RESUMEN
PURPOSE: The purpose of this study was to evaluate the relationships between the three-dimensional anatomy of operated hip in standing position using low-dose stereo-radiography imaging system and postoperative hip disability and osteoarthritis outcome score (HOOS) after total hip arthroplasty (THA). MATERIAL AND METHODS: A total of 123 patients who underwent THA during a one-year period were included. There were 50 men and 73 women with a mean age of 67.3±13.6 (SD) years (range: 19-89 years). All patients underwent pre- and postoperative low-dose stereo-radiography examination and completed a HOOS form (score from 0 to 100, 100 for full satisfaction). We recorded 16 anatomical parameters before THA, and 15 after THA. After binary transformation of HOOS score using 70 as threshold value, outcome was assessed using logistic or generalised linear models. RESULTS: A total of 103 patients (103/123; 83.7%) had a HOOS score≥70 and were considered as the satisfied group. A significant difference in pelvic incidence (the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting the same point to the centre of the bicoxofemoral axis) was found between the satisfied 56.4±10.4 (SD)° (range: 31-85°) and the unsatisfied group 48.7±8.9 (SD)° (range: 40-65) (P=0.006). The relative variation of offset (distance from the centre of rotation of the femoral head to a line bisecting the long axis of the femur) compared to the contralateral hip was -7% in the satisfied group and 7.2% in the unsatisfied group (P=0.01). CONCLUSION: Pelvic incidence, a parameter independent of the reconstructed anatomy, probably influences the quality of life of patients with THA, via pelvic compensatory capabilities. A loss of femoral offset negatively influences the satisfaction of patients.
Asunto(s)
Artroplastia de Reemplazo de Cadera , Prótesis de Cadera , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fémur , Articulación de la Cadera/diagnóstico por imagen , Articulación de la Cadera/cirugía , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Radiografía , Resultado del Tratamiento , Adulto JovenRESUMEN
Dactylitis refers to a global swelling of a finger or a toe giving it a clinical sausage-shape presentation. It is an extremely suggestive symptom as it guides the rheumatologist towards a shortlist of diagnoses. However, radiologists are less familiar with dactylitis. The aim of this review is to detail and illustrate the main causes of dactylitis using standard X-ray imaging, ultrasound, computed tomography and magnetic resonance imaging in order to make radiologists more familiar with this symptom by illustrating the various conditions that are associated with dactylitis including infection, peripheral spondyloarthritis, sarcoidosis, microcrystalline deposition, osteoid osteoma, and sickle cell disease.
Asunto(s)
Artritis/diagnóstico por imagen , Articulaciones de los Dedos , Articulación del Dedo del Pie , Adulto , Anciano , Edema/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
In the absence of obvious trauma, the calcifications/ossifications of the bone surface and soft tissues of the wrist, hand and fingers can be challenging and may not be noticed or lead to unnecessary examinations and monitoring. Although these are usually benign conditions and despite a favorable spontaneous outcome, surgical resection may be required and recurrence may occur. In practice, only paraneoplastic syndromes such as secondary hypertrophic osteoarthropathy (Pierre Marie-Bamberger syndrome) may reveal a malignant tumor, most often pulmonary. We suggest a diagnostic approach based on the initial clinical presentation (acute pain, chronic pain, growth±pain) and the radiological features.
Asunto(s)
Huesos/patología , Calcinosis/diagnóstico , Tejido Conectivo/patología , Dedos/patología , Mano/patología , Imagen por Resonancia Magnética/métodos , Osificación Heterotópica/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Muñeca/patología , Calcinosis/etiología , Calcinosis/patología , Diagnóstico Diferencial , Humanos , Osificación Heterotópica/etiología , Osificación Heterotópica/patología , Síndromes Paraneoplásicos/diagnósticoRESUMEN
In 1892, J. Wolff, an orthopedic surgeon, stated that the internal architecture and shape of a bone were related to the direction of stresses placed upon it. Conventional radiographs and MRI can demonstrate the adaptability of bones to stresses. Imaging also demonstrates that this adaptability has limitations, and that excessive stress may lead to fracture.
