of Radiology, Clínica Internacional, Lima, Peru (D.F.U.); and Department of Radiology, Clínica Alemana de Santiago, Vitacura, Chile (G.A.S.B.)
| | - Darwin Fernández Umpire
- From the Department of Medical Imaging, Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6 (D.V.F., K.S.R., Z.J.); Department of Radiology, Clínica Internacional, Lima, Peru (D.F.U.); and Department of Radiology, Clínica Alemana de Santiago, Vitacura, Chile (G.A.S.B.)
| | - Kawan S. Rakhra
- From the Department of Medical Imaging, Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6 (D.V.F., K.S.R., Z.J.); Department of Radiology, Clínica Internacional, Lima, Peru (D.F.U.); and Department of Radiology, Clínica Alemana de Santiago, Vitacura, Chile (G.A.S.B.)
| | - Zaid Jibri
- From the Department of Medical Imaging, Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6 (D.V.F., K.S.R., Z.J.); Department of Radiology, Clínica Internacional, Lima, Peru (D.F.U.); and Department of Radiology, Clínica Alemana de Santiago, Vitacura, Chile (G.A.S.B.)
| | - Gonzalo A. Serrano Belmar
- From the Department of Medical Imaging, Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6 (D.V.F., K.S.R., Z.J.); Department of Radiology, Clínica Internacional, Lima, Peru (D.F.U.); and Department of Radiology, Clínica Alemana de Santiago, Vitacura, Chile (G.A.S.B.)
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Hagag U, Nahas AE, Almohamad ZA, Brehm W, Gerlach K. 3T Magnetic resonance imaging and computed tomography of the bovine carpus. BMC Vet Res 2022; 18:236. [PMID: 35733155 PMCID: PMC9214995 DOI: 10.1186/s12917-022-03346-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background Lameness in cattle is a major health problem and causes great economic losses. Carpal injury is a common cause of forelimb lameness in cattle. Radiography and/or ultrasonography of the carpus is a challenge due to complex anatomy of the joint. Additional imaging using computed tomography (CT) or magnetic resonance imaging (MRI) may be indispensable for reaching a decisive diagnosis. Precise evaluation of the clinical CT and MRI images necessitates an in-depth knowledge of the normal CT and MRI tissue variants. Therefore, our purpose was to provide a detailed description of the normal CT and MRI appearance of the osseous and soft tissue structures of twelve cadaveric bovine carpi using CT and 3 Tesla MRI. Carpi were frozen, transected in sagittal, dorsal and transverse planes then adjoined to their corresponding CT and MRI images. Results The clinically significant articular and peri-articular structures of the bovine carpus were identified and characterized on the CT and MRI images. CT images provided a remarkable delineation of the cortical, subchondral, and cancellous bone. The high-field 3 Tesla MRI offered high definition and distinction of the delicate soft tissues of the bovine carpus. Conclusions 3 Tesla high-field MRI offers new opportunities in soft tissue tomography but cannot be compared with CT in terms of bone imaging. Clinicians have to determine whether CT, MRI or both imaging techniques are required in clinical situations.
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Affiliation(s)
- Usama Hagag
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, 62511, Egypt.
| | - Ayman El Nahas
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, PO Box 400, 31982, Al-Ahasa, Saudi Arabia
| | - Zakriya Ali Almohamad
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, PO Box 400, 31982, Al-Ahasa, Saudi Arabia
| | - Walter Brehm
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 21, 04103, Leipzig, Germany
| | - Kerstin Gerlach
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 21, 04103, Leipzig, Germany
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Ng WHA, Griffith JF, Ng ISH. How to Report: Wrist MRI. Semin Musculoskelet Radiol 2021; 25:670-680. [PMID: 34861712 DOI: 10.1055/s-0041-1736313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Knowledge of the imaging anatomy of the wrist is essential for reporting magnetic resonance imaging (MRI). This familiarity should include the carpal bones, tendons (extensor and flexor compartments), triangular fibrocartilage complex (TFCC), intrinsic and extrinsic ligaments, and nerves, especially the median and ulnar nerves. Limitations of MRI in visualizing these structures, particularly the intrinsic ligaments and the TFCC, need to be considered. This article outlines the main features to comment on when reporting common conditions of the wrist on MRI, with some examples of terminology that can be used to describe these abnormalities.
