Musculoskeletal Radiology

373 Pages·2016·1.65 MB·English

Musculoskeletal Radiology
MK001-EB-X
Peri-articular Fat Pads: An Adjunctive Tool in the Diagnosis of Occult Injury
All Day Location: MK Community, Learning Center
Participants
Brett Larsen, Phoenix, AZ (Presenter) Nothing to Disclose
Mary J. Connell, MD, Phoenix, AZ (Abstract Co-Author) Nothing to Disclose
Dan G. Gridley, MD, Phoenix, AZ (Abstract Co-Author) Nothing to Disclose
Albert Roh, MD, Phoenix, AZ (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
The Purpose of this exhibit is: 1. To review location and anatomy of common peri-articular fat pads and their normal appearance 2.
To recognize abnormalities in fat pads when occult soft-tissue or bony injury is present 3. To explain the utility of fat pads in the
diagnosis of occult injury and correlate plain film findings with MRI
MK002-EB-X
MR Signal Abnormalities of the Adolescent Growth Plate
All Day Location: MK Community, Learning Center
Participants
Iman Khodarahmi, MD, PhD, Newark, NJ (Presenter) Nothing to Disclose
Marcia F. Blacksin, MD, West Caldwell, NJ (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
While some pediatric and adult joint pathologies overlap, there are significant differences, and therefore, interpreters of pediatric
MR must be cognizant of these differences as well as normal variants. Upon completing this exhibit, the reviewer will become
familiar with MR signal characteristics of normal adolescent physis as well as MR appearance of different growth plate physiologic
and pathologic conditions based on images from our institution. Clinical significance and key imaging similarities and differences for
these conditions will be reviewed. Finally, the readers will be provided with a table of take-home points so they will have familiarity
when such lesions appear on their work queue.
TABLE OF CONTENTS/OUTLINE
MR characteristics of the normal adolescent growth plate. Focal epiphyseal edema Acute physeal traumatic fractures Chronic
physeal stress injuries (Overuse syndrome) Marrow reconversion/residual red marrow Local physeal widening (Physeal extensions)
Physeal bars Infection Neoplastic conditions Summary
MK003-EB-X
Benign Soft Tissue Tumors of the Digits: MR Imaging with Pathologic Correlation
All Day Location: MK Community, Learning Center
Participants
Anastasia F. Barron, DO, Chicago, IL (Presenter) Nothing to Disclose
Anupam Basu, MD, Chicago, IL (Abstract Co-Author) Nothing to Disclose
Vivek Yedavalli, MD, Chicago, IL (Abstract Co-Author) Nothing to Disclose
Kathan A. Amin, MD, Chicago, IL (Abstract Co-Author) Nothing to Disclose
Christelle Chedrawy, MD, Chicago, IL (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
1. Discuss the diagnostic approach to soft tissue masses specifically located in the fingers and the importance of pathologic
correlation.2. Emphasize specific MRI imaging findings for this rather short list of begin lesions.3. Highlight key anatomic and clinical
features that aid in diagnosing soft tissue tumors in the digits.
TABLE OF CONTENTS/OUTLINE
1.Purpose: Emphasize MR imaging features, clinical presentation, and importance of histology in the diagnosis of soft-tissue masses
of the digits.2.Background a. focused review of pertinent anatomyb. overview of WHO classifications for malignant tumors of the
digitsc. highlight common clinical presentation3. Discuss approach to evaluating tumors in the fingersa. preferred imaging modalities
and why4. Example cases for each diagnosis in the differential of benign soft tissue tumors of the digitsa. common patient
presentation and demographicsb. key MR imaging findingsc. pathology correlation with focused explanation of histology featuresd.
