Vertebral pneumaticity of the North American therizinosaur Nothronychus.

Nothronychus was a large, derived therizinosaur from the Upper Cretaceous of Utah and New Mexico. The genus is known from elements that have been referred to single individuals. Therizinosaurs were unusual maniraptoran theropods close to the origin of birds. The axial skeleton is extensively pneumatized, but CT scans reveal an apneumatic synsacrum. Inferred air sacs invade the basicranium, the presacral vertebrae, and the proximal caudal vertebrae, but bypassed the sacrum resulting in a caudosacral hiatus similar to some sauropods and reflecting the development of multiple diverticula from the abdominal air sac. The vertebral pneumatic chambers are described here and compared with those observed in the theropod Allosaurus and the recent avian Dinornis. The vertebrae of Nothronychus are intermediate between those two theropods. It is inferred to have possessed avian-like abdominal air sacs. This theropod would have had unidirectional lungs, as in birds, but this character cannot be related to endothermy.

Spinal Neuroarthropathy: Pathophysiology, Clinical and Imaging Features, and Differential Diagnosis.

Spinal neuroarthropathy (SNA), or Charcot spine, is a progressive destructive arthropathy occurring after loss of neuroprotective sensation and proprioceptive reflexes. Clinical diagnosis is difficult because of the variable length to presentation after initial neurologic damage and the limited symptoms given preexisting neurologic deficits. SNA is also a diagnostic challenge because its imaging features are similar to those of spinal conditions such as discitis-osteomyelitis, osseous tuberculosis, hemodialysis-related spondyloarthropathy, and pseudarthrosis. The most important imaging clues for diagnosis of SNA are involvement of both anterior and posterior elements at the thoracolumbar and lumbosacral junctions. Additional imaging clues include vacuum phenomenon within the disk (indicating excessive motion), malalignment, and paraspinal soft-tissue masses or fluid collections containing bone debris. Despite these imaging signs, findings may overlap in some cases with those of infection, or SNA can be superinfected, and biopsy may be necessary. Development of SNA requires a preexisting neurologic condition, most commonly traumatic spinal cord injury. Areas of greatest mobility and weight bearing within the desensate spine experience repetitive microtrauma and unregulated hyperemia, leading to destruction of the intervertebral articulations. The progressive and destructive nature of SNA causes substantial deformity, loss of function, and often further neurologic deficits. Patients present with deformity, back pain, audible noises during movement, or new neurologic symptoms. The mainstay of treatment is surgical débridement, reduction, and fusion. The radiologist can help initiate early intervention by using key imaging features to distinguish SNA from imaging mimics and prevent further neurologic deterioration. (©)RSNA, 2016.

A re-evaluation of the basicranial soft tissues and pneumaticity of the therizinosaurian Nothronychus mckinleyi (Theropoda; Maniraptora).

The soft-tissue reconstruction and associated osteology of the North American therizinosaurian Nothronychus mckinleyi is updated. The cranial nerve topology is revised, bringing it more in line with coelurosaurs. The trunk of the trigeminal nerve is very short, with an incompletely intracranial trigeminal ganglion, an ophthalmic branch diverging anteriorly first, with later divergences of the maxillomandibular branches, following typical pathways. The facial nerve has been re-evaluated, resulting in a very typical configuration with an extracranial geniculate ganglion. The single foramen leading to the cochlea probably transmitted the vestibulocochlear nerve, along with some fibers of the facial. This configuration is reduced from the more standard three foramina (vestibular, cochlear, and facial) and may be apomorphic for therizinosaurs. Some alteration is proposed for the dorsiflexive musculature. The insertion point for m. transversospinalis capitis is partially changed to extend onto the parietal, along with a proposed functional difference in the moment arm. The expansion of the basicranial pneumatic system is limited to the paratympanic system, enhancing low frequency sound sensitivity. There is little expansion of the median pharyngeal and subcondylar sinuses. Ossification of the surrounding epithelium may provide some information on the embryology of the theropod skull. It may be associated with a reduced stress field, or the general similarity of the basicranium with anterior cervical vertebrae may reflect activation of a cervical vertebral (Hox) gene regulating ossification of the pneumatic sinuses. This might be a local, selectively neutral, fixed gene in the basicranium reflecting embryological regulation of cervical vertebrae development.

Accelerated repair of cortical bone defects using a synthetic extracellular matrix to deliver human demineralized bone matrix.