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Affiliation(s)
- Wing Hung Alex Ng
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - James Francis Griffith
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
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Accuracy of magnetic resonance imaging of the wrist for clinically important lesions of the major interosseous ligaments and triangular fibrocartilage complex; correlation with radiocarpal arthroscopy. Skeletal Radiol 2021; 50:1605-1616. [PMID: 33474588 DOI: 10.1007/s00256-020-03701-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To demonstrate the utility of MRI in separating clinically relevant from minor or incidental lesions of the triangular fibrocartilage complex and the major interosseous ligaments in the wrist. MATERIALS AND METHODS In this retrospective study, we identified 89 patients and correlated MRI finding with subsequent arthroscopy. Triangular fibrocartilage complex abnormalities have been subdivided into disc lesions-central and radial-or ulnar-sided tears according to MRI appearances and surgical findings as the clinical and surgical approach is very different. Interosseous ligament tears were subdivided into partial or complete, highlighting the principle of recognising surgically relevant lesions. RESULTS For simple central to radial tears and perforations of the triangular fibrocartilage complex, MRI was 98.3% accurate. MRI identified all peripheral triangular fibrocartilage complex tears seen at arthroscopy; however, the specificity of 66.7% may reflect partly the use of arthroscopy limited to the radiocarpal joint. MRI proved 95.4% accurate for surgically relevant scapholunate interosseous ligament tears and was highly accurate at separating limited from complete lunotriquetral interosseous ligament tears showing 100% accuracy for complete tears. CONCLUSIONS The study shows excellent correlation between MRI and arthroscopic findings that determine surgical relevance with a very high sensitivity for triangular fibrocartilage complex lesions and accurate separation of minor versus surgically relevant ligamentous tears.
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Qazi S, Graham D, Regal S, Tang P, Hammarstedt JE. Distal Radioulnar Joint Instability and Associated Injuries: A Literature Review. J Hand Microsurg 2021; 13:123-131. [PMID: 34539128 PMCID: PMC8440053 DOI: 10.1055/s-0041-1730886] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The distal radioulnar joint (DRUJ) allows supination and pronation of the distal forearm and wrist, an integral motion in everyday human activity. DRUJ injury and chronic instability can be a significant source of morbidity in patients' lives. Although often linked with distal radius fractures, DRUJ injury may occur in a variety of other upper extremity injuries, as well as an isolated pathology. Diagnosis of this injury requires the clinician to have a high index of suspicion and low threshold for clinical testing and further imaging of the DRUJ. The purpose of this article is to provide a review on DRUJ anatomy and biomechanics, to discuss common diagnostic and treatment modalities, and to identify common injuries associated with DRUJ instability.
