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2.
Heart Fail Clin ; 18(1): 61-72, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34776084

RESUMO

Cardiac amyloidosis is an infiltrative disorder caused by transthyretin or immunoglobulin free light-chain deposition, which determines clinical disease with similar phenotype but different time course, prognosis and therapy. Multimodality imaging is the cornerstone for disease diagnosis and management. Multimodality imaging has revolutionized the approach to the disease favoring its awareness and simplifying its diagnosis, especially in ATTR cardiac amyloidosis. This describes the different imaging tools, from the traditional to the more novel ones, and highlights the different approach in each different setting (prognosis, subtyping, prognosis, monitoring disease progression, and response to therapy).


Assuntos
Amiloidose , Cardiomiopatias , Amiloidose/diagnóstico por imagem , Cardiomiopatias/diagnóstico por imagem , Ecocardiografia , Humanos , Imagem Multimodal , Prognóstico
3.
Clin Sports Med ; 41(1): 1-13, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782067

RESUMO

Patellofemoral pain is one of the most common symptoms of patients presenting to sports medicine clinics. Obtaining a pertinent history and performing a thorough examination is crucial to identifying the subset of patients with instability who are most likely to benefit from surgical stabilization. A comprehensive radiographic work-up that includes standard radiographs and advanced imaging helps elucidate the diagnosis and provides crucial information for preoperative planning. This article reviews the evaluation, physical examination, and interpretation of radiographic imaging of patients with patellofemoral pain as an introduction to subsequent articles in this issue discussing surgical interventions.


Assuntos
Instabilidade Articular , Articulação Patelofemoral , Humanos , Patela/diagnóstico por imagem , Articulação Patelofemoral/diagnóstico por imagem , Exame Físico , Radiografia
4.
Clin Sports Med ; 41(1): 109-121, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782068

RESUMO

Management of the patient with multiple risk factors for recurrent patellar instability is complex. Surgeons must possess familiarity with the anatomic risk factors that are associated with first time and recurrent instability events and weigh them in the patient's individualized surgical "menu" options for surgical patellar stabilization. Addressing individual risk factors, pairing imaging findings with physical examination, and thoughts on prioritizing risk factors to determine which should be prioritized for surgical correction are discussed.


Assuntos
Instabilidade Articular , Luxação Patelar , Articulação Patelofemoral , Humanos , Instabilidade Articular/cirurgia , Luxação Patelar/diagnóstico por imagem , Luxação Patelar/epidemiologia , Luxação Patelar/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Recidiva , Fatores de Risco
5.
Clin Sports Med ; 41(1): 137-155, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782070

RESUMO

Cartilage defects of the patellofemoral joint are commonly found in association with patellar instability owing to abnormal biomechanics. Strategies to address chondral defects of the patellofemoral joint secondary to instability should first address causes of recurrent instability. Most patellofemoral chondral defects associated with instability are less than 2 cm2 and do not generally require intervention beyond chondroplasty. Larger defects of the patella and/or the trochlea can be repaired with osteochondral or surface cartilage repair.


Assuntos
Doenças das Cartilagens , Instabilidade Articular , Articulação Patelofemoral , Humanos , Instabilidade Articular/cirurgia , Patela/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia
6.
Clin Sports Med ; 41(1): 15-26, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782071

RESUMO

Coronal malalignment of the patellofemoral joint may contribute to both instability as well as pain and joint overload. The use of distal realignment procedures has evolved to include uniplanar and multiplanar osteotomies, which allows patient-specific treatment. With a careful understanding of the complex pathoanatomy, including osseous, soft tissue, and dynamic muscular factors, an appropriately designed tibial tubercle osteotomy (TTO) is an invaluable tool for the orthopedic surgeon to improve joint biomechanics and off-load articular injuries. Current techniques have improved TTO surgery to limit complications and produce reliably good results.


Assuntos
Instabilidade Articular , Articulação Patelofemoral , Humanos , Instabilidade Articular/cirurgia , Osteotomia , Patela , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Tíbia/cirurgia
7.
Clin Sports Med ; 41(1): 27-46, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782074

RESUMO

Rotational deformity is a less common cause of patellar instability than trochlear dysplasia and patella alta. In some cases, rotational deformity is the primary bony factor producing the instability and should be corrected surgically. More research is needed on what are normal values for femoral version and tibial torsion, as well as when the axial plane alignment needs to be corrected. Many tools can be used to evaluate the axial plane and surgeons should be familiar with each of them. Understanding the advantages and disadvantages of each site for osteotomy will help the surgeon choose the most appropriate osteotomy.


Assuntos
Instabilidade Articular , Luxação Patelar , Articulação Patelofemoral , Fêmur/cirurgia , Humanos , Instabilidade Articular/cirurgia , Patela , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Tíbia/cirurgia
8.
Clin Sports Med ; 41(1): 47-63, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782075

RESUMO

Valgus malalignment is an important risk factor in recurrent patella instability. This article explores the role of corrective osteotomy and discusses the various described methods both on the femoral and tibial sides of the joint. A detailed operative technique of medial closing wedge distal femoral osteotomy is included.