emphasize lesion's delineating characteristicse. diagnostic limitations of imaging5. Clinical and medicolegal ramifications of
misdiagnosis6. Conclusion
MK004-EB-X
Comprehensive Review of CPPD Arthropathy: Common and Unusual Imaging Findings
All Day Location: MK Community, Learning Center
Participants
Mumtaz B. Syed, MD, Knoxville, TN (Presenter) Nothing to Disclose
Andrew J. Vincent, MD, Knoxville, TN (Abstract Co-Author) Nothing to Disclose
Peter T. Petruzzi, MD, Knoxville, TN (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
Calcium pyrophosphate deposition disease is a metabolic arthropathy caused by the deposition of calcium pyrophosphate dihydrate
(CPPD) in and around joints, especially in articular and fibrocartilage. The etiology of CPPD is unknown. Excess calcium has a
probable relationship with chondrocalcinosis, with hemochromatosis and hyperparathyroidism being two major risk factors. Although
CPPD is often asymptomatic, with only radiographic changes such as chondrocalcinosis, various clinical manifestations may occur,
including acute arthritis (pseudogout) and chronic arthritis. Bone destruction may occur as a result of the inflammation. Although
almost any joint may be involved by CPPD, the knees, wrists, and hips are most commonly affected. Other joints involved by CPPD
athropathy include TMJ and atlanto-odontoid structures of the cervical spine. CPPD is the most common cause of secondary
metabolic osteoarthritis. We review the radiographic findings of CPPD arthropathy with correlative CT and MRI mages of various
joints affected with chonedrocalcinosis.
TABLE OF CONTENTS/OUTLINE
Introduction Pathophysiology Review of Imaging Findings and Multimodality Correlation Differential Diagnosis Conclusion
MK005-EB-X
A Pictorial Review of Peri-coccygeal Mass in Adult
All Day Location: MK Community, Learning Center
Participants
Jang Gyu Cha, MD, Bucheon, Korea, Republic Of (Presenter) Nothing to Disclose
Jisook Yi, MD, Bucheon-Si, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Hyun-Joo Kim, MD, Seoul, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Sung-Moon Lee, MD, Daegu, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Sun Joo Lee, MD, Busan , Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
1. To illustrate the various imaging feature of the common and unusual peri-coccygeal masses which include congenital lesions,
infectious lesions and neoplastic lesions in adult with pathologic correlation.2. Recognize differential diagnosis of peri-coccygeal
mass in adult, presenting as solid and cyst mass lesion.
TABLE OF CONTENTS/OUTLINE
1. Introduction2. Normal anatomy and embryology of peri-coccygeal area.3. Congenital lesion A. Pilnodidal sinus/ cyst 4. Benign
lesion A. Cystic mass: Epidermal cyst, Bursitis, Synovial cyst B. Solid mass: Lipoma, Hemangioma, Schwannoma/Neurofibroma,
Myxopapillary ependymoma5. Malignant lesion A. Metastasis B. Chordoma SummaryVarious pathologic masses which include
congenital, infectious and neoplastic condition can occurs in the peri-coccygeal area. But peri-coccygeal mass in adult is
uncommon and not well known to radiologists. Knowledge of the normal anatomy and familiarity with the imaging features of these
lesions are important for determining the type of mass or narrowing the differential diagnosis.
MK006-EB-X
Sound Imaging: What all Radiologists Should Know about Sonographic Evaluation of Peripheral Neuropathy
All Day Location: MK Community, Learning Center
Participants
Zachary R. Ashwell, MD, Aurora, CO (Presenter) Nothing to Disclose
Colin D. Strickland, MD, Denver, CO (Abstract Co-Author) Nothing to Disclose
Jonathan A. Flug, MD, MBA, Aurora, CO (Abstract Co-Author) Nothing to Disclose
Seema M. Meraj, MD, Lindenhurst, NY (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
The purpose of this study is:1. To review the normal anatomy and ultrasonographic appearance of peripheral nerves.2. To discuss
important landmarks for orientation and evaluation of the upper and lower extremities.3. To review the various pathologic
appearances of peripheral neuropathy as it applies to various scenarios including direct and indirect trauma, overuse injuries and
compression by external structures.4. To show and discuss several of the more common entities and general radiologist is likely to
encounter in practice and emphasize the importance of familiarity with ultrasound as a growing imaging modality.
