Endovascular repair of thoracic aortic aneurysms.

Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here.

A template approach for detecting fractures in adults sustaining low-energy ankle trauma.

Low-energy trauma such as sprains account for 75% of injuries to the ankle; therefore, ankle pain is one of the most common problems encountered by emergency physicians. A close inspection of the radiographs is often required for diagnosis and this depends on the knowledge of high-risk areas since proper treatment relies on the accuracy of the initial diagnosis. In this article, we will present a template that has helped to increase the accuracy for detecting subtle avulsion fractures, chip fractures, and osteochondral fractures of the hind foot in adults sustaining low-energy ankle injuries. By utilizing this search strategy and understanding where the potential sites for fractures exist, the detection of these subtle fractures can be maximized.

Duplex Doppler Imaging of Dialysis Fistulae and Grafts.

Arteriovenous fistulae and grafts for hemodialysis access are a lifeline in patients with end-stage renal disease. A significant cause of morbidity and mortality in this population is dialysis access dysfunction. Duplex ultrasound imaging is an excellent modality to evaluate arteriovenous fistulae and grafts, the 2 main types of long-term hemodialysis access. This review provides a detailed Doppler ultrasound protocol for evaluation of fistulae or grafts to familiarize imagers with their normal appearance, highlighting common dialysis access complications.

MR Imaging of the Triangular Fibrocartilage Complex.

MR imaging has emerged as the mainstay in imaging internal derangement of the soft tissues of the musculoskeletal system largely because of superior contrast resolution. The complex geometry and diminutive size of the triangular fibrocartilage complex (TFCC) and its constituent structures can make optimal imaging of the TFCC challenging; therefore, production of clinically useful images requires careful optimization of image acquisition parameters. This article provides a foundation for advanced TFCC imaging including factors to optimize magnetic resonance images, arthrography, detailed anatomy, and classification of injury. In addition, clinical presentations and treatments for TFCC injury are briefly considered.