Table Of ContentImaging of Orthopaedic
Fixation Devices
and Prostheses
Imaging of Orthopaedic
Fixation Devices
and Prostheses
Thomas H. Berquist, MD, FACR
ProfessorofDiagnosticRadiology
MayoClinicCollegeofMedicine
Rochester,Minnesota;
ConsultantinDiagnosticRadiology
MayoClinicJacksonville
Jacksonville,Florida
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Imagingoforthopaedicfixationdevicesandprostheses/editor,ThomasH.Berquist.
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Includesbibliographicalreferencesandindex.
ISBN-13:978-0-7817-9252-3(alk.paper)
ISBN-10:(invalid)0-7817-9252-3(alk.paper)
1. Orthopedicapparatus—Imaging. 2. Musculoskeletalsystem—Diseases—Imaging. 3. Musculoskeletalsystem—
Diseases—Surgery. I. Berquist,ThomasH.(ThomasHenry),1945-
[DNLM:1. MusculoskeletalDiseases—diagnosis. 2. DiagnosticImaging. 3. MusculoskeletalDiseases—surgery.
4. OrthopedicFixationDevices.WE141I3012009]
RD755.5.I382009
617(cid:1).9—dc22
2008024236
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I dedicate this text to my loving wife, Mary,
for her continued support and understanding.
Preface
In 1995 we published an Atlas of Orthopaedic Appliances and Prostheses. This was a work
dedicated to bridging the gap between orthopaedic surgeons and imagers. I have continued to
dedicate efforts to improve the understanding of orthopaedic procedures and ‘‘what the surgeon
needstoknow’’whenorderingpreoperativeandpostoperativeimagingstudies.
Orthopaedicinstrumentationandprosthesescontinuetoevolve,makingitdifficultforimagers
tokeepupwithallpossibleimplantsthatmayappearonradiographsorotherimagingmodalities.
Withthisinmind,itisessentialforsurgeonsandradiologiststoworkcloselyandwe,asimagers,
needtobecomefamiliarwiththeinstrumentationsystemsoursurgeonsprefer.
Thiseditionisdesignedtobemoreconcisethantheprioratlaswithnoattempttodemonstrate
everypossiblefixationdeviceorprostheses.Wereviewtheimportantclinicalandimagefeaturesof
orthopaedic devices including clinical concepts and patient selection, the normal appearance
of orthopaedic devices and the image features, and most appropriate modalities for evaluating
complications.
Chapter 1 is a concise review of image modalities that may play a role in evaluation of
orthopaedicfixationdevicesandprostheses.Chapter2providesalistanddefinitionsofcommonly
used orthopaedic terms and an overview of general fixation devices including screws, plates,
intramedullary nails, wires and cables, and soft tissue anchors. These chapters serve to reduce
redundancy in later chapters where these devices may be used. Chapters 3 through 13 are
anatomically oriented and focus on fixation devices, prostheses, and procedures for a given
anatomic region. Emphasis is placed on indications, clinical data and decision making, as well
as preoperative and postoperative imaging and complications. Each chapter includes trauma,
orthopaedicclassificationswhereappropriate,andjointreplacementandothercommonorthopaedic
proceduresrelatedtotheanatomicregioncoveredinthechapter.Chapter14reviewsclinicaldata,
staging,andpreoperativeandpostoperativeimaginginpatientswithmusculoskeletalneoplasms.
This text will be most useful to practicing radiologists and radiologists in training. Other
physicianswhodealwithorthopaedicproblemswillalsofindtheinformationprovidedinthistext
extremelyuseful.
vii
Acknowledgments
Preparation of this text required the support of numerous individuals and colleagues. I first wish
to thank my colleagues in musculoskeletal imaging at Mayo Jacksonville, Laura Bancroft, Mark
Kransdorf,andJeffreyPetersonfortheirsupportandassistanceinprovidingthenecessaryimages
neededtofulfillthemissionofthistext.Ialsowanttothankmycolleaguesinorthopaedicsurgery,
MarkBroderson,StephenTrigg,CedricOrtiguera,PeterMurry,MaryO’Connor,KurtisBlasser,
andJosephWhalenfortheirconsultativesupport.
Daniel Huber and John Hagen were instrumental in providing images and art required to
demonstrateanatomy,normalandabnormalimagefeaturesfordevicesdescribedinthistext.The
vendors of orthopaedic devices were also very helpful in providing photographs and artwork to
assistwithdemonstrationofdevicesandtheirindicationstousealongwiththeimagesinthistext.
Finally,IwishtothankRyanShaw,LisaMcAlliser,andKerryBarrettfromLippincottWilliams
&Wilkinsfortheirassistanceandsupportwiththisproject.
ix
