MR Imaging of the glenohumeral ligaments

The glenohumeral ligaments, particularly the inferior one, are the major passive stabilizers of the joint, and the labrum functions as a site of ligamentous attachment. The strong union between the collagen fibers of the glenohumeral ligaments and the glenoid labrum is more resistant to injury than the union between the glenoid rim and the labmm. Labral tears associated with glenohumeral instability are therefore usually secondary to avulsion rather than impaction. This article reviews the normal MR imaging anatomy, variants and pitfalls of the glenohumeral ligaments, and the basic biomechanics of the glenohumeral ligaments. Examples of injuries involving these structures are provided

ACR Appropriateness Criteria(R) Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae

Stress fractures, including both fatigue and insufficiency types, are frequently encountered in clinical practice as a source of pain in both athletes and patients with predisposing conditions. Radiography is the imaging modality of choice for baseline diagnosis. MRI has greatly improved our ability to diagnose radiographically occult stress fractures. Tc-99m bone scan and CT may also be useful as diagnostic tools. Although fatigue and insufficiency fractures can be self-limited and go onto healing even without diagnosis, there is usually value in initiating prompt therapeutic measures as incomplete stress fractures have the potential of progressing to completion and requiring more invasive treatment or delay in return to activity. This is particularly important in the setting of stress fractures of the femoral neck. Accuracy in the identification of these injuries is also relevant because the differential diagnosis includes entities that would otherwise be treated significantly different (ie, osteoid osteoma, osteomyelitis, and metastasis). The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment

Imaging Evaluation of Developmental Hip Dysplasia in the Young Adult

OBJECTIVE. the purpose of this article is to review the clinical and imaging features as well as the potential complications of hip dysplasia in the young adult. Hip dysplasia is an important cause of secondary osteoarthrosis, which accounts for a significant proportion of patients requiring total hip arthroplasty. the radiographic diagnosis of mild hip dysplasia in the young adult may be subtle and is primarily based on the detection of deficient coverage of the femoral head by the acetabulum.CONCLUSION. Cross-sectional imaging, including CT and MRI, afford improved detection and characterization by providing morphologic information about acetabular deficiency. MRI also allows evaluation of potential associated injuries to the articular cartilage, the labrum, and the ligamentum teres. Familiarity with the radiographic and cross-sectional imaging findings of mild hip dysplasia in the young adult may allow a timely diagnosis and implementation of treatment strategies, which may prevent or delay the development of early osteoarthritis.New York Univ, Langone Med Ctr, Dept Radiol, New York, NY 10016 USAHosp Joint Dis & Med Ctr, New York, NY 10016 USANew Britain Radiol Associates, New Britain, CT USAHosp Univ Ramon y Cajal, Madrid, SpainUniversidade Federal de São Paulo, UNIFESP, HSP, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, HSP, São Paulo, BrazilWeb of Scienc