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Affiliation(s)
- Sohail Qazi
- Department of Orthopaedic Surgery, Temple University Hospital, Philadelphia, Pennsylvania, United States
| | - David Graham
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
| | - Steven Regal
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
| | - Peter Tang
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
| | - Jon E. Hammarstedt
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
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Banjar M, Nor FEM, Singh P, Horiuchi S, Quek ST, Yoshioka H. Comparison of visibility of ulnar sided triangular fibrocartilage complex (TFCC) ligaments between isotropic three-dimensional and two-dimensional high-resolution FSE MR images. Eur J Radiol 2020; 134:109418. [PMID: 33302025 DOI: 10.1016/j.ejrad.2020.109418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/29/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Assessment of the ulnar attachment of the triangular fibrocartilage complex (TFCC) in a neutral forearm position remains challenging. Our study aims to evaluate the visibility of ulnar sided TFCC on 3 T MRI and compare isotropic 3D FSE sequences utilizing multiplanar reformation (MPR) with standard high-resolution 2D FSE sequences. METHODS Ninety-nine MRI wrist studies in patients with wrist pain were retrospectively analyzed. Patients were scanned with a neutral forearm position and reviewed with isotropic 3D coronal FSE proton density-weighted images (PDWI) and 2D coronal FSE PDWI. MPR was used for 3D assessment. Visibility of the dorsal radioulnar ligament (DRUL), triangular ligament (TL), and volar radioulnar ligament (VRUL) was assessed by three raters utilizing a five-point grading scale. Grades were compared between 2D and 3D sequences. Intrarater and interrater reliability for the delineation of anatomic structures was measured by Spearman's rank correlation coefficient, Cohen's kappa, and percentage of exact agreement/agreement within a range of ±1 score point. RESULTS Visibility grades in 3D were statistically significantly higher than those in 2D in all ligaments by all raters (p < 0.01). In Spearman's rank correlation coefficient and Cohen's kappa analysis, interrater correlations and agreements are variable but tended to be higher on 3D than on 2D. Both 2D and 3D sequences showed high intrarater exact agreement in all ligaments (80-91 % on 2D and 88-95 % on 3D). All exact interrater agreements on 3D were acceptable for TL (83-93 %) and acceptable to close to acceptable for VRUL (72-96 %). CONCLUSION The utilization of isotopic 3D imaging combined with MPR function significantly improves visibility of ulnar attachment of the TFCC.
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Affiliation(s)
- Mai Banjar
- Department of Diagnostic Imaging, National University Hospital, Singapore; Medical Imaging Department, King Abdullah Medical Complex Jeddah, Saudi Arabia.
| | | | - Pavel Singh
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Saya Horiuchi
- Department of Radiology, St Luke's International Hospital, Tokyo, Japan
| | - Swee Tian Quek
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine, CA, USA
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Tarabin N, Gehrmann S, Mori V, Oezel L, Wollschläger L, Rommelfanger G, Frenken M, Abrar D, Schleich C. Assessment of Articular Cartilage Disorders After Distal Radius Fracture Using Biochemical and Morphological Nonenhanced Magnetic Resonance Imaging. J Hand Surg Am 2020; 45:619-625. [PMID: 32291096 DOI: 10.1016/j.jhsa.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 12/27/2019] [Accepted: 02/11/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess radiocarpal articular cartilage after distal radius fracture, with and without intra-articular extension, compared with healthy controls using multiparametric, nonenhanced magnetic resonance imaging (MRI). METHODS In this prospective study, multiparametric MRI of the radiocarpal articular cartilage was performed in 26 participants (16 males and 10 females; mean age, 39.5 ± 14.7 years; range, 20-70 years) using 3T MRI. The cohort consisted of 14 patients with a distal radius fracture and 12 healthy volunteers. The radiocarpal articular cartilage was assessed using morphological (Double Echo Steady-State [DESS] and True Fast Imaging With Steady-State Precession [TrueFISP]) and biochemical (T2∗) MRI sequences without an intravenous contrast agent. The modified Outerbridge classification system for morphological analyses and region-of-interest biochemical analysis were applied to assess the degree of articular cartilage damage in each patient. RESULTS Morphological articular cartilage assessment showed no difference between the DESS sequence and the reference standard, TrueFISP. In the morphological (DESS and TrueFISP) and biochemical (T2∗) assessments, patients with intra-articular fractures did not show articular cartilage damage different from those with extra-articular fractures. Greater articular cartilage degradation was observed after distal radius fracture compared with controls. CONCLUSIONS Posttraumatic radiocarpal articular cartilage damage did not differ between fractures with intra-articular and extra-articular extension, but patients with fractures had notably higher articular cartilage degradation compared with healthy controls. Magnetic resonance imaging using advanced multiparametric sequences may facilitate accurate, noninvasive assessment of articular cartilage changes after distal radius fracture without the need for a contrast agent. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic IV.
