Imaging findings at the quadrangular joint in carpal boss

A carpal boss was initially described as a bony, sometimes painful mass at the quadrangular joint. Clinical examination and plain radiography will usually reveal the diagnosis. US and CT may add information. MRI may illustrate a variable bony morphology and additional bony and soft tissue pathologies. Bone marrow edema shows a significant correlation with a painful carpal boss. Hence, MRI may be of additional diagnostic value in patients with persistent pain and preoperatively. This paper presents a review of the anatomy and pathology in carpal boss. The merit of each imaging modality – in particular MRI – is mentioned

Secondary abutment syndromes of the wrist in trauma : a pictorial essay

Traumatic lesions of the wrist occur frequently and may give rise to underdiagnosed secondary abutment syndromes. The latter are a common cause of incapacitating pain and limited range of motion, despite minimal or even absent alterations on radiographs. Moreover, the complex wrist anatomy often results in ignorance or underappreciation of these syndromes. This paper presents a pictorial review of frequent and rare secondary abutment syndromes at the wrist joint, which - in contrast to primary abutment syndromes - are not based on anatomical variants or congenital deformations. The merit of each imaging modality is briefly mentioned

MRI diagnosis of carpal boss and comparison with radiography

Background: A carpal boss is a potentially painful bony mass in the region of the second or third carpometacarpal joint. The combination of clinical examination and radiography is usually sufficient for the diagnosis. Purpose: To determine whether magnetic resonance imaging (MRI) examination of the quadrangular joint can assist the diagnosis of persistent pain near a carpal boss. Material and Methods: Fifty-seven patients with a carpal boss were retrospectively reviewed using MRI and conventional radiographs and compared to an asymptomatic control group. Results: MRI demonstrated a variable morphology and a variety of bone and soft tissue abnormalities associated with carpal boss. Bone marrow edema around the quadrangular joint shows a significant correlation (Fisher's exact test: P< 0.001) and a positive correlation (Pearson's test r = 0.632, significant at the 0.01 level [two-tailed]) with a painful carpal boss. Conclusion: MRI offers detailed examination of bone and soft tissue abnormalities associated with a carpal boss. Local bone marrow edema strongly correlates with a painful carpal boss

Visualization techniques of the facial arteries

Background As the face is known for its extreme variation in vascular anatomy and the number of filler-associated complications due to intra-arterial injection is increasing, we are in need of a method to visualize anyone's individual arterial anatomy of the face in a completely harmless way. Aims The different medical imaging methods and a recently developed MRA protocol are reviewed. Methods The literature of the last twenty years-with special attention for the last five years-concerning the different medical imaging modalities of the facial arteries was reviewed. Results A harmless visualisation of the facial arteries is currently only possible with US or MRA. US may identify single vessels but never the complete arterial network. A combination of IR "heat enhancement" and a MRA 3D-TOF sequence might make it feasible to visualize a large number of facial arteries in a risk-free, radiation-free, contrast-free and non-invasive way. Conclusion Currently, a new combination of IR "heat enhancement" and a MRA 3D-TOF sequence might be the only method to visualize a large number of facial arteries

Hand and wrist : a kaleidoscopic view of accessory ossicles, variants, coalitions, and others

Accessory bones, variants, and coalitions are not uncommon at the hand-wrist region. They are often overlooked because they are usually asymptomatic and found incidentally on imaging. However, they may sometimes present as a (painful) swelling or mimic a (sequel of a) fracture. Other symptoms may be attributed to impingement and exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of their existence are the clues to a correct identification. Plain radiography and magnetic resonance imaging (MRI) play a pivotal role in the correct diagnosis. In general, signal intensity on MRI is similar to the normal bony structures. However, concomitant bone marrow edema may indicate the presence of impingement. Therefore, MRI sequences with fat suppression should be included in case of symptomatic findings. This article provides a kaleidoscopic overview of some of the prevalent bony anomalies of the hand-wrist region and their potential pathogenic nature

Hand and wrist : a kaleidoscopic view of accessory ossicles, variants, coalitions, and others

Accessory bones, variants, and coalitions are not uncommon at the hand-wrist region. They are often overlooked because they are usually asymptomatic and found incidentally on imaging. However, they may sometimes present as a (painful) swelling or mimic a (sequel of a) fracture. Other symptoms may be attributed to impingement and exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of their existence are the clues to a correct identification. Plain radiography and magnetic resonance imaging (MRI) play a pivotal role in the correct diagnosis. In general, signal intensity on MRI is similar to the normal bony structures. However, concomitant bone marrow edema may indicate the presence of impingement. Therefore, MRI sequences with fat suppression should be included in case of symptomatic findings. This article provides a kaleidoscopic overview of some of the prevalent bony anomalies of the hand-wrist region and their potential pathogenic nature

Systematic review: The oncological safety of adipose fat transfer after breast cancer surgery

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