TABLE OF CONTENTS/OUTLINE
Normal Anatomy and Sonographic Appearance: - Brachial Plexus - Radial, Median and Ulnar nerves - Femoral and Peroneal
nervesCommon Pathologies: - Brachial Plexus Injury - Ulnar Neuritis - Radial Nerve Injury after Fracture - Carpal Tunnel
SyndromeSpecific Advantages over other modalities: - Metallic Artifact - Motion - Cost/efficiency
MK007-EC-X
MR Neurography Anatomy of the Articular and Cutaneous Innervation of the Knee Taught Through a Real-
data-based 3D Computer Model
All Day Location: MK Community, Learning Center
Participants
Mesa Schumacher, MA, BA, Baltimore, MD (Presenter) Nothing to Disclose
David Rini, Baltimore, MD (Abstract Co-Author) Nothing to Disclose
Jan Fritz, MD, Baltimore, MD (Abstract Co-Author) Research Grant, Siemens AG; Research Consultant, Siemens AG; Speaker,
Siemens AG
TEACHING POINTS
1. Sensory innervation of the knee follows a characteristic pattern of constantly present nerves with minor variations of non-
constant branches.2. High spatial resolution 2D and 3D MR neurography facilitates detailed visualization of the constantly present
nerves.3. Knowledge of the course of the anterior, medial, lateral and posterior nerves of the knee in correlation with surgical
incision and arthroscopy sites enables diagnosis of neuropathic pain related to neuromas and entrapment following surgery.
TABLE OF CONTENTS/OUTLINE
High spatial resolution 2D and 3D MR neurography protocols Topography and layer pattern of the nerve about the knee Femoral and
sciatic origins and main branching pattern Knee joint Innervation Medial Medial retinacular n Medial cutaneous n of the thigh
Infrapatellar br of saphenous n Anterior br of obturator n Lateral Lateral retinacular n Superior lateral genicular n (SLGN) N to the
vastus lateralis N to the vastus intermedius Posterior Posterior division of obturator n Posterior articular br of tibial n Anterior Lateral
femoral cutaneous n Anterior femoral cutaneous n Cutaneous nerves of the knee Common surgical incisions and arthroscopy
patterns in relation to nerve injury
MK008-EB-X
Sacroiliitis: What Rheumatologist Needs to Know and Radiologist Must Report
All Day Location: MK Community, Learning Center
Participants
Angela P. Guarnizo Capera, MD, Bogota, Colombia (Presenter) Nothing to Disclose
Carolina Rumie Valois, Bogota, Colombia (Abstract Co-Author) Nothing to Disclose
Camilo A. Barragan Leal, MD, Bogota, Colombia (Abstract Co-Author) Nothing to Disclose
Rafael Gomez, MD, Bogota, Colombia (Abstract Co-Author) Nothing to Disclose
Juan N. Useche, MD, Miami, FL (Abstract Co-Author) Nothing to Disclose
Sonia Bermudez, MD, Bogota, Colombia (Abstract Co-Author) Nothing to Disclose
Oscar M. Rivero Rapalino, MD, Bogota, Colombia (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
To describe the characteristic findings in different imaging modalities in patients with sacroiliitis.To identify key MRI findings
associated with active inflammatory disease in patients with early stage sacroiliitis.To determine the imaging findings associated
with chronic stage sacroiliitis.To determine the differential diagnosis of sacroiliitis.
TABLE OF CONTENTS/OUTLINE
IntroductionSacroiliitis: characteristic findings in different imaging modalities (conventional radiography, CT, scintigraphy)MRI
findings in sacroiliitis: early stage, chronic stageASAS criteriaDifferential diagnosesConclusions
MK009-EB-X
Sonographic and Sonoelastographic Findings during and after Treatment of Plantar Fasciitis; A Common
Pathology
All Day Location: MK Community, Learning Center
Participants
Minchul Kim, MD, Seoul, Korea, Republic Of (Presenter) Nothing to Disclose
Yun Sun Choi, MD, PhD, Seoul, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Hyoungseop Kim, Seoul, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Myung-Won You, MD, Seoul, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Jin-Su Kim, MD, Seoul, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
Ki Won Young, Seoul, Korea, Republic Of (Abstract Co-Author) Nothing to Disclose
TEACHING POINTS
To review the imaging features concerning of ultrasound in the assessment of plantar fasciitis To review post-treatment
sonongraphic findings of plantar fasciitis, including well demonstrated sonoelastography images
TABLE OF CONTENTS/OUTLINE
Review the clinical and imaging features of plantar fasciitis Description of radiologic findings (radiograph, B-mode ultrasound,
sonoelastography) Review of treatment options - injection, extracorporeal shockwave therapy, low-level laser therapy and
extracorporeal pulse-activated therapy Identify post-procedural changes and possible complications after injectionsfor plantar
fasciitis on US