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Affiliation(s)
- Nahla Tarabin
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Sebastian Gehrmann
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Valentina Mori
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Lisa Oezel
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Lena Wollschläger
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Golnessa Rommelfanger
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Daniel Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
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Torabi M, Lenchik L, Beaman FD, Wessell DE, Bussell JK, Cassidy RC, Czuczman GJ, Demertzis JL, Khurana B, Klitzke A, Motamedi K, Pierce JL, Sharma A, Walker EA, Kransdorf MJ. ACR Appropriateness Criteria® Acute Hand and Wrist Trauma. J Am Coll Radiol 2019; 16:S7-S17. [DOI: 10.1016/j.jacr.2019.02.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/09/2019] [Indexed: 12/28/2022]
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Mori V, Sawicki LM, Sewerin P, Eichner M, Schaarschmidt BM, Oezel L, Gehrmann S, Bittersohl B, Antoch G, Schleich C. Differences of radiocarpal cartilage alterations in arthritis and osteoarthritis using morphological and biochemical magnetic resonance imaging without gadolinium-based contrast agent administration. Eur Radiol 2018; 29:2581-2588. [PMID: 30542752 DOI: 10.1007/s00330-018-5880-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/19/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To identify differences of radiocarpal cartilage alterations in osteoarthritis and arthritis using multiparametrical magnetic resonance imaging (MRI) comprising morphological and biochemical sequences without gadolinium-based contrast agent administration. METHODS In this prospective study, multiparametrical MRI of the radiocarpal cartilage was performed in 47 participants (mean age, 46.6 ± 17.6 years; min., 20 years; max., 79 years) on a 3 Tesla MRI. The cohort consisted of 11 patients suffering from arthritis, 10 patients with osteoarthritis, 14 patients after distal radius fracture, and 12 healthy volunteers. The radiocarpal cartilage was assessed using morphological (DESS, TrueFISP) and biochemical (T2*) MRI sequences without the application of intravenous contrast agent. The modified Outerbridge classification system for morphological and region-of-interest analyses for biochemical analysis was applied to assess the degree of cartilage damage in each patient before data were statistically tested for significant difference between the groups using a post hoc Tukey test. RESULTS In morphological imaging, cartilage damage was significantly more frequent in arthritis and osteoarthritis than in healthy volunteers (DESS: p = 0.01, p = 0.0004; TrueFISP: p = 0.02, p = 0.0001). In T2* imaging, patients with osteoarthritis showed higher cartilage damage compared to patients with arthritis (p = 0.01). CONCLUSION With multiparametrical MRI, it is possible to identify differences of radiocarpal cartilage alterations of patients with arthritis and osteoarthritis using the combination of morphological and biochemical MR imaging of the radiocarpal cartilage without the application of contrast agent. Multiparametrical MRI without the usage of contrast agent may be a potential tool helping to distinguish both entities. KEY POINTS • Multiparametrical MRI with morphological and biochemical sequences allows the differentiation of patients with arthritis and osteoarthritis. • High-resolution MRI of radiocarpal cartilage is possible without administration of contrast agent.
