Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 251
Filtrar
1.
Radiol Med ; 125(2): 188-196, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31760553

RESUMO

PURPOSE: The study was conducted to search for confident radiological signs in symptomatic cases of accessory bones. A normal accessory bone appearance on X-ray does not exclude that the accessory bone is the source of the discomfort; because of this, MRI examination can later be applied as part of the diagnosis. METHODS: We retrospectively analysed cases of 64 patients with recognized 70 symptomatic accessory bones of the foot. The average age was 29.2 (range 8-42) years. We included only patients with X-ray and MRI examinations. We investigated the following radiological features of the bone (structural and signal) in relation to soft tissue. RESULTS: The most constant symptoms identified in our study were bone marrow oedema (93%) and soft tissue oedema (77%). Changes in structures in which accessory bones were located or in adjacent structures to accessory bone were identified: tendon changes 51%, fluid adjacent to bone 51% and tenosynovitis 46%. MRI revealed changes in bone structure that are not seen on X-ray, including changes in contour (28%), sclerosis (3%) or osteonecrosis (3%). CONCLUSIONS: MRI plays an important role in determining whether accessory bones cause symptoms because it shows specific and accurate changes in accessory bone and/or in adjacent soft tissue.


Assuntos
Ossos do Pé/anormalidades , Ossos do Pé/diagnóstico por imagem , Deformidades Congênitas do Pé/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Doenças da Medula Óssea/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos
2.
Br J Radiol ; 93(1106): 20190620, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31573325

RESUMO

CT is a readily available imaging modality for cross-sectional characterization of acute musculoskeletal injuries in trauma. Dual-energy CT provides several additional benefits over conventional CT, namely assessment for bone marrow edema, metal artifact reduction, and enhanced assessment of ligamentous injuries. Winter sports such as skiing, snowboarding, and skating can result in high speed and high energy injury mechanisms; dual-energy CT is well suited for the characterization of those injuries.


Assuntos
Esportes na Neve/lesões , Tomografia Computadorizada por Raios X/métodos , Adulto , Traumatismos do Tornozelo/diagnóstico por imagem , Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/lesões , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Lesões do Quadril/diagnóstico por imagem , Humanos , Imagem Tridimensional , Traumatismos do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Fraturas do Rádio/diagnóstico por imagem , Fraturas da Tíbia/diagnóstico por imagem , Traumatismos do Punho/diagnóstico por imagem , Adulto Jovem
3.
Radiol Med ; 124(10): 1028-1036, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31273545

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) to identify bone marrow edema (BME) of the ankle. METHODS: This prospective institutional review board approved study included 40 consecutive patients (29 males and 11 females; mean age of 32.3 years) studied with DECT (80 kV and tin filter 150 kV) and MRI within 10 days. DECT data were post-processed for generating non-calcium images of the ankle. Two radiologists evaluated the presence of BME on color-coded maps. Diagnostic accuracy values for diagnosing BME were calculated for DECT maps (qualitative assessment) and for CT numbers (quantitative assessment) by using receiver operator curves and area under the curve (AUC), using MRI as the gold standard. Interobserver and intraobserver agreements were calculated with k-statistics. A p < 0.05 was considered statistically significant. RESULTS: DECT depicted BME in 23/25 patients (92.0%). The sensitivity, specificity, PPV and NPV, and accuracy achieved by evaluating the DECT images were 92.0, 86.6, 92.0, 84.6, and 90.0%, for reader 1 and 88.0, 86.6, 91.6, 78.6, and 87.5, for reader 2, respectively. The interobserver and intraobsever agreements were near perfect (k = 0.87 and k = 0.83, respectively). DECT numbers were significantly different between positive (mean - 12.6 ± 29.6 HU) and negative cases (mean - 64.2 ± 34.5 HU) with a p value < 0.001. By using - 20HU cutoff to identify BME (AUC of 0.896.), the sensitivity, specificity, PPV and NPV, and accuracy of the quantitative analysis were 88.0, 92.6, 95.7, 92.6, and 87.5%, respectively. CONCLUSION: DECT represents an accurate imaging tool for demonstration of BME of the ankle when compared to MRI.