Assuntos
Geno Valgo , Instabilidade Articular , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Geno Valgo/diagnóstico por imagem , Geno Valgo/cirurgia , Humanos , Instabilidade Articular/cirurgia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Osteotomia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
9.
Clin Sports Med ; 41(1): 65-76, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782076

RESUMO

Patella alta is described as abnormally high-riding patella in relation to the femur, the trochlear groove, or the tibia with decreased bony stability. Patella alta represents an important predisposing factor for patellofemoral instability. Different measurement methods are used to define patella alta. Despite the clinical importance of patella alta, there is only limited consensus on cutoff values, indications for treatment, and ideal correction. In addition, the impact of patella alta on other risk factors for lateral patellar instability is significant. This must be considered when assessing clinical complaints and choosing the best individual treatment. Combined surgical interventions may be necessary.


Assuntos
Instabilidade Articular , Luxação Patelar , Articulação Patelofemoral , Humanos , Instabilidade Articular/cirurgia , Patela/diagnóstico por imagem , Patela/cirurgia , Luxação Patelar/diagnóstico por imagem , Luxação Patelar/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Fatores de Risco
10.
Clin Sports Med ; 41(1): 77-88, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782077

RESUMO

When? Only patients with high-grade trochlear dysplasia types B and D, in which the prominence of the trochlea (supratrochlear spur) is over 5 mm, recurrent patellar dislocation, and maltracking. How? Sulcus deepening trochleoplasty: modifies the trochlear shape with a central groove and oblique medial and lateral facets; decreases the patellofemoral joint reaction force by reducing the trochlear prominence (spur); and reduces the tibial tubercle and the trochlear groove value by a proximal realignment. Pros: This procedure is highly effective in restoring patellofemoral stability and satisfying the patients. Cons: The patients must be aware of the risk of continuing residual pain and range-ofmotion limitation and that the development of patellofemoral osteoarthritis is not predictable.


Assuntos
Instabilidade Articular , Luxação Patelar , Articulação Patelofemoral , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Instabilidade Articular/cirurgia , Luxação Patelar/diagnóstico por imagem , Luxação Patelar/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
11.
Clin Sports Med ; 41(1): 97-108, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782079

RESUMO

Through this article, the authors aim to summarize the techniques performed on both first time and recurrent skeletally immature patients experiencing patellar dislocation. This article focuses on several key points, such as the importance of medial patellofemoral ligament femoral insertions being distal to the growth plate and performing extensive lateral release and quadricep tendon lengthening in cases of obligatory dislocation. Although acknowledging the procedures discussed cannot be considered for all patients, as individuals with open growth plates may require additional operative time, in many cases these techniques yield high rates of success.


Assuntos
Luxação Patelar , Articulação Patelofemoral , Humanos , Articulação do Joelho , Ligamentos Articulares/cirurgia , Luxação Patelar/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Tendões
13.
Handb Exp Pharmacol ; 271: 547-577, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34363128

RESUMO

Kappa opioid receptor (KOR) neuroimaging using positron emission tomography (PET) has been immensely successful in all phases of discovery and validation in relation to radiotracer development from preclinical imaging to human imaging. There are now several KOR-specific PET radiotracers that can be utilized for neuroimaging, including agonist and antagonist ligands, as well as C-11 and F-18 variants. These technologies will increase KOR PET utilization by imaging centers around the world and have provided a foundation for future studies. In this chapter, I review the advances in KOR radiotracer discovery, focusing on ligands that have been translated into human imaging, and highlight key attributes unique to each KOR PET radiotracer. The utilization of these radiotracers in KOR PET neuroimaging can be subdivided into three major investigational classes: the first, measurement of KOR density; the second, measurement of KOR drug occupancy; the third, detecting changes in endogenous dynorphin following activation or deactivation. Given the involvement of the KOR/dynorphin system in a number of brain disorders including, but not limited to, pain, itch, mood disorders and addiction, measuring KOR density in the living brain will offer insight into the chronic effects of these disorders on KOR tone in humans. Notably, KOR PET has been successful at measuring drug occupancy in the human brain to guide dose selection for maximal therapeutic efficacy while avoiding harmful side effects. Lastly, we discuss the potential of KOR PET to detect changes in endogenous dynorphin in the human brain, to elucidate neural mechanisms and offer critical insight into disease-modifying therapeutics. We conclude with comments on other translational neuroimaging modalities such as MRI that could be used to study KOR-dynorphin tone in the living human brain.


Assuntos
Tomografia por Emissão de Pósitrons , Receptores Opioides kappa , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Dinorfinas , Humanos , Ligantes
14.
Neurosurg Clin N Am ; 33(1): 105-112, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34801135

RESUMO

Craniosynostosis involves the premature fusion of 1 or more cranial sutures and commonly presents as an isolated, nonsyndromic diagnosis. A subset of patients have syndromic craniosynostosis. Several unique considerations must be taken into account when managing patients with syndromic craniosynostosis. A multidisciplinary craniofacial team with a central coordinator is particularly useful for coordinating care among various specialists, and close monitoring is mandatory owing to the increased risk of intracranial hypertension. Surgical management varies among centers, but core options include fronto-orbital advancement with cranial vault remodeling, posterior vault expansion, endoscopic-assisted suturectomy with postoperative orthotic therapy, and midface advancement.