Injectable hydrogel and porous sponge formulations of Carbylan-GSX, a crosslinked synthetic extracellular matrix (ECM), were used to deliver human demineralized bone matrix (DBM) in a rat femoral defect model. A cortical, full-thickness 5-mm defect was created in two femurs of each rat. Six rats were assigned to each of five experimental groups (thus, 12 defects per group). The defects were either untreated or filled with Carbylan-GSX hydrogel or sponges with or without 20% (w/v) DBM. Radiographs were obtained on day 1 and at weeks 2, 4, 6, and 8 postsurgery of each femur. Animals were sacrificed at week 8 postsurgery and each femur was fixed, embedded, sectioned, and processed for Masson's Trichrome staining. The bone defects were measured from radiographs and the fraction of bone healing was calculated. The average fractions of bone healing for each group were statistically different among all groups, and all treatment groups were significantly better than the control group. The Carbylan-GSX sponge with DBM was superior to the sponge without DBM and to the hydrogel with DBM. Histology showed that defects treated with the Carbylan-GSX sponge plus DBM were completely filled with newly generated bone tissue with a thickness comparable to native bone. Carbylan-GSX sponge was an optimal delivery vehicle for human DBM to accelerate bone healing.

Pigmented villonodular synovitis of the cervical spine: case report and review of the literature.

Pigmented villonodular synovitis (PVNS) is an uncommon, benign, but locally aggressive lesion characterized most commonly by synovial proliferation of the appendicular large joints, but occasionally involving a bursa or the tendon sheath. PVNS of the spine is rare, typically involving the posterior elements. The lytic radiographic appearance and fludeoxyglucose avidity of PVNS may mimic malignant bone lesions, including metastatic disease or myeloma. On T 1 and T 2 weighted, and gradient recalled echo MRI sequences, the low signal intensity may mimic giant cell tumour of the bone, gout or synovial amyloid deposits, thus posing a diagnostic dilemma for the imagers and the treating clinicians. We present a pathologically confirmed case of PVNS of the cervical spine in a 49-year-old female, detailing her imaging work-up, describing histopathological correlation and highlighting the lesion location and involvement of the joint space as useful imaging discriminators for diagnosing PVNS of the cervical spine.

Radiologic evaluation of the shoulder girdle.

The radiologic evaluation of the shoulder girdle is an important adjunct to the clinical history and physical examination. Close collaboration between musculoskeletal clinicians and musculoskeletal radiologists improves the diagnostic performance of imaging studies. Technologic advantages, especially in MRI, have improved appreciation of shoulder anatomy, biomechanics, and injury patterns, allowing for the development of more targeted surgical and nonsurgical treatment strategies. This article reviews imaging considerations of the major clinical entities related to the shoulder.

The pulmonary anatomy of Alligator mississippiensis and its similarity to the avian respiratory system.

Using gross dissections and computed tomography we studied the lungs of juvenile American alligators (Alligator mississippiensis). Our findings indicate that both the external and internal morphology of the lungs is strikingly similar to the embryonic avian respiratory system (lungs + air sacs). We identified bronchi that we propose are homologous to the avian ventrobronchi (entobronchi), laterobronchi, dorsobronchi (ectobronchi), as well as regions of the lung hypothesized to be homologous to the cervical, interclavicular, anterior thoracic, posterior thoracic, and abdominal air sacs. Furthermore, we suggest that many of the features that alligators and birds share are homologous and that some of these features are important to the aerodynamic valve mechanism and are likely plesiomorphic for Archosauria.

Noninvasive determination of ligament strain with deformable image registration.

Ligament function and propensity for injury are directly related to regional stresses and strains. However, noninvasive techniques for measurement of strain are currently limited. This study validated the use of Hyperelastic Warping, a deformable image registration technique, for noninvasive strain measurement in the human medial collateral ligament using direct comparisons with optical measurements. Hyperelastic Warping determines the deformation map that aligns consecutive images of a deforming material, allowing calculation of strain. Diffeomorphic deformations are ensured by representing the deformable image as a hyperelastic material. Ten cadaveric knees were subjected to six loading scenarios each. Tissue deformation was documented with magnetic resonance imaging (MRI) and video-based experimental measurements. MRI datasets were analyzed using Hyperelastic Warping, representing the medial collateral ligament (MCL) with a hexahedral finite element (FE) model projected to a manually segmented ligament surface. The material behavior was transversely isotropic hyperelastic. Warping predictions of fiber stretch were strongly correlated with experimentally measured strains (R (2) = 0.81). Both sets of measurements were in agreement with previous ex vivo studies. Warping predictions of fiber stretch were insensitive to bulk:shear modulus ratio, fiber stiffness, and shear modulus in the range of +2.5SD to -1.0SD. Correlations degraded when the shear modulus was decreased to 2.5SD below the mean (R (2) = 0.56), and when an isotropic constitutive model was substituted for the transversely isotropic model (R (2) = 0.65). MCL strains in the transitional region near the joint line, where the material behavior and material symmetry are more complex, showed the most sensitivity to changes in shear modulus. These results demonstrate that Hyperelastic Warping requires the use of a constitutive model that reflects the material symmetry, but not subject-specific material properties for accurate strain predictions for this application. Hyperelastic Warping represents a powerful technique for noninvasive strain measurement of musculoskeletal tissues and has many advantages over other image-based strain measurement techniques.