Assuntos
Articulação do Tornozelo/diagnóstico por imagem , Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Estudos Prospectivos , Sensibilidade e Especificidade
4.
Clin Nucl Med ; 44(8): 680-682, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274623

RESUMO

A 46-year-old woman presented with a complaint of fever. CRP was 2.1 mL/L in blood, white blood cell count was 20-29/hpf, and bacterial count was 3418/µL in a urinalysis. Ga scan revealed accumulation of Ga in the left distal femur, although she had no symptoms around the site. MRI demonstrated diffuse high signal intensity on T2-weighted STIR images. Osteomyelitis was suspected, and biopsy was performed. Bacterial culture of the bone marrow was negative, and histological examination showed no infiltration of inflammatory cells. Two months after the biopsy, disappearance of altered signal intensity of MRI was observed.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Cintilografia , Radioisótopos de Gálio , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos
5.
BMC Musculoskelet Disord ; 20(1): 330, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307450

RESUMO

BACKGROUND: The aetiology of bone marrow oedema-like abnormalities (BMOA) seen on magnetic resonance imaging (MRI) is as yet not fully understood. The current study aimed to investigate the potential of projection radiography and Raman microspectroscopy to provide information regarding the underlying physiological changes associated with BMOA in equine bone samples. METHODS: MRI was used to assess 65 limbs from 43 horses. A subset of 13 limbs provided 25 samples, 8 with BMOA present and 17 as controls; these were examined with projection radiography to assess bone mineral density and Raman spectroscopy to assess bone composition. Statistical analysis was conducted using SPSS, the relationship between BMOA and age was tested using binary logistic regression, other outcome measures via unpaired t-tests. RESULTS: Overall BMOA was found to be associated with locally increased bone density (p = 0.011), suggesting increased bone formation; however, no measurable changes relating to bone remodelling were found, and there were no detectable changes in the chemical composition of bone. CONCLUSIONS: BMOA is associated with locally increased bone density, without an associated change in the chemical composition of bone, suggesting this is not linked to BMOA. The presence of increased bone density associated with BMOA does appear to suggest that an increased amount of bone formation is occurring in these regions, but as Raman microspectroscopy data do not demonstrate any significant changes in bone chemical composition associated with BMOA, it would appear that the increased bone volume is due to a greater amount of bone being formed rather than an imbalance in relation to bone remodelling. The study provides a proof of principle for the use of Raman microspectroscopy and projection radiography in in vitro studies of BMOA.


Assuntos
Densidade Óssea , Doenças Ósseas/veterinária , Doenças da Medula Óssea/veterinária , Osso e Ossos/química , Edema/veterinária , Animais , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/patologia , Doenças da Medula Óssea/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Edema/diagnóstico por imagem , Edema/patologia , Membro Anterior , Cavalos , Imagem por Ressonância Magnética , Espectroscopia de Ressonância Magnética/métodos , Estudo de Prova de Conceito , Análise Espectral Raman/métodos
7.
J Shoulder Elbow Surg ; 28(12): 2334-2342, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31300369

