MR Imaging Biomarkers for Clinical Impairment and Disease Progression in Patients with Shoulder Adhesive Capsulitis: A Prospective Study.

BACKGROUND: MRI diagnostic criteria of shoulder adhesive capsulitis (AC) are nowadays widely used, but there is little information available on the association between MRI findings and clinical impairment. PURPOSE: To determine the correlation of MRI findings with the Constant-Murley Score (CMS), pain duration and symptoms at the one-year follow-up in AC patients. MATERIALS AND METHODS: This monocentric prospective study included 132 patients with a clinical diagnosis of shoulder AC who underwent shoulder MRI. Mean patient age was 54.1 ± 9.3 years, and there were 55 men and 77 women. A radiologist examined all patients and completed the CMS just prior to MRI. Pain duration was assessed along with the signal intensity and measured the maximal thickness of the inferior glenohumeral ligament (IGHL) by two radiologists. Medical record analysis was performed in a sub-group of 49 patients to assess prognosis approximately one year after the MRI examination. Linear regression analysis with the Pearson test and the Fisher exact test were used to determine the association between MRI findings and clinical impairment. RESULTS: There was a significant difference in mean pain duration score (3.8 ± 1.2 versus 3.2 ± 0.9 and 3.8 ± 1.2 versus 3.2 ± 0.9, respectively, for readers 1 and 2) and in mean mobility scores (15.7 ± 8 points versus 19.6 ± 10.1 points and 15.8 ± 8.2 points versus 19.4 ± 10 points, respectively, for readers 1 and 2) in patients with a high IGHL signal compared to those with a low IGHL signal (p < 0.05). IGHL was thicker in patients with clinical improvement at one-year follow-up compared to those presenting clinical stability or worsening (p < 0.05). CONCLUSIONS: In patients with shoulder AC, the degree of signal intensity at the IGHL was inversely related to shoulder pain duration and range of motion, and a thickened IGHL indicated a favorable outcome at one-year follow-up.

Alternative PACS interface devices are well-accepted and may reduce radiologist's musculoskeletal discomfort as compared to keyboard-mouse-recording device.

OBJECTIVE: To evaluate the use of two alternative picture archiving and communication systems (PACS) interface devices (a graphics tablet and a handheld controller) in clinical practice and on task-oriented exercises. MATERIAL AND METHODS: Eleven senior radiologists were prospectively evaluated. The participants used the two tested interface devices for 10 working periods each and answered a questionnaire to evaluate the ergonomics of this experience. The prevalence of work-related musculoskeletal discomfort with the standard PACS interface set (mouse-keyboard-recording device) and these two devices was assessed. Exercises evaluating image scrolling and selection, image zooming and panning, image windowing, performing measurements, and reporting were performed with the standard PACS interface set and with the two tested devices. The sitting posture and hand position were evaluated. RESULTS: The general appreciation of the two alternative interface devices was considered to be similar to that of the standard interface set. The ergonomics of the handheld controller was considered to be slightly better than that of the standard interface set. The prevalence of musculoskeletal discomfort was 81%, 45%, and 18% for the standard interface set, graphics tablet, and handheld controller, respectively. With the graphics tablet and the handheld controller in 45% and 60%, respectively, there was a working posture change with respect to the standard interface set. The mean total exercise completion times of both tested devices were 27% higher than that of the standard interface set. CONCLUSION: Despite the increase in completion time of the task-oriented exercises, the tested devices were well accepted and considered to be more comfortable than the standard set. KEY POINTS: • Alternative PACS interface devices can be used as a substitute for the standard mouse-keyboard-recording device set with a potential improvement in work ergonomics and a reduction in work-related musculoskeletal discomfort.

Asymmetric and Diffuse Uptake of Left Femur in a 3-Year-Old Child Bone Scan: An Unusual Aspect in Acute Lymphoblastic Leukemia.

Acute leukemia is a severe disease frequently encountered in childhood, often diagnosed in later stages because of nonspecific symptoms. It is known to produce uptake in bone scan, and previously described patterns have shown symmetrical abnormalities. However, we report the unusual aspect of the bone scan in a 3-year-old child who was referred to explore an isolated pain of his lower left limb, with hyperthermia and markers of inflammation. A bone scan showed an intense, asymmetrical uptake of the entire left femur. A few days later, his blood count showed circulating blast cells, leading to the diagnosis of leukemia.