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Affiliation(s)
- Valentina Mori
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, 40225, Düsseldorf, Germany
| | - Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, 40225, Düsseldorf, Germany.
| | - Philipp Sewerin
- Department and Hiller-Research-Unit for Rheumatology, UKD, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Markus Eichner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, 40225, Düsseldorf, Germany
| | - Benedikt M Schaarschmidt
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, 40225, Düsseldorf, Germany
| | - Lisa Oezel
- Department of Trauma and Hand Surgery, University Hospital, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sebastian Gehrmann
- Department of Trauma and Hand Surgery, University Hospital, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Bernd Bittersohl
- Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, 40225, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, 40225, Düsseldorf, Germany
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Influence of the thickness of the transverse carpal ligament in carpal tunnel syndrome. Rev Esp Cir Ortop Traumatol (Engl Ed) 2018. [DOI: 10.1016/j.recote.2018.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bartolomé-Villar A, Pastor-Valero T, Fuentes-Sanz A, Varillas-Delgado D, García-de Lucas F. Influence of the thickness of the transverse carpal ligament in carpal tunnel syndrome. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017; 62:100-104. [PMID: 29239809 DOI: 10.1016/j.recot.2017.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 10/06/2017] [Accepted: 10/20/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine if the thickness of the transverse carpal ligament measured by T2 axial magnetic resonance imaging actually influences the onset of carpal tunnel syndrome. MATERIAL AND METHOD 94 patients between January 2015 and June 2016, of whom 28 had carpal tunnel syndrome, underwent magnetic resonance imaging, 37 with discomfort in different carpus regions without symptoms of carpal tunnel and 29 healthy subjects. Two observers performed 3 measurements in 3 different levels, and in the 3 groups of patients. RESULTS No statistically significant differences in transverse carpal ligament thickness measurements between the carpal tunnel syndrome group and the group without carpal tunnel involvement became apparent, but statistical differences between the control group and the carpal tunnel syndrome group, and between the control group and the group without involvement of the carpal tunnel were observed. In both these groups, the thickness of the transverse ligament was higher than in the control group. DISCUSSION An increase in the thickness of the transverse ligament in was found in this study in subjects with involvement of carpal tunnel syndrome as evidenced by numerous studies in the literature. There is no certain causative factor, but rather a set of facts that make onset of the syndrome possible in a specific group of patients. CONCLUSION Carpal tunnel syndrome is multifactorial. The thickness of the transverse ligament does not directly affect the onset of symptoms.
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Affiliation(s)
- A Bartolomé-Villar
- Servicio de Diagnóstico por Imagen, Hospital FREMAP, Majadahonda, Madrid, España.
| | - T Pastor-Valero
- Servicio de Diagnóstico por Imagen, Hospital FREMAP, Majadahonda, Madrid, España
| | - A Fuentes-Sanz
- Servicio de Cirugía Ortopédica y Traumatología, Hospital FREMAP, Majadahonda, Madrid, España
| | - D Varillas-Delgado
- Servicios Auxiliares VEMESA, Unidad de Investigación, Hospital FREMAP, Majadahonda, Madrid, España
| | - F García-de Lucas
- Servicio de Cirugía Ortopédica y Traumatología, Hospital FREMAP, Majadahonda, Madrid, España
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Ng AWH, Griffith JF, Fung CSY, Lee RKL, Tong CSL, Wong CWY, Tse WL, Ho PC. MR imaging of the traumatic triangular fibrocartilaginous complex tear. Quant Imaging Med Surg 2017; 7:443-460. [PMID: 28932701 DOI: 10.21037/qims.2017.07.01] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Triangular fibrocartilage complex is a major stabilizer of the distal radioulnar joint (DRUJ). However, triangular fibrocartilage complex (TFCC) tear is difficult to be diagnosed on MRI for its intrinsic small and thin structure with complex anatomy. The purpose of this article is to review the anatomy of TFCC, state of art MRI imaging technique, normal appearance and features of tear on MRI according to the Palmar's classification. Atypical tear and limitations of MRI in diagnosis of TFCC tear are also discussed.
