Reply to "the half-moon sign of the femoral neck is nonspecific for the diagnosis of osteoid osteoma."

[No abstract available

Imaging of impingement syndromes around the hip joint

Impingement syndromes are increasingly recognised as significant causes of hip pain and dysfunction. A broad spectrum of intraarticular and extraarticular conditions has been implicated in their pathophysiology. Physical examination is often inconclusive as clinical findings may be unclear or misleading, often simulating other disorders. With current improvements in imaging techniques and better understanding of hip impingement related pathomechanisms, these entities can be accurately diagnosed. In addition, preoperative imaging has allowed for targeted treatment planning. This article provides an overview of the various types of hip impingement, including femoroacetabular impingement, ischiofemoral impingement, snapping hip syndrome, greater trochanteric-pelvic and subspine impingement. Current literature data regarding their pathogenesis, clinical manifestation and imaging work-up are discussed. © 2017 Wichtig Publishing

The effect of injection volume on long-term outcomes of US-guided subacromial bursa injections

Purpose: Limited data exist on the efficacy of high- compared to low-volume US-guided corticosteroid injections (CI) in the subacromial-subdeltoid (SA-SD) bursa. Our purpose was to compare the short- and long-term efficacy of low- and high-volume injections, by using a capacity reference of SA-SD bursa volume, as assessed on cadaveric specimens. Method: Within two years, 136 patients (63 males, 73 females; mean age: 46.11 ± 10.28 years) who underwent SA-SD bursa US-guided CI for subacromial impingement, rotator cuff tendinopathy or shoulder overuse were prospectively included. Patients were randomly assigned to low-volume (1 mL triamcinolone acetonide/40 mg) or high-volume (1 mL triamcinolone acetonide/40 mg, 9 mL anaesthetic agents) groups (67 and 69 patients, respectively). Visual Analogue Scores (VAS) were recorded at baseline, 30 min, 3 weeks, 3 months, 6 months and 1 year post-treatment. Predictors of complete recovery (VAS ≤ 2) at 1 year were analysed with multivariate Cox regression analysis. SA-SD bursa cadaveric dissection in 10 specimens was performed for volume assessment. Results: Injection volume was the only predictor of complete pain resolution at 1 year. High-volume CI yielded higher chances of early pain recovery (2.837 HR, 95% CI 1.737–4.633, P < .001). Mean VAS scores at baseline and subsequent time-points were 6, 2.6, 2.2, 2, 1.6 and 1 for the high-volume and 7.8, 7.3, 4.7, 3.2, 2.5 and 1.8 for the low-volume group, respectively (P < .001, at all time-points). Cadaveric measurements showed a minimum SA-SD bursa volume of approximately 6.9 mL. Conclusions: High-compared to low-volume US-guided CI are superior for achieving early pain recovery. © 2020 Elsevier B.V

Normal Magnetic Resonance Imaging Anatomy of the Anterolateral Knee Ligament with a T2/T1-Weighted 3-Dimensional Sequence: A Feasibility Study

Purpose The anatomy of the lateral knee compartment has been recently further explored with description of the anterolateral knee ligament (ALL). The purpose of this study was to confirm the presence of ALL on cadaveric knees and to describe its normal anatomy in young healthy volunteers, utilizing a high-resolution 3-dimensional (3D) pulse sequence. Methods Dissection was performed on 9 cadaveric knees in order to confirm the presence of ALL. Conventional 2-dimensional sequences of 10 knees at 1.5 T and 10 knees at 3 T, with a slice thickness of 2-4 mm, were reviewed for the presence of ALL. A 3D T2/T1-weighted gradient echo sequence (constructive interference in steady state [CISS]), yielding in-plane resolution of 0.4 mm × 0.4 mm × 0.4 mm, was applied in 14 healthy volunteers (26 knees). All 3D images were manipulated using multiplanar reconstruction (MPR) and the presence and width of ALL were recorded. Results Cadaveric dissection disclosed the presence of ALL in 8 of 9 knees. Conventional knee MR imaging depicted ALL only on coronal images (18 of 20) whereas the CISS revealed ALL on 24 of 26 studied knees (92.3%). ALL has a mean thickness of 1.1 ± 0.27 mm measured on coronal MR images. Conclusions ALL can be thoroughly assessed in young healthy individuals with the use of high-resolution 3D MR imaging with MPR at 1.5 T. © 2016 Canadian Association of Radiologists

Hydroxyapatite deposition disease around the hip: Outcomes of CT-guided treatment