RESUMO

BACKGROUND: Rapidly destructive arthropathy (RDA) of the shoulder is rare. Consequently, there are very few studies that have reported the characteristic findings of this disease. This study aimed to analyze the clinical, radiographic, and histologic features of patients with RDA of the shoulder. METHODS: In total, 9 cases (8 patients) were enrolled in this study. All patients were elderly women, with a mean age of 72.7 years (range, 57-78 years). The mean duration of symptoms was 4.1 months (range, 1.2-5.9 months). Reverse total shoulder arthroplasty and total shoulder arthroplasty were performed in 5 cases with massive rotator cuff tears and 4 without them, respectively. RESULTS: The mean duration of radiologically evident joint destruction after negative results on radiography was 3.1 months (range, 1.0-5.9 months). On plain radiography, humeral head flattening and collapse that appeared like cut grass were observed (100%). Relatively good preservation of the glenoid with a normal joint space was observed in 7 cases, whereas glenoid erosion was observed in 2 (22.2%). T1-weighted magnetic resonance imaging showed a subchondral fracture (100%) of low signal intensity with associated bone marrow edema. Histologically, chronic inflammation of the synovium and osteocytes in the lacunae, as well as callus formation, were observed along the subchondral fracture. CONCLUSION: Flattening and collapse of the humeral head within an average of 4 months of symptom onset are characteristic of RDA of the shoulder. Bone marrow edema, joint effusion, and subchondral fracture on magnetic resonance imaging and fracture fragments and callus formation on histopathologic analysis were observed. Glenoid erosion was observed in 2 cases with arthrosis progression.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Artropatias/diagnóstico por imagem , Artropatias/patologia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/patologia , Idoso , Artroplastia do Ombro , Doenças da Medula Óssea/complicações , Edema/complicações , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/patologia , Cavidade Glenoide/diagnóstico por imagem , Humanos , Cabeça do Úmero/diagnóstico por imagem , Artropatias/complicações , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Radiografia
8.
BMJ Case Rep ; 12(7)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31296627

RESUMO

We present a case of transient osteoporosis of the hip in a 38-year-old recreational trail runner. Shortly after a trail running competition, he developed acute hip pain, functional disability and an antalgic gait. Diagnosis was made with MRI showing bone marrow oedema, plain radiographs demonstrating osseous demineralisation and bone scintigraphy showing uniform radioactive uptake. Treatment included off-loading of the anatomical site for 6 months until symptom resolution, analgaesia, Vitamin D, bisphosphonates and pulsed electromagnetic field therapy. He recovered fully and returned to running activities 8 months after initial presentation. Transient osteoporosis of the hip is rare but benign, self-limiting condition; however, awareness and exact diagnosis are important as runners often present with hip pain and other more serious pathologies such as avascular necrosis or stress fractures need to be excluded.


Assuntos
Dor Aguda/complicações , Artralgia/complicações , Osteoporose/complicações , Osteoporose/diagnóstico por imagem , Corrida , Dor Aguda/terapia , Adulto , Analgesia , Artralgia/terapia , Conservadores da Densidade Óssea/uso terapêutico , Doenças da Medula Óssea/complicações , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/terapia , Ácido Clodrônico/uso terapêutico , Edema/complicações , Edema/diagnóstico por imagem , Edema/terapia , Radiação Eletromagnética , Articulação do Quadril/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Osteoporose/terapia , Radiografia , Cintilografia , Vitamina D/uso terapêutico
9.
J Assoc Physicians India ; 67(3): 46-51, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31304706

RESUMO

Abstract: Multiplanar MR imaging provides excellent spatial and contrast resolution necessary to differentiate the signal intensities of fatty (yellow) marrow elements from hematopoietic (red) marrow elements and hence it is useful for evaluation of various pathologies of bone marrow. Utilization of typical imaging features on conventional MR imaging techniques and other newer imaging techniques, such as diffusion-weighted imaging (DWI) and in- and out-of-phase MRI, for better characterisation of bone marrow pathologies has been highlighted. Aims and Objectives: To determine the prevalence of various bone marrow pathologies in spine. To study the MRI signal changes of bone marrow in various lesions such as anaemia, leukaemia, lymphomas and various bone marrow disorders. Materials and Methods: A total of 100 patients who were investigated between November 2012 and October 2014 were included. MRI spine studies were done on a 3.0 Tesla Philips Achieva Medical Systems. Observations and Results: In our study, out of 100 cases studied for various spinal pathologies, 48 patients were male and 52 were female indicating almost equal male to female distribution. Maximum cases were degenerative with most common site of involvement being lumbar followed by cervical region. There were only 3 cases of depletion disorder and no case with deposition disorder. The mean age group was 45.37 years, with the range being 9 years to 72 years. Maximum patients (n = 67) were found in the age group of 41-60. Conclusion: Various bone marrow disorders were classified and evaluated separately. A systematic approach to its evaluation by categorization is essential with prudent use of both conventional and problem-solving techniques, such as CSI and DWI, for accurate diagnosis and appropriate patient management. Conventional radiology depicts changes of an altered bony matrix while MRI displays changes at a cellular level and is well suited for imaging the bone marrow. MRI serves as a screening method in bone marrow disorders and the diagnosis is established in context with the clinical findings or by biopsy.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Medula Óssea , Imagem por Ressonância Magnética , Adulto , Criança , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coluna Vertebral
10.
Semin Musculoskelet Radiol ; 23(3): 276-288, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31163502