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Affiliation(s)
- Alex W H Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Cindy S Y Fung
- Department of Diagnostic Imaging, North District Hospital, Hong Kong, China
| | - Ryan K L Lee
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Cina S L Tong
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Clara W Y Wong
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing Lim Tse
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Pak Cheong Ho
- Department of Orthopedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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Abstract
The first imaging modality in patients suspected of distal radioulnar joint pathology should be conventional radiography to exclude or diagnose wrist pathology including osteoarthritis, rheumatoid arthritis, calcium pyrophosphate deposition disease, (healed) fractures, or impaction syndromes. When conventional radiography is inconclusive, high resolution 3 Tesla magnetic resonance imaging is advised. We provide a broad overview of the literature regarding the use of intra-articular contrast both with computed tomography (CTA) or magnetic resonance imaging (MRA). Conventional arthrography and unenhanced computed tomography are not indicated. This article discusses the most useful imaging techniques in terms of clinical indications, patient positioning, technical imaging requirements, and diagnostic performance in patients with suspected distal radioulnar joint pathology. Furthermore, the most prevalent pathologies are discussed, with the focus on imaging characteristics in both stable and unstable distal radioulnar joints.
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Affiliation(s)
- S Jens
- 1 Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - T Luijkx
- 2 Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands
| | - F F Smithuis
- 1 Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - M Maas
- 1 Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
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Lee RKL, Griffith JF, Tang WK, Ng AWH, Yeung DKW. Effect of traction on wrist joint space and cartilage visibility with and without MR arthrography. Br J Radiol 2017; 90:20160932. [PMID: 28181830 DOI: 10.1259/bjr.20160932] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To compare the effect of traction during non-arthrographic and arthrographic MR examination of the wrist with regard to joint space width, joint fluid dispersion and cartilage surface visibility. METHODS Prospective 3-T MRI study of 100 wrists in 96 patients. The first 50 wrists underwent MR arthrography first without traction and then with traction. The following 50 wrists underwent standard MR first without traction and then with traction. On these examinations, two radiologists independently measured (i) joint space width, semi-quantitatively graded (ii) joint fluid dispersion between opposing cartilage surfaces and (iii) articular cartilage surface visibility. The three parameters were compared between the two groups. RESULTS Traction led to an increase in joint space width at nearly all joints in all patients (p < 0.05), although more so in the arthrography (∆ = 0.08-0.79 mm, all p < 0.05) than in the non-arthrography (∆ = 0.001-0.61 mm, all p < 0.05) group. Joint fluid dispersion and cartilage surface visibility improved after traction in nearly all joints (p < 0.05) in all patients and more so in the arthographic than in the non-arthrography group. CONCLUSION Traction did significantly improve cartilage surface visibility for standard MRI of the wrist although the effect was not as great as that seen with MR arthography or MR arthrography with traction. Advances in knowledge: This is the first study to show the beneficial effect of traction during standard non-arthrography MRI of the wrist and compare the effect of traction between non-arthrographic and arthrographic MRI of the wrist.
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Affiliation(s)
- Ryan K L Lee
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
| | - W K Tang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
| | - Alex W H Ng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
| | - David K W Yeung
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
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Longo UG, Loppini M, Del Vescovo R, Cazzato L, Zobel BB, Maffulli N, Denaro V. Safety of dorsal wrist arthroscopy portals: A magnetic resonance study. Surgeon 2016; 16:101-106. [PMID: 27856161 DOI: 10.1016/j.surge.2016.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/02/2016] [Accepted: 09/10/2016] [Indexed: 10/20/2022]
Abstract
In wrist arthroscopy, the standard dorsal portals are the most commonly used. However, their placement can be associated with injuries to the neurovascular structures of the radiocarpal joint. The present study assessed and compared the distance of commonly used dorsal portals to radial and ulnar neurovascular structures. Forty patients (20 males, 20 females) were evaluated with T1-weighted spin-echo (SE) magnetic resonance (MR) sequences. We measured the distance between 1-2 and 3-4 portals and radial vascular bundle and the nearest branch of the superficial branch of radial nerve (SBRN). We also measured the distance between 4 and 5, 6/U and 6/R and ulnar vascular bundle and the nearest branch of the dorsal ulnar nerve (DUN). The median age of patients was 39 years (95% IC 36.97-43.32 years). The 3-4 portal was farther away from the vascular structure than the 1-2 portal (P < 0.0001), 4-5 portal (P = 0.008), 6/R (P < 0.0001), and 6/U portals (P < 0.0001). Moreover, the 3-4 portal was farther away from the nerve branch than the 1-2 portal (P < 0.0001), 4-5 portal (P < 0.0001), 6/R (P < 0.0001), and 6/U portals (P < 0.0001). No statistical significant differences were found between the two genders. The 3-4 and 4-5 portals are the farthest away from the neurovascular structures, and likely reduce the risk to damage these structures. On the other hand, the 1-2 and 6/U portals likely increase the risk of neurovascular damage, because of their proximity to neurovascular structures. LEVEL OF EVIDENCE Diagnostic study; Level III.