Asunto(s)
Diagnóstico por Imagen , Fracturas por Estrés/diagnóstico , Procesamiento de Imagen Asistido por Computador , Fenómenos Biomecánicos , Huesos/fisiopatología , Fracturas por Compresión/diagnóstico , Fracturas por Compresión/fisiopatología , Fracturas por Estrés/fisiopatología , Humanos , Aumento de la Imagen , Músculo Esquelético/fisiopatología , Fracturas Osteoporóticas/diagnóstico , Fracturas Osteoporóticas/fisiopatología , Sensibilidad y EspecificidadRESUMEN
A fluoroscopy-guided lumbar spine injection procedure may be complicated by immediate paralysis. Twelve cases (five recent and seven published) that occurred between 2002 and 2008 were reviewed (history of lumbar surgery, route of injection, image-guidance, injection of contrast, type of steroid, level of paraplegia, MR imaging features). MRI showed cord ischemia from arterial origin. The high number of patients with prior lumbar spine surgery suggests that the presence of scar tissue could increase the risk of paraplegia. A transforaminal approach was used in all patients without history of lumbar surgery while transforaminal, interlaminar and juxta-zygapophyseal approaches were used in patients with prior lumbar surgery. The high number of cases in France could be explained by the exclusive use of prednisolone acetate which has a higher rate of macro-aggregate formation that could lead to embolization in medullary arteries.
Asunto(s)
Corticoesteroides/administración & dosificación , Corticoesteroides/efectos adversos , Fluoroscopía , Procesamiento de Imagen Asistido por Computador , Inyecciones Epidurales/efectos adversos , Inyecciones Epidurales/métodos , Vértebras Lumbares , Imagen por Resonancia Magnética , Paraplejía/etiología , Tomografía Computarizada por Rayos X , Anciano , Cicatriz/complicaciones , Cicatriz/diagnóstico , Francia , Humanos , Laminectomía , Vértebras Lumbares/patología , Masculino , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Factores de Riesgo , Isquemia de la Médula Espinal/diagnóstico , Isquemia de la Médula Espinal/etiologíaRESUMEN
Man, with his erect posture, evolves in a world subject to the laws of gravity. His spine reflects these constraints. The morphology and static of human spine and biomechanical relationships between spine and pelvis are in direct relation with bipedia. Owing to this position the pelvis widened and straightened, characteristic sagittal spinal curves appeared and the perispinal muscles were deeply reorganized. Each pelvis is characterized by an important anatomical landmark: the pelvic incidence that reflects the sagittal morphology of the pelvis. Based on this anatomical characteristic, a chain of reactions determines the more efficient equilibrium of the whole body in the sagittal plane in term of energy consumption. Incidence affects the sacral slope, which determines lumbar lordosis, which itself influences pelvic tilt, thoracic kyphosis, and even hip and knee position. All these landmarks can easily be studied on a sagittal radiograph. Knowledge of these functional relationships is essential to understand the origin of low back pain, sagittal imbalance and above all before surgical treatment of spine disorders especially when arthrodesis is considered.
Asunto(s)
Huesos Pélvicos/diagnóstico por imagen , Columna Vertebral/diagnóstico por imagen , Anciano , Artroplastia de Reemplazo de Cadera , Fenómenos Biomecánicos , Femenino , Articulación de la Cadera/diagnóstico por imagen , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Cifosis/diagnóstico por imagen , Lordosis/diagnóstico por imagen , Dolor de la Región Lumbar/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Equilibrio Postural/fisiología , Postura/fisiología , Radiografía , Sacro/diagnóstico por imagen , Curvaturas de la Columna Vertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Fusión Vertebral , Espondilolistesis/cirugía , Vértebras Torácicas/diagnóstico por imagenRESUMEN
Man is standing up and he moves himself in a world subject to the gravity's laws. His spine reflects these constraints. Each bivertebral unit that composes the long supple stem of the spine has an anatomic cohesion with some mobility. The mobility of the spine is the sum of the motilities of its elementary units. Despite the criticisms, all deserved, the dynamic radiographies in flexion (seating position) and in extension (standing position, lower limbs straight and buttocks wedged) give major informations with important clinical consequences. Some semiologic points of the radiographic study of the vertebra are perfectly explained by its specific architecture: a radiolucent lesion is difficult to see whereas a sclerotic one is much more easy to individualize; the sclerotic line of the vertebral endplate must be continuous and any interruption is pathologic; the corners of the vertebra must be sharp; the foramen's shape reflects the size of the spinal canal.
