The many faces of osteomyelitis : a pictorial review

The purpose of this pictorial review is to present an overview of the radioclinical features of osteomyelitis. The presentation of the disease may vary depending on the clinical stage (acute, subacute and chronic), the pathogenesis of the infection and the age of the patient. Thorough knowledge of the basic pathophysiological mechanisms is a prerequisite to understanding the variable imaging appearance of osteomyelitis. Special subtypes of osteomyelitis including CRMO and SAPHO will be discussed very shortly

Cone beam CT of the musculoskeletal system : clinical applications

Objectives: The aim of this pictorial review is to illustrate the use of CBCT in a broad spectrum of musculoskeletal disorders and to compare its diagnostic merit with other imaging modalities, such as conventional radiography (CR), Multidetector Computed Tomography (MDCT) and Magnetic Resonance Imaging. Background: Cone Beam Computed Tomography (CBCT) has been widely used for dental imaging for over two decades. Discussion: Current CBCT equipment allows use for imaging of various musculoskeletal applications. Because of its low cost and relatively low irradiation, CBCT may have an emergent role in making a more precise diagnosis, assessment of local extent and follow-up of fractures and dislocations of small bones and joints. Due to its exquisite high spatial resolution, CBCT in combination with arthrography may be the preferred technique for detection and local staging of cartilage lesions in small joints. Evaluation of degenerative joint disorders may be facilitated by CBCT compared to CR, particularly in those anatomical areas in which there is much superposition of adjacent bony structures. The use of CBCT in evaluation of osteomyelitis is restricted to detection of sequestrum formation in chronic osteomyelitis. Miscellaneous applications include assessment of (symptomatic) variants, detection and characterization of tumour and tumour-like conditions of bone. Teaching Points: Review the spectrum of MSK disorders in which CBCT may be complementary to other imaging techniques. Compare the advantages and drawbacks of CBCT compared to other imaging techniques. Define the present and future role of CBCT in musculoskeletal imaging

Isolated periosteal avulsion fracture of the teres major in a rugby player

We describe a case of an isolated periosteal avulsion fracture of the teres major tendon. A 29-year-old rugby player presented following a direct hit with his opponent followed by a fall on the ground. Clinical examination showed a limited and painful abduction of his left arm. MR-arthrography showed no capsulolabral lesions but revealed an extra-articular lesion at the origin of the teres major tendon. Follow-up radiography and CT showed progressive ossification of the lesion. To the best of our knowledge, this is the first case of a distal avulsion fracture of the teres major tendon reported in the imaging literature

Staging of osteochondral lesions of the talus : MRI and Cone Beam CT

Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. Although Magnetic Resonance Imaging (MRI) at 1.5 Tesla is the leading cross-sectional modality for detection and staging of OCL, lack of spatial resolution hampers accurate assessment of thin articular cartilage. Cone Beam Computed Tomography (CBCT) arthrography is better suited for precise staging of cartilage lesions. The purpose of this pictorial review is to illustrate the strength of each imaging method