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Affiliation(s)
- Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Mattia Loppini
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Riccardo Del Vescovo
- Department of Radiology, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Luigi Cazzato
- Department of Radiology, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Bruno Beomonte Zobel
- Department of Radiology, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84081 Baronissi, Salerno, Italy; Centre for Sport and Exercise Medicine, Queen Mary University of London, London, England, United Kingdom.
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy
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LiMarzi GM, O'Dell MC, Scherer K, Pettis C, Wasyliw CW, Bancroft LW. Magnetic Resonance Arthrography of the Wrist and Elbow. Magn Reson Imaging Clin N Am 2016. [PMID: 26216774 DOI: 10.1016/j.mric.2015.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Magnetic resonance (MR) arthrography of the wrist and elbow is useful for detecting a variety of intra-articular pathologies. MR dictations should address whether intrinsic ligament tears of the wrist are partial-thickness or full-thickness, and involve the dorsal, membranous, and/or volar components of the ligaments. With regard to elbow soft tissue pathology, partial-thickness tears of the anterior band of the ulnar collateral ligament in overhead-throwing athletes are well evaluated with MR arthrography. MR arthrography also is helpful in staging osteochondritis dissecans of the capitellum, caused by repetitive valgus impaction injury in adolescent or young adult baseball pitchers.
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Affiliation(s)
- Gary M LiMarzi
- Florida Hospital Diagnostic Radiology Residency Program, Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 East Rollins, Orlando, FL 32803, USA; Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA
| | - M Cody O'Dell
- Florida Hospital Diagnostic Radiology Residency Program, Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 East Rollins, Orlando, FL 32803, USA; Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA
| | - Kurt Scherer
- Florida Hospital Diagnostic Radiology Residency Program, Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 East Rollins, Orlando, FL 32803, USA; Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA
| | - Christopher Pettis
- Florida Hospital Diagnostic Radiology Residency Program, Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 East Rollins, Orlando, FL 32803, USA; Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA
| | - Christopher W Wasyliw
- Florida Hospital Diagnostic Radiology Residency Program, Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 East Rollins, Orlando, FL 32803, USA; Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA
| | - Laura W Bancroft
- Florida Hospital Diagnostic Radiology Residency Program, Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 East Rollins, Orlando, FL 32803, USA; Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA.