Asunto(s)
Columna Vertebral/diagnóstico por imagen , Fenómenos Biomecánicos , Humanos , Disco Intervertebral/diagnóstico por imagen , Inestabilidad de la Articulación/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Osteólisis/diagnóstico por imagen , Complicaciones Posoperatorias , Equilibrio Postural/fisiología , Postura/fisiología , Intensificación de Imagen Radiográfica/métodos , Rango del Movimiento Articular/fisiología , Canal Medular/diagnóstico por imagen , Compresión de la Médula Espinal/diagnóstico por imagen , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Espondilolistesis/diagnóstico por imagenRESUMEN
The main views and indications in adult foot and ankle radiography are detailed. Among foot and ankle diseases, mechanical ones are most frequent, including usual podologic changes (commonly followed by peculiar involvement of certain bones, ligaments, joints, tendons and other soft tissues), synostoses, occult and stress fractures, sprains, and tendon changes. Although they are less frequently encountered in common clinical practice, the radiographic appearance of inflammatory, infectious, and tumoral diseases of foot and ankle are disclosed as well. The correlation existing between some subtle radiographic changes and their counterpart on US, CT, or MR examinations are also emphasized.
Asunto(s)
Articulación del Tobillo/diagnóstico por imagen , Huesos del Pie/diagnóstico por imagen , Adulto , Traumatismos del Tobillo/diagnóstico por imagen , Artritis/diagnóstico por imagen , Artritis Reumatoide/diagnóstico por imagen , Enfermedades Óseas/diagnóstico por imagen , Complicaciones de la Diabetes/diagnóstico por imagen , Huesos del Pie/lesiones , Fracturas Óseas/diagnóstico por imagen , Fracturas Cerradas/diagnóstico por imagen , Fracturas por Estrés/diagnóstico por imagen , Humanos , Artropatías/diagnóstico por imagen , Radiografía , Esguinces y Distensiones/diagnóstico por imagen , Sinostosis/diagnóstico por imagen , Sinovitis/diagnóstico por imagen , Tendinopatía/diagnóstico por imagen , Traumatismos de los Tendones/diagnóstico por imagen , Tendones/diagnóstico por imagenRESUMEN
Soft tissue masses around the foot and ankle are frequent. While benign lesions are two times more frequent than malignant lesions, the latter still represent one third of all lesions. The main purpose of this article is to propose a systematic approach to the differential diagnosis of soft tissue tumors of the foot and ankle based on a combination of 5 elements: clinical history and physical examination, top 10 most frequent diagnoses, patient age, lesion location, and MRI features of the mass. Selected soft tissue tumors will be described and illustrated with emphasis on these 5 elements.
Asunto(s)
Tobillo/patología , Enfermedades del Pie/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico , Factores de Edad , Anciano , Articulación del Tobillo/patología , Bursitis/diagnóstico , Quistes/diagnóstico , Diagnóstico Diferencial , Fibroma/diagnóstico , Tumores de Células Gigantes/diagnóstico , Gota/diagnóstico , Hemangioma/diagnóstico , Humanos , Artropatías/diagnóstico , Lipoma/diagnóstico , Imagen por Resonancia Magnética , Anamnesis , Persona de Mediana Edad , Neuroma/diagnóstico , Examen Físico , Nódulo Reumatoide/diagnóstico , Tendinopatía/diagnósticoRESUMEN
The authors propose that a coronal STIR sequence with large FOV, similar to the de Sèze projection, including lumbar spine, sacrum, pelvis and hips should be obtained in all patients as part of the lumbar spine MRI protocol. For an additional few minutes of scanning time, this additional sequence could demonstrate the presence of lesions (hips, pelvis, sacrum, SI joints, retroperitoneum...) that would otherwise go undetected on standard sagittal and axial MRI images of the lumbar spine.