RESUMO

Bone marrow edema (BME) represents a frequent and easily detected MR imaging finding that is recognized as a common source of pain. It is considered a nonspecific finding that constitutes a central component of a wide spectrum of pathologies affecting the hip joint, showing high variability in terms of prognosis and treatment requirements. Solid knowledge of the various BME patterns and associated imaging findings indicative of these conditions can aid in differentiation. Additionally, correlation with clinical and laboratory data are essential for arriving at a final diagnosis in several cases. In this review, we describe the disease characteristics and imaging findings and also highlight the differential diagnostic clues regarding common hip disorders associated with BME including avascular necrosis, transient osteoporosis, stress injuries, and infectious/inflammatory disorders.


Assuntos
Artralgia/etiologia , Doenças da Medula Óssea/diagnóstico por imagem , Edema/complicações , Edema/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Artralgia/fisiopatologia , Medula Óssea/diagnóstico por imagem , Edema/fisiopatologia , Humanos
11.
Eur Radiol ; 29(11): 5941-5949, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31041562

RESUMO

OBJECTIVE: To evaluate feasibility and diagnostic performance of multi-level calcium suppression in spectral detector computed tomography (SDCT) for assessment of bone metastasis. MATERIALS AND METHODS: Retrospective IRB-approved study on 21 patients who underwent SDCT (120 kV, reference mAs 116) and MRI. Thoracic and lumbar vertebrae (n = 357) were included and categorized as normal (n = 133) or metastatic (n = 203) based on MRI (STIR, T1w, ±contrast). The multi-level virtual non-calcium (VNCa) algorithm computes dynamic soft tissue/calcium pairs allowing for computation of different suppression index levels to address inter-individual variance of prevalent calcium composition weights. We computed images with low, medium, and high calcium suppression indices and compared them with conventional images (VNCa_low/med/high and conventional images (CI)). For quantitative image analysis, regions of interest were placed in normal and metastatic bone. Two readers reviewed the datasets independently in multiple sessions. They determined the presence of vertebral metastases on a per vertebra basis using a binary scale. Statistic assessment was performed using ANOVA with Tukey HSD, Student's T test, and ROC analysis. RESULTS: Attenuation of both normal and metastatic bone was lower in VNCa images than that in conventional images (e.g., CI/VNCa_low, - 46.3 to 238.8 HU/343.3-60.2 HU; p ≤ 0.05). VNCa_low+med improved separation of normal and metastatic bone in ROC analysis (AUC, CI/VNCa_low/VNCa_med = 0.74/0.95/0.98; p ≤ 0.05). In subjective analysis, both sensitivity and specificity were clearly improved in VNCa_low as compared with CI (0.85/0.84 versus 0.78/0.82). Readers showed a good inter-rater reliability (kappa = 0.65). CONCLUSIONS: Multi-level VNCa reconstructed from SDCT improve quantitative separation of normal and metastatic bone and subjective determination of bone metastases when using low to intermediate calcium suppression indices. KEY POINTS: • Spectral detector CT allows for multi-level calcium suppression in CT images and low and medium calcium suppression indices improved separation of normal and metastatic bone. • Thus, multi-level calcium suppression allows to optimize image contrast in regard to dedicated pathologies. • Low-level virtual non-calcium images (index 25-50) improved diagnostic performance regarding detection of metastasis.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Cálcio , Neoplasias da Coluna Vertebral/secundário , Tomografia Computadorizada por Raios X/métodos , Adulto , Algoritmos , Medula Óssea/diagnóstico por imagem , Métodos Epidemiológicos , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem
12.
AJR Am J Roentgenol ; 213(3): 493-505, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31039024

RESUMO

OBJECTIVE. Dual-energy CT (DECT) involves the acquisition of CT attenuation data at two different energy levels. In musculoskeletal imaging, gout detection is the most validated clinical indication for DECT. However, there is emerging evidence for several other clinical musculoskeletal applications, including metal artifact reduction and bone marrow imaging for traumatic, neoplastic, and inflammatory processes. CONCLUSION. In this article, we review the current role of DECT in musculoskeletal imaging, primarily focusing on nongout entities.


