RESUMEN
Hyperextension of the first metatarsophalangeal joint can lead to a turf toe injury of the plantar plate complex, resulting in significant morbidity for athletes. This article reviews the anatomy, pathophysiology, classification, and imaging findings of turf toe injuries. In turf toe trauma, many different structures can be injured, with the sesamoid-phalangeal ligaments the most common. Diagnosis, classification, and treatment options rely on clinical evaluation and specific magnetic resonance imaging findings. It is vital for radiologists to understand the anatomy, pathophysiology, and imaging findings of turf toe injuries to ensure an accurate diagnosis and appropriate management.
Asunto(s)
Traumatismos en Atletas , Traumatismos de los Pies , Hallux , Articulación Metatarsofalángica , Humanos , Traumatismos en Atletas/terapia , Hallux/diagnóstico por imagen , Hallux/lesiones , Articulación Metatarsofalángica/diagnóstico por imagen , Articulación Metatarsofalángica/lesiones , Imagen por Resonancia Magnética , Traumatismos de los Pies/diagnóstico por imagenRESUMEN
OBJECTIVES: CT coronary angiography (CTCA) has become a valuable diagnostic test in the workup of patients with possible coronary artery disease (CAD). Because of inherent limitations in spatial resolution, epicardial vessels with a small diameter, in general less than 1.5-2 mm, have so far been excluded in studies assessing clinical utility of CTCA. This study sought to assess the clinical impact of CTCA taking into account pathology in small coronary arteries. METHODS: We conducted a retrospective cohort study of all patients with possible CAD who underwent dual-source CTCA and subsequent invasive coronary angiography (ICA) between January 2010 and July 2017. Patients with an Agatston calcium score ≥1000 were reported separately. Diagnostic accuracy of CTCA on a patient, vessel and segment level was calculated. The physician's therapeutic decision was defined as conservative, medical antianginal treatment or revascularisation. Using ICA as the reference, we calculated the precision of CTCA to replicate these therapeutic recommendations. RESULTS: In total, 1209 patients underwent both CTCA and ICA. Overall diagnostic performance of CTCA showed a sensitivity of 90% (95% CI 86% to 93%) and specificity of 40% (95% CI 36% to 45%). With regard to clinical decision making, CTCA showed good performance: 91% of patients who were treated medically or by revascularisation were correctly identified. Prevalence of disease in small vessel segments was low: 16% showed significant CAD on ICA. Prevalence of significant disease was 70% in patients with an Agatston score ≥1000: the majority underwent revascularisation. CONCLUSIONS: From a true patient perspective, without exclusion of smaller coronary artery segments, CTCA allows safe patient management.
Asunto(s)
Angiografía por Tomografía Computarizada , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Vasos Coronarios/diagnóstico por imagen , Calcificación Vascular/diagnóstico por imagen , Anciano , Bélgica/epidemiología , Toma de Decisiones Clínicas , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Prevalencia , Pronóstico , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Tiempo , Calcificación Vascular/epidemiología , Calcificación Vascular/terapiaRESUMEN
Various conditions may result in forefoot pain. Magnetic resonance (MR) imaging allows accurate assessment of many of these conditions. We provide an overview of forefoot disorders divided into bones, capsule and plantar plate, musculotendinous structures, neurovascular structures, and subcutaneous tissue. We review normal anatomical features as well as MR imaging findings of common disorders.
Asunto(s)
Imagen por Resonancia Magnética/métodos , Metatarsalgia/diagnóstico por imagen , Dedos del Pie/anatomía & histología , Dedos del Pie/diagnóstico por imagen , HumanosRESUMEN
We present a very unusual case of an accessory articulation of the transverse processes of C6 and C7. Only four previous cases have been described in English literature. Our case stresses the importance of computed tomography (CT) and post-processing images to discriminate this variant from posttraumatic or degenerative lesions. Multiplanar reformations and volume-rendered images should be added to the cervical spine CT protocol.