Asunto(s)
Aumento de la Imagen/métodos , Vértebras Lumbares/patología , Imagen por Resonancia Magnética/métodos , Enfermedades Óseas/diagnóstico , Diagnóstico Diferencial , Articulación de la Cadera/patología , Humanos , Artropatías/diagnóstico , Huesos Pélvicos/patología , Espacio Retroperitoneal , Articulación Sacroiliaca/patología , Sacro/patología , Enfermedades de la Columna Vertebral/diagnóstico , Vértebras Torácicas/patología , Factores de TiempoRESUMEN
The extensor system of the foot is mainly composed by a powerful engine, the triceps surae muscle, equiped with a very sophisticated driving belt, the unit Achilles tendon-posterior part of calcaneus bone-plantar aponeurosis, in continuity with the fibrous skeleton of the triceps surae. The exact knowledge of the anatomy of this fibrous skeleton allows us to understand the occurence of the main anatomical lesions of the extensor system and its imaging. On these solid bases, it's possible to divide the lesions of the foot's extensor system in different subtypes with, for each one, a typical clinical feature, a characteristic imaging and an codified treatment. The pair radiography-ultrasonography is enough for diagnosis and follow-up of the majority of lesions. The others need MRI.
Asunto(s)
Traumatismos en Atletas/diagnóstico , Traumatismos de los Pies/diagnóstico , Pie/anatomía & histología , Tendón Calcáneo/lesiones , Adulto , Traumatismos en Atletas/diagnóstico por imagen , Diagnóstico Diferencial , Pie/diagnóstico por imagen , Traumatismos de los Pies/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Músculo Esquelético/lesiones , Radiografía , Rotura , Traumatismos de los Tendones/diagnóstico , Ultrasonografía DopplerRESUMEN
In seven of eight patients with osteoporosis circumscripta of the cranial vault, the pagetic bone lacunae were separated from the normal bone by a lucent rim visible on conventional radiographs and computed tomography scans. The contour of the rim was sharp on the side of the healthy surrounding bone and hazy on the side of the defect. To our knowledge, this sign has been reported in one single previous article dealing with two pagetic patients with the bisphosphonate escape phenomenon.
Asunto(s)
Osteítis Deformante/diagnóstico por imagen , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Medios de Contraste , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Osteólisis/diagnóstico por imagen , Osteosclerosis/diagnóstico por imagen , Intensificación de Imagen Radiográfica , Cintigrafía , Estudios RetrospectivosRESUMEN
Three different techniques will be discussed. The first procedure is the biopsy of the lumbar vertebra or lumbar intervertebral disc for patients with tumors or infections of the lumbar spine. The different needles that can be used in function of consistency and location of the lesion will be shown. The transpedicular and posterolateral techniques will be described. Cementoplasty for tumors and selected patients with osteoporotic vertebral collapse generates much interest. The transpedicular and posterolateral techniques will be described. Indications and complications, more frequent in patients with tumors, will be reviewed. Finally, foraminal injections of steroids in patients with radicular symptoms secondary to degenerative change will be discussed. Techniques for needle placement will be reviewed. Results from these injections will also be reviewed.