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Scapholunate kinematics of asymptomatic wrists in comparison with symptomatic contralateral wrists using four-dimensional CT examinations: initial clinical experience. Skeletal Radiol 2016; 45:437-46. [PMID: 26659662 DOI: 10.1007/s00256-015-2308-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/04/2015] [Accepted: 11/30/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Using four-dimensional CT scan (4DCT), we aimed at showing the kinematics of scapholunate (SL) interval in asymptomatic wrists in comparison with symptomatic contralateral wrists with inconclusive radiographic findings. METHODS This is an IRB approved, HIPPA compliant, retrospective study. Patients suspected of SL interosseous ligament (SLIL) injuries were referred for further evaluation of chronic wrist pain (>3 months). Twelve wrists (11 subjects) with chronic symptoms and inconclusive plain radiographs and 10 asymptomatic wrists (in 10 different subjects) were scanned using 4DCT. The minimum SL interval was measured during three wrist motions: relaxed-to-clenched fist, flexion-to-extension, and radial-to-ulnar-deviation. Changes were recorded using double-oblique multiplanar reformation technique. RESULTS We extracted the normal limits of the SL interval as measured by dynamic CT scanning during active motion in asymptomatic wrists. In asymptomatic wrists, the average SL interval was observed to be smaller than 1 mm during all motions. In symptomatic wrists, during exams performed with clenched fist (SL interval (mean ± SD) = 2.53 ± 1.19 mm), extension (2.54 ± 1.48 mm) or ulnar deviation (2.06 ± 1.12 mm), the average SL interval was more than 2 mm. In contrast to symptomatic wrists, no significant change in SL interval measurements was detected during wrist motions in asymptomatic wrists. There was a mild to moderate correlation between SL interval change and presence/absence of symptoms (point-biserial correlation coefficients: 0.29-0.55). CONCLUSION In patients with wrist pain suspicious for SLIL injury and inconclusive radiographs, SL interval increase can be detected with 4DCT in the symptomatic wrist compared to the asymptomatic wrist.
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Shahabpour M, Staelens B, Van Overstraeten L, De Maeseneer M, Boulet C, De Mey J, Scheerlinck T. Advanced imaging of the scapholunate ligamentous complex. Skeletal Radiol 2015. [PMID: 26219592 DOI: 10.1007/s00256-015-2182-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies.
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Affiliation(s)
- Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Barbara Staelens
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
| | | | - Michel De Maeseneer
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Cedric Boulet
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Johan De Mey
- Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Thierry Scheerlinck
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
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Abstract
Excellent morphological imaging of cartilage is now possible and allows the detection of subtle cartilage pathologies. Besides the standard 2D sequences, a multitude of 3D sequences are available for high-resolution cartilage imaging. The first part therefore deals with modern possibilities of morphological imaging. The second part deals with functional cartilage imaging with which it is possible to detect changes in cartilage composition and thus early osteoarthritis as well as to monitor biochemical changes after therapeutic interventions. Validated techniques such as delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping as well the latest techniques, such as the glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) technique will be discussed.
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Dumont C, Lerzer S, Vafa MA, Tezval M, Dechent P, Stürmer KM, Lotz J. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions. Skeletal Radiol 2014; 43:1411-20. [PMID: 25081633 DOI: 10.1007/s00256-014-1955-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 05/25/2014] [Accepted: 06/25/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). MATERIALS AND METHODS A total of 20 CMC I joints of 14 asymptomatic volunteers (6× both sides) and 28 CMC I joints of 22 patients (6× both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. RESULTS The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21%), combined rupture of the AOL + IML in 5 of 28 (18%) and isolated IML rupture in 4 of 28 (14%) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). CONCLUSION MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb-extension and abduction-to evaluate the ligaments and dorsal subluxation of MC I.
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Affiliation(s)
- Clemens Dumont
- Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medical Center Göttingen, Goettingen, Germany,
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The role of imaging in diagnosing diseases of the distal radioulnar joint, triangular fibrocartilage complex, and distal ulna. AJR Am J Roentgenol 2014; 203:146-53. [PMID: 24951208 DOI: 10.2214/ajr.13.11573] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this article is to review the anatomy, biomechanics, and multimodality imaging findings of common and uncommon distal radioulnar joint (DRUJ), triangular fibrocartilage complex, and distal ulna abnormalities. CONCLUSION The DRUJ is a common site for acute and chronic injuries and is frequently imaged to evaluate chronic wrist pain, forearm dysfunction, and traumatic forearm injury. Given the complex anatomy of the wrist, the radiologist plays a vital role in the diagnosis of wrist pain and dysfunction.
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