Assuntos
Craniossinostoses , Hipertensão Intracraniana , Craniossinostoses/diagnóstico por imagem , Craniossinostoses/cirurgia , Humanos , Lactente , Crânio , Síndrome
15.
Magn Reson Imaging Clin N Am ; 30(1): 1-18, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802573

RESUMO

Routine and advanced MR imaging sequences are used for locoregional spread, nodal, and distant staging of head and neck squamous cell carcinoma, aids treatment planning, predicts treatment response, differentiates recurrence for postradiation changes, and monitors patients after chemoradiotherapy.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Estadiamento de Neoplasias , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem
16.
Magn Reson Imaging Clin N Am ; 30(1): 109-120, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802574

RESUMO

Treatment strategies and recommended surveillance imaging differ for head and neck cancers depending on subsite and neoplasm type, and pose confusion for referring physicians and interpreting radiologists. The superior soft tissue resolution offered by magnetic resonance imaging is most useful in the surveillance of cancers with high propensities for intraorbital, intracranial, or perineural disease spread, which most commonly include those arising from the sinonasal cavities, nasopharynx, orbits, salivary glands, and the skin. This article discusses recommended surveillance protocoling and reviews treatment approaches, common posttreatment changes, and pearls for identifying disease recurrence in a subsite-based approach.


Assuntos
Neoplasias de Cabeça e Pescoço , Imageamento por Ressonância Magnética , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Recidiva Local de Neoplasia
17.
Magn Reson Imaging Clin N Am ; 30(1): 121-133, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802575

RESUMO

Head and neck reconstructive surgical techniques are complex; now the microvascular free tissue transfer is the most frequently used. The postreconstruction imaging interpretation is challenging due to the altered anatomy and flap variability. We aim to improve radiologists' knowledge with diverse methods of flap reconstruction for an accurate appreciation of their expected cross-sectional imaging appearance and early detection of tumor recurrence and other complication.


Assuntos
Neoplasias de Cabeça e Pescoço , Procedimentos Cirúrgicos Reconstrutivos , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Imageamento por Ressonância Magnética , Pescoço/diagnóstico por imagem , Pescoço/cirurgia , Recidiva Local de Neoplasia , Retalhos Cirúrgicos
18.
Magn Reson Imaging Clin N Am ; 30(1): 135-149, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802576

RESUMO

Neoplasms of the salivary glands are characterized by their marked histologic diversity giving them nonspecific imaging findings. MR imaging is the best imaging modality to evaluate salivary gland tumors. Multiparametric MR imaging combines conventional imaging features, diffusion-weighted imaging, and perfusion imaging to help distinguish benign and low-grade neoplasms from malignant tumors; however, a biopsy is often needed to establish a definitive histopathologic diagnosis. An awareness of potential imaging pitfalls is important to prevent mistakes in salivary neoplasm imaging.


Assuntos
Imageamento por Ressonância Magnética , Neoplasias das Glândulas Salivares , Imagem de Difusão por Ressonância Magnética , Humanos , Imagem de Perfusão , Neoplasias das Glândulas Salivares/diagnóstico por imagem
19.
Magn Reson Imaging Clin N Am ; 30(1): 151-198, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802577

RESUMO

This article reviews soft tissue tumors of the head and neck following the 2020 revision of WHO Classification of Soft Tissue and Bone Tumours. Common soft tissue tumors in the head and neck and tumors are discussed, along with newly added entities to the classification system. Salient clinical and imaging features that may allow for improved diagnostic accuracy or to narrow the imaging differential diagnosis are covered. Advanced imaging techniques are discussed, with a focus on diffusion-weighted and dynamic contrast imaging and their potential to help characterize soft tissue tumors and aid in distinguishing malignant from benign tumors.


Assuntos
Neoplasias Ósseas , Neoplasias de Tecidos Moles , Neoplasias Ósseas/diagnóstico , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Neoplasias de Tecidos Moles/diagnóstico por imagem
20.
Magn Reson Imaging Clin N Am ; 30(1): 19-33, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34802578

RESUMO

Nasopharyngeal carcinoma is endemic in parts of the world such as southern China and Southeast Asia. It is predominantly an undifferentiated carcinoma with a strong genetic basis and a close association with the Epstein-Barr virus. The ability of MR imaging to depict the boundaries of the primary tumor and its relationship with the complex structures of the skull base makes it the technique of choice for imaging of this disease in the head and neck. This article describes the MR imaging findings pertinent to staging and management and a new role of MR imaging in early cancer detection, in addition to a brief discussion of differential diagnoses.


Assuntos
Infecções por Vírus Epstein-Barr , Neoplasias Nasofaríngeas , Herpesvirus Humano 4 , Humanos , Imageamento por Ressonância Magnética , Carcinoma Nasofaríngeo/diagnóstico por imagem , Neoplasias Nasofaríngeas/diagnóstico por imagem
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