Asunto(s)
Biopsia con Aguja/métodos , Vértebras Lumbares , Radiografía Intervencional , Radiología Intervencionista , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/tratamiento farmacológico , Corticoesteroides/administración & dosificación , Analgésicos/administración & dosificación , Anestesia Local , Antiinflamatorios/administración & dosificación , Biopsia con Aguja/efectos adversos , Biopsia con Aguja/economía , Cementos para Huesos , Niño , Contraindicaciones , Cortisona/administración & dosificación , Costos y Análisis de Costo , Estudios de Seguimiento , Humanos , Disco Intervertebral/patología , Vértebras Lumbares/patología , Metilmetacrilato/administración & dosificación , Osteoporosis/tratamiento farmacológico , Estudios Prospectivos , Radiculopatía/tratamiento farmacológico , Enfermedades de la Columna Vertebral/patología , Fracturas de la Columna Vertebral/terapia , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/tratamiento farmacológico , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/terapia , Factores de TiempoRESUMEN
Because of their size and superficial location the ankle tendons can be well evaluated with ultrasound (US). The excellent definition of the modern high frequency probes allows us to consider US the technique of first choice in their assessment. Basic US appearances correlate well with the MRI findings. Since US can diagnose most tendon disorders including tendinopathies, tears, dislocations and enthesopathies MRI is less often utilized. US can easily depict the main ankle ligaments. The basic US appearance of ligament tears is well known. US can be considered an inexpensive and accurate technique in the evaluation of ankle sprains.
Asunto(s)
Traumatismos del Tobillo/diagnóstico por imagen , Articulación del Tobillo/diagnóstico por imagen , Tobillo/diagnóstico por imagen , Artropatías/diagnóstico por imagen , Tobillo/anatomía & histología , Tobillo/patología , Traumatismos del Tobillo/patología , Articulación del Tobillo/patología , Humanos , Artropatías/patología , Ligamentos Articulares/diagnóstico por imagen , Ligamentos Articulares/lesiones , Traumatismos de los Tendones/diagnóstico por imagen , UltrasonografíaRESUMEN
Degenerative changes in the lumbar spine involve intervertebral disks and intervertebral posterior elements at different extents. Much less attention has been directed toward degenerative changes of the posterior vertebral elements, however, when compared with intervertebral disk degeneration. These changes may involve the apophyseal joints, the bony elements of the neural arch, the intervening soft tissues, and the spinal longitudinal ligament. Roentgenographic, CT, and MR findings in these changes are depicted.
Asunto(s)
Vértebras Lumbares/patología , Humanos , Hiperostosis/diagnóstico por imagen , Hiperostosis/patología , Ligamentos Longitudinales/diagnóstico por imagen , Ligamentos Longitudinales/patología , Vértebras Lumbares/diagnóstico por imagen , Osteoartritis/diagnóstico por imagen , Osteoartritis/patología , Radiografía , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/patologíaRESUMEN
Despite many efforts, there is no clear and widely accepted definition of lumbar instability because there are no unquestionable and currently applicable clinical or radiologic criteria available for this entity. This article reviews the current concepts of lumbar instability and the different imaging modalities used to make the diagnosis as evident as possible.
Asunto(s)
Inestabilidad de la Articulación/radioterapia , Vértebras Lumbares , Espondilolistesis/diagnóstico por imagen , Humanos , Vértebras Lumbares/diagnóstico por imagen , Imagen por Resonancia Magnética , Mielografía , Tomografía Computarizada por Rayos XRESUMEN
Experience in the field of musculoskeletal diseases and advanced technology of medical sonographers allow increasing accuracy in US investigations of most lesions of both hip and knee superficial tendons. In this field, US is more and more widely replacing other imaging modalities, including MR imaging. Ultrasonography may now be used also for articular diseases purpose, including joint effusion, synovitis, intraarticular loose bodies, ligamentous injuries, articular cysts, as well as for certain osseous lesions like stress or insufficiency fractures of superficial bones. However, ultrasonography has still to be evaluated for these latter indications.
Asunto(s)
Articulación de la Cadera/diagnóstico por imagen , Articulación de la Rodilla/diagnóstico por imagen , Humanos , Enfermedades Musculares/diagnóstico por imagen , UltrasonografíaRESUMEN
UNLABELLED: The main ligaments and tendons of the ankle and the hind-foot can now be studied by US. This simple and safe technic constitutes a more and more reliable alternative to MRI and CT scan. AIMS: Know the normal US appearance of the tendons and ligaments of the ankle and the hind-foot, and how to study them with US. Know their main usual pathological appearance.