Assuntos
Gota/diagnóstico por imagem , Doenças Musculoesqueléticas/diagnóstico por imagem , Imagem Radiográfica a Partir de Emissão de Duplo Fóton , Tomografia Computadorizada por Raios X , Artefatos , Doenças da Medula Óssea/diagnóstico por imagem , Humanos , Metais , Próteses e Implantes
13.
J Am Acad Orthop Surg ; 27(20): 752-759, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-30964755

RESUMO

Bone marrow lesions of the knee in patients with osteoarthritis (OA-BML) are an important clinical entity that may explain progressive pain, decreased quality of life, and impaired function. MRI of OA-BMLs demonstrates a region of subchondral bone with hyperintense marrow signal on T2-weighted images. Histopathology retrieval studies have demonstrated that these lesions correlate with microdamage of the trabecular bone, and subsequently, this leads to a vicious cycle of subchondral bone attrition, attempts at repair, pain, and progressive deformity. These lesions have also been linked to accelerated loss of adjacent articular cartilage and increases in the severity of knee pain, prompting patients to seek musculoskeletal care and treatment. Multiple studies have also correlated the presence of an OA-BML with an increased probability of seeking knee arthroplasty. Knowledge of these lesions is important in the context that knee OA is both a cartilage-based and bone-based disease. Further study of OA-BMLs may provide opportunities for early intervention and OA disease-modifying treatments.


Assuntos
Doenças da Medula Óssea/patologia , Doenças das Cartilagens/patologia , Osteoartrite do Joelho/patologia , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/cirurgia , Doenças das Cartilagens/diagnóstico por imagem , Doenças das Cartilagens/cirurgia , Humanos , Imagem por Ressonância Magnética , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos
14.
Medicine (Baltimore) ; 98(11): e14620, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30882628

RESUMO

The purpose of this study was to investigate the correlation of bone marrow edema (BME) in sacroiliac joint (SIJ) with clinical characteristics and clinical response, and whether the quick decrease of BME could be served as a novel marker for dose tapering of etanercept in ankylosing spondylitis (AS) patients.Ninety active AS patients underwent etanercept treatment for 6 months were enrolled consecutively and classified into standard dose group (n = 37) and dose tapering group (n = 53). BME in SIJ and clinical response were assessed by SPARCC criteria and ASAS 40 response criteria, respectively. "Quick decrease of BME in SIJ" was defined as the decrease of SPARCC score≥50% from M0 to M1.BME in SIJ was positively correlated with pain VAS score, BASDAI score, CRP, IL-1ß, IL-17, and TNF-α levels. ASAS 40 response rate at M6 was lower in dose tapering group than standard dose group, while higher in patients with a quick decrease of BME in SIJ than other patients. Besides, the ASAS 40 response rate in dose tapering group was similar to standard dose group in patients with a quick decrease of BME in SIJ but was lower than standard dose group in patients without a quick decrease of BME in SIJ at M6.A quick decrease of BME in SIJ predicts better treatment response to etanercept, and it might be served as a novel marker for dose tapering initiation of etanercept in AS patients.