PURPOSE Hydroxyapatite deposition disease (HADD) around the hip joint is a self-limiting condition usually treated conservatively. The aim of the present study is to directly compare the outcomes of CT-guided and conservative treatments in cases of refractory hip HADD. METHODS Two groups of patients with refractory hip HADD were prospectively constructed from a pool of 484 patients referred for greater trochanter pain syndrome, based on the presence of calcifications around the hip and the failure of conservative treatment. Study group included 22 hips, which underwent CT-guided barbotage and steroid injection treatment, whereas control group consisted of 28 hips that were treated conservatively. Evaluation of the outcome of both groups was performed over a one-year follow-up period with the use of a score measuring clinical improvement in terms of pain and functional impairment. RESULTS Three weeks after the initiation of treatment, study group exhibited significantly higher scores compared with the control group (P 0.1). CONCLUSION CT-guided treatment provides relief of debilitating symptoms in the acute phase. © Turkish Society of Radiology 2016

MRI of the hip: Current concepts on bone marrow oedema

Bone marrow oedema (BME) is commonly found in hip MR imaging. BME is a nonspecific finding which can be related to a wide variety of diseases. However, there are cases where its existence or its pattern can narrow the differential or even point to a specific diagnosis. Therefore, deep understanding of its pathophysiology is of utmost importance for clinicians and radiologists in order to avoid diagnostic pitfalls. We hereby present currently established knowledge on BME related to adult hip pathology, aiming to raise physicians’ suspicion and to highlight that it is mandatory to combine specific imaging patterns with the history, clinical and laboratory findings in order to achieve accurate diagnosis. © 2017 Wichtig Publishing

Fetal position in Alzheimer's disease. An anatomic body remodelling due to retrogenesis

Acquired fetal position by patients in end stage Alzheimer's disease is a quite common sign. The theory of retrogenesis was proposed to explain this anatomic remodelling of the human body. Copyright © 2018 Balkan Medical Unio

Medial heel pain in a long-distance runner

[No abstract available

Morel-lavallée lesions of the knee: MRI findings compared with cadaveric study findings

OBJECTIVE. The purpose of this study is to describe the MRI findings and treatment decisions and outcome for Morel-Lavallée lesions (MLLs) of the knee and to investigate whether evidence exists to support an increased frequency of such lesions on the medial or lateral side by performing a cadaveric experiment. MATERIALS AND METHODS. In a 4-year period, 24 MRI studies of 24 consecutive patients (16 male patients and eight female patients) with knee MLLs were retrospectively reviewed. Patient demographic characteristics, treatment decisions and outcome, and associated injuries were recorded. The location of the MLL was categorized as medial, lateral, or global. Lesions were categorized according to an established MRI classification. During the cadaveric experiment, the compartmental pressures of the medial or lateral aspect of the knee were monitored in 20 cadaveric knees. The chi-square test, t test, and Pearson correlation were used for statistical analysis. RESULTS. MLLs were located medially in 16 patients, laterally in two patients, and globally in six patients. The medial location was significantly more common than a lateral or global location (p &lt; 0.05). MLLs were classified as type I in 14 patients, type II in eight patients, and type III in two patients. MRI type was correlated with the chronicity of injury (r 2 = 0.614; p = 0.0014). Fractures were the most common associated injuries, occurring in seven of 24 patients. In 17 patients, all of whom had conservatively treated type I or type II lesions, complete resolution of the MLL occurred. The maximum compartmental pressures were significantly higher on the lateral side than on the medial side (p &lt; 0.0001). CONCLUSION. Knee MLLs have a predilection for the medial side, which may be attributed to the lower resistance in this location, and they have variable patterns on MRI, which correlate with chronicity. Conservative treatment of type I and II lesions seems effective. © American Roentgen Ray Society

Quadratus femoris tear as an unusual cause of hip pain: A case report

Purpose: To show that quadratus femoris muscle partial or complete tear is an extremely rare if not underdiagnosed cause of hip pain. Methods: We present the case of a 75-year-old Caucasian woman with spontaneous non-traumatic quadratus femoris tear. Results: Computed Tomography showed quadratus femoris tear with occult underlying ischiofemoral impingement pathology. Conclusions: Quadratus femoris muscle is a hip external rotator and adductor and is situated along the posterior aspect of the hip joint and its proximity of anatomy with other external rotators leads to diagnostic pitfalls for radiologists. Identification of the exact muscle tear will establish the diagnosis, guide the proper physical therapy and reliably inform the patient what to expect after treatment. © 2016 Wichtig Publishing