Assuntos
Antirreumáticos/administração & dosagem , Doenças da Medula Óssea/etiologia , Edema/etiologia , Etanercepte/administração & dosagem , Espondilite Anquilosante/complicações , Espondilite Anquilosante/tratamento farmacológico , Adulto , Biomarcadores , Doenças da Medula Óssea/diagnóstico por imagem , Proteína C-Reativa/metabolismo , Edema/diagnóstico por imagem , Feminino , Humanos , Interleucina-17/sangue , Interleucina-1beta/sangue , Imagem por Ressonância Magnética , Masculino , Dor Musculoesquelética/etiologia , Medição da Dor , Articulação Sacroilíaca , Índice de Gravidade de Doença , Espondilite Anquilosante/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto Jovem
15.
J Vet Med Sci ; 81(4): 593-597, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-30828037

RESUMO

This study focused on 8 Thoroughbred racehorses showing bone marrow oedema-type signal in the proximal sagittal groove of the proximal phalanx, with the aim of understanding its clinical significance. Standing magnetic resonance imaging played an important role in assessing osseous abnormalities that were not radiographically identifiable. Further, a histopathological result from one of the cases showed there was oedema surrounding adipose tissues with increase in density of trabecular scaffolding. This may indicate presence of osseous injury within the area of decreased elasticity due to subchondral bone modeling. This study suggests that detection of osseous abnormality based on bone marrow oedema-type signal, and application of appropriate care following injury would contribute to prevent deterioration of stress-related fractures of the proximal phalanx.


Assuntos
Doenças da Medula Óssea/veterinária , Edema/veterinária , Membro Anterior/diagnóstico por imagem , Tecido Adiposo/patologia , Animais , Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico , Feminino , Fraturas de Estresse/diagnóstico por imagem , Fraturas de Estresse/veterinária , Cavalos , Imagem por Ressonância Magnética/veterinária , Masculino
16.
Skeletal Radiol ; 48(10): 1525-1539, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30903260

RESUMO

There is a large variety of conditions that can result in 'bone marrow edema' or 'bone marrow lesions' (BML) in the wrist on magnetic resonance imaging (MRI). The combination of clinical history and the distribution of the BML can serve as a valuable clue to a specific diagnosis. This article illustrates the different patterns of BML in the wrist to serve as a useful guide when reviewing wrist MRI studies. Imaging artefacts will also be briefly covered.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Punho/diagnóstico por imagem , Doenças da Medula Óssea/patologia , Diagnóstico Diferencial , Edema/patologia , Humanos , Punho/patologia
17.
Radiol Med ; 124(6): 487-494, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30712165

RESUMO

PURPOSE: The aim of this study was to evaluate DECT diagnostic accuracy in the identification of vertebral bone marrow edema, using MRI as standard of reference. METHODS: This prospective institutional review board-approved study included 76 consecutive patients (29 males and 47 females; mean age 62.3, range 51-82 years) studied with DECT (90 kV and tin filter 150 kV) and MRI within 7 days. Three radiologists evaluated DECT (reader 1 and 2) and MRI images (reader 3). Diagnostic accuracy of the DECT maps (qualitative assessment) and of the CT numbers (quantitative assessment), interobserver and intraobserver agreements were calculated. RESULTS: MRI revealed 61 edematous vertebrae and 52 collapsed non-edematous vertebrae. The sensitivity, specificity, PPV and NPV and accuracy of the qualitative assessment of the DECT maps were 88.6, 92.3, 93.1, 87.3 and 90.3%, for reader 1, 90.2, 90.3, 91.6, 88.7 and 90.3, for reader 2, and 91.8, 90.4, 91.6, 90.4 and 91.1% for quantitative analysis, respectively. DECT numbers were significantly different between positive (mean - 23 HU, range - 189, 29 HU) and negative cases (mean - 126 HU, range - 321, - 66 HU) with p < 0.001. The ROC curve analysis revealed an AUC of 0.886 (95% confidence interval 0.722-0.913). The interobserver and intraobserver agreements were near perfect (k = 0.87 and k = 0.83, respectively). CONCLUSION: DECT represents an accurate imaging technique for demonstrating bone marrow edema in vertebral compression fracture, if compared to MRI.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Fraturas por Compressão/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade
18.
Radiol Clin North Am ; 57(2): 359-375, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30709475

RESUMO

Benign and malignant as well as focal and diffuse disease processes can involve the spinal marrow. This is a review of the commonly encountered spinal marrow abnormalities and the distinguishing magnetic resonance features that may provide clues to disease.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Doenças da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Medula Óssea/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Coluna Vertebral/diagnóstico por imagem
19.
Foot (Edinb) ; 38: 50-53, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30639799

RESUMO

Bone Marrow Oedema Syndrome during childhood is a rare benign transient condition without clear pathophysiology. It usually resolves after conservative treatment, but resolution may exceed up to 8 months. A 12-year-old child with bone marrow oedema of the left foot which was diagnosed by magnetic resonance imaging (MRI) is reported. She presented with a six week subacute pain and mild swelling on the dorsal surface of the foot. Routine plain radiographs, blood tests, biochemical and serological tests were normal with the exception of serum Vitamin D levels that were reduced. The management of the child included partial weight-bearing, administration of anti-inflammatory drugs and supplementation of Vitamin D due to insufficient Vitamin D intake. After six months the child did not have any clinical symptoms and MRI showed complete resolution of the oedema. This is the first report of a juvenile bone marrow oedema correlated with hypovitaminosis D that was successfully treated with Vitamin D administration.


Assuntos
Doenças da Medula Óssea/etiologia , Edema/etiologia , Doenças do Pé/etiologia , Deficiência de Vitamina D/complicações , Vitamina D/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Biomarcadores/sangue , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/tratamento farmacológico , Criança , Edema/diagnóstico por imagem , Edema/tratamento farmacológico , Feminino , Doenças do Pé/diagnóstico por imagem , Humanos , Deficiência de Vitamina D/tratamento farmacológico
20.
Arthritis Care Res (Hoboken) ; 71(1): 39-45, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29648685

RESUMO

OBJECTIVE: To determine the association of effusion detected by physical examination with the prevalence of bone marrow lesions (BMLs) on magnetic resonance imaging (MRI), and the incidence/progression of BMLs over 3 years in subjects with knee osteoarthritis. METHODS: A population-based cohort with knee pain (n = 255) was assessed for effusion on physical examination. On MRI, BMLs were graded 0-3 (none, mild, moderate, severe), and incidence/progression was defined as a worsening of the sum of BML scores over 6 surfaces by ≥1 grade. We analyzed the full cohort and a mild disease subsample with a Kellgren/Lawrence (K/L) grade <3. Cross-sectional logistic and longitudinal exponential regression analyses were performed, adjusted for age, sex, body mass index (BMI) and pain. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for effusion detected by physical examination versus BMLs (prevalence and incidence/progression). RESULTS: The weighted mean age was 56.7 years, the mean BMI was 26.5, 56.3% were women, 20.1% had effusion on physical examination, and 80.7% had a K/L grade <3. Effusion on physical examination was significantly associated with prevalent BMLs in the full cohort (odds ratio [OR] 6.10 [95% confidence interval (95% CI) 2.77-13.44]) and in the K/L grade <3 cohort (OR 6.88 [95% CI 2.76-17.15]). In the full cohort, sensitivity, specificity, PPV, and NPV were 34.6, 92.5, 79.9, and 62.1%, respectively, and in the K/L <3 cohort 31.7, 94.0, 75.5, and 70.1%, respectively. Longitudinally, effusion on physical examination was not significantly associated with BML incidence/progression in the full cohort (hazard ratio [HR] 1.83 [95% CI 0.95-3.52]) or in the K/L grade <3 cohort (HR 1.73 [95% CI 0.69-4.33]). In the two cohorts, sensitivity, specificity, PPV, and NPV were 32.0, 82.2, 42.2, and 74.9%, respectively, and 21.2, 85.6, 30.1, and 78.8% respectively. CONCLUSION: BMLs on MRI can be predicted from physical examination effusion cross-sectionally, with a high PPV of 79.9%. Assessment for knee effusion on physical examination is useful for determining potential candidates with BMLs before costly MRI screening for recruitment into clinical trials.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/epidemiologia , Articulação do Joelho/diagnóstico por imagem , Exame Físico/tendências , Vigilância da População , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética/tendências , Masculino , Pessoa de Meia-Idade , Exame Físico/métodos , Vigilância da População/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA