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1.
Objective
To assess whether there is a significant difference in the ischiofemoral space in patients with multiple hereditary exostoses affecting the proximal femora compared to normal patients.Introduction
Ischiofemoral impingement is an increasingly recognized cause of hip and buttock pain. This causes narrowing of the ischiofemoral space resulting in an abnormal quadratus femoris muscle.Materials and methods
We performed a retrospective search for individuals with MHE with proximal femoral involvement on pelvic MRI over a 7-year period (2006–2013). Suitable patients were age- and sex-matched with a control group. The minimum ischiofemoral space (MIFS) was recorded in each hip, as was the presence of edema and atrophy of quadratus femoris and concomitant hip osteoarthrosis. MRI features suggestive of ischiofemoral impingement were defined as MIFS less than 10 mm or an abnormal quadratus femoris muscle.Results
Twenty-one hips in 11 individuals with MHE were included in the study. A total of 42 hips were analyzed. The mean age was 37 years (range, 13–72 years) and 55 % were male. There was a significant difference (p?<?0.05) in the MIHS in individuals with MHE (mean, 10.7 mm, range, 0–21 mm) compared to a control group (mean, 18.1 mm, range, 10.5–26.5 mm). MRI features suggestive of ischiofemoral impingement were seen in 13/21 (62 %) hips in the MHE group and 0/21 (0 %) in the control group.Conclusions
The reduced ischiofemoral space and associated quadratus femoris abnormalities in patients with MHE involving the proximal femora may account for hip/buttock symptoms in the absence of significant degenerative change. 相似文献2.
An association between hip pain and quadratus femoris MRI abnormality with concurrent narrowing of the ischiofemoral space
has been reported in a number of patients to date, raising the possibility that the muscular damage observed is due to ischiofemoral
impingement [1]. Possible impingement has been noted primarily in middle-aged females either with or without a history of trauma or surgery,
and associated snapping of the hip is a rarely described feature [1–3]. We report here on a 17-year-old girl who presented with post-traumatic hip pain; she later developed evidence of ischiofemoral
narrowing and quadratus femoris edema on MRI in addition to an audible snapping. Surgical resection of the lesser trochanter
was performed, relieving both her hip pain and the snapping. To our knowledge, this is the first reported case of non-iatrogenic
ischiofemoral impingement with surgical confirmation. The diagnosis of ischiofemoral impingement should be considered in patients
complaining of a snapping hip. 相似文献
3.
4.
Objective
Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging.Materials and methods
The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded.Results
Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003).Conclusion
Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain. 相似文献5.
Donmez FY Basaran C Ulu EM Uyusur A Tarhan NC Muhtesem Agildere A 《European journal of radiology》2009,71(3):536-540
Purpose
To evaluate and demonstrate the MRI findings of renal transplant recipients with hip and knee pain and to investigate the most common etiology of pain.Materials and methods
69 hip MRIs of 57 patients with hip pain and 30 knee MRIs of 24 patients with knee pain with no history of trauma were retrospectively evaluated by two radiologists.Results
In the evaluation of hip MRIs, 24 patients had avascular necrosis and effusion, 2 patients had bone marrow edema consistent with early stage of avascular necrosis. 18 patients had only intraarticular effusion, 6 patients had tendinitis, 6 patients had bursitis and 1 patient had soft tissue abscess. Five patients had muscle edema and five patients had muscle atrophy as additional findings to the primary pathologies. Among patients with knee pain, nine patients had degenerative joint disease. Seven patients had chondromalacia, five had bone marrow edema, six had meniscal tear, six had ligament rupture and two had bone infarct. Three of the patients had muscle edema accompanying to other pathologies.Conclusion
The most common etiology of hip pain in renal transplant recipients is avascular necrosis as expected, intraarticular effusion is found to be the second reason for pain. However, knee pain is explained by ligament pathology, meniscal tear, chondromalacia or degenerative joint disease rather than osteonecrosis. 相似文献6.
Value of dynamic sonography in the management of shoulder pain in patients with rheumatoid arthritis
Nevien El-Liethy Heba Kamal Nagui Abdelwahab Ghada Azkalany 《The Egyptian Journal of Radiology and Nuclear Medicine》2014
Purpose
The purpose of this study is to evaluate the role of dynamic high resolution ultrasonography in the detection of abnormalities of rheumatoid arthritis and to find out the value added to the management plan of the disease.Patients and methods
21 shoulders of rheumatoid arthritis patients complaining of shoulder pain were scanned with ultrasound (static and dynamic) and compared to clinical examination.Result
The most predictive sign of rheumatoid arthritis was sub-acromial impingement which was screened and graded by ultrasound in (100%). Other US signs included sub-acromial bursitis in 14.2%, biceps teno-synovitis in 52.4%, supraspinatous tendinopathy in 57.1%, supraspinatous partial thickness bursal surface tear in 14.2% and joint effusion in 9.5% of our patients. The combination of more than one finding was of higher sensitivity than isolated sign alone.Conclusion
Dynamic ultrasound examination for the diagnosis of shoulder impingement in Rheumatoid arthritis should be done in addition to the clinical and static ultrasound examination to improve the management plan. 相似文献7.
OBJECTIVE: The objective of this study is to report the MR appearance of quadratus femoris muscle tear, another cause of hip pain. We will review the pertinent anatomy of the quadratus femoris muscle, summarize the current literature on quadratus femoris muscle tear, and report our experience in the diagnosis of quadratus femoris muscle tear on MRI. CONCLUSION: MRI is an important tool in assisting clinicians to make a correct diagnosis for the patient who presents with hip pain. Although quadratus femoris muscle tear is an uncommon injury, radiologists should be aware of this entity to assist with making a diagnosis that is usually unsuspected clinically. 相似文献
8.
Zilkens C Miese F Kim YJ Hosalkar H Antoch G Krauspe R Bittersohl B 《European journal of radiology》2012,81(11):3420-3425
Purpose
To assess acetabular and femoral hip joint cartilage with three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) in patients with degeneration of hip joint cartilage and asymptomatic controls with morphologically normal appearing cartilage.Methods and materials
A total of 40 symptomatic patients (18 males, 22 females; mean age: 32.8 ± 10.2 years, range: 18–57 years) with different hip joint deformities including femoroacetabular impingement (n = 35), residual hip dysplasia (n = 3) and coxa magna due to Legg–Calve–Perthes disease in childhood (n = 2) underwent high-resolution 3D dGEMRIC for the evaluation of acetabular and femoral hip joint cartilage. Thirty-one asymptomatic healthy volunteers (12 males, 19 females; mean age: 24.5 ± 1.8 years, range: 21–29 years) without underlying hip deformities were included as control. MRI was performed at 3 T using a body matrix phased array coil. Region of interest (ROI) analyses for T1Gd assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions.Results
T1Gd mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1Gd values were significantly higher in the control group than in the patient group whereas significant differences in T1Gd values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group.Conclusions
Our study demonstrates the potential of high-resolution 3D dGEMRIC at 3 T for separate acetabular and femoral hip joint cartilage assessment in various forms of hip joint deformities. 相似文献9.
Tagliafico A Gandolfo N Michaud J Perez MM Palmieri F Martinoli C 《European journal of radiology》2012,81(6):1207-1210
Purpose
Rupture of the distal triceps tendon is an uncommon injury that may be unrecognized on clinical examination. The purpose of the study is to describe the role of US in distal triceps tendon tears evaluation.Materials and methods
IRB approval was obtained and patients gave written informed consent. Of 77 consecutive US examinations of the elbow obtained over a five-year period, eight patients with correlative MR and surgery available were identified having partial or complete distal triceps tendon tear.Results
N = 4 complete tears of the triceps tendon and n = 4 partial tears of the distal triceps involving the lateral/superficial head were identified. Patients with partial tear had a history of a single traumatic event that determined a sudden eccentric contraction of the triceps muscle against resistance. US demonstrated on axial and longitudinal planes a partial tear of the triceps brachii tendon that resulted in a fusiform swelling and retraction of the lateral/superficial head in four patients. It was possible to identify the normal insertion of the medial head of the triceps moving the transducer medially. MR and surgical findings were concordant with US findings in every patient.Conclusion
Ultrasound is able to differentiate complete from partial triceps tendon tears. US has the potential to identify isolated lesions of the lateral/superficial head of the triceps with an intact medial head. 相似文献10.
Ahmed M. Abdrabou Mennatallah H. Shalaby 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):977-981
Purpose
To highlight the relationship between coraco-humeral distance and subscapularis tendon tear.Material and methods
Sixty-two shoulder MRI studies were examined. Twenty-two patients had partial or complete tear of subscapularis tendon and forty shoulder as a control group. Axial and oblique sagittal MR images were examined to measure the coraco-humeral distance followed by statistical analysis to correlate the distance with tendon tear.Results
A cut-off value of 8.25?mm for the coraco-humeral distance gave a sensitivity of 77.5% and specificity of 72.7% for subscapularis tendon tear.Conclusion
There is a well-known relationship between the coraco-humeral distance and the subscapularis tendon tear and its meticulous assessment in subjects with pain in the anterior shoulder region increases the diagnosis of subcoracoid impingement. 相似文献11.
Dirk Mueller Christoph Schaeffeler Thomas Baum Flavia Walter Hans Rechl Ernst J. Rummeny Klaus Woertler 《European journal of radiology》2014
Purpose
To evaluate magnetic resonance (MR) perfusion and diffusion imaging characteristics in patients with transient bone marrow edema (TBME), avascular necrosis (AVN), or subchondral insufficiency fractures (SIF) of the proximal femur.Materials and methods
29 patients with painful hip and bone marrow edema pattern of the proximal femur on non-contrast MR imaging were examined using diffusion-weighted and dynamic gadolinium-enhanced sequences. Apparent diffusion coefficients (ADCs) and perfusion parameters were calculated for different regions of the proximal femur. Regional distribution and differences in ADC values and perfusion parameters were evaluated.Results
Seven patients presented with TBME, 15 with AVN and seven with SIF of the proximal femur. Perfusion imaging showed significant differences for maximum enhancement values (Emax), slope (Eslope) and time to peak (TTP) between the three patient groups (p < 0.05). In contrast, no significant differences for ADC values were calculated when comparing TBME, AVN, and SIF patients.Conclusion
Diffusion weighted imaging of bone marrow of the proximal femur did not show significant differences between patients with TBME, AVN or SIF. In contrast, MR perfusion imaging demonstrated significant differences for the different patient groups and may as a complementary imaging technique add information to the understanding of the pathophysiology of diseases associated with bone marrow edema. 相似文献12.
Introduction
The impact of resistance exercise on the growth of the vastus lateralis was assessed through interstitial microdialysis measurement of free Insulin-like Growth Factor-I at +3 h30, +4 h50 and +6 h after exercise in 4 healthy subjects.Results
We observed 3 h30 after exercise an interstitial increase in 3 over 4 subjects, and thereafter a progressive decrease. In the mean time, free or total plasma concentrations did not change.Conclusion
Resistance exercise seemed to induce an early increase of muscle interstitial free Insulin-like Growth Factor-I in order to initiate muscle growth by an autocrine – paracrine way. 相似文献13.
Purpose
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic entity characterized by headache, blurred vision and seizures with typical parieto-occipital predominantly vasogenic edema, occasionally with cytotoxic edema. The association between the degree and type of edema in PRES with biochemical parameter, especially serum lactate dehydrogenase, has not been determined.Material and methods
Thirty-five patients with typical clinical symptoms and characteristic MR imaging findings of PRES were included in this study. The extent of brain edema was graded on the anatomical distribution by 2 observers blinded to patients’ clinical record, as well as the type of brain edema determined on DWI and ADC map. The levels of biochemical parameters were correlated with the degree of edema and compared between different types of edema.Results
Serum LDH concentrations between patients with cytotoxic edema and with vasogenic components were not statistically different (NWU test, U = 93.0, Z = 1.818, P = 0.069). Only serum lactate dehydrogenase (LDH) concentration was significantly correlated with the score of brain edema distribution (Spearman's rho correlation, r = 0.721, P = 0.00). No relationship was found between other biochemical parameters and the degree and type of brain edema.Conclusion
Increased serum LDH level, which plays an essential role in endothelial injury, may be a potential risk factor for the development of edema in PRES. 相似文献14.
Purpose
To evaluate the diagnostic efficacy of using additional oblique coronal 1 mm proton density-weighted (PDW) MR imaging of the knee for detection and grading anterior cruciate ligament (ACL), anteromedial bundle (AMB) and posterolateral bundle (PLB) injuries.Materials and methods
We prospectively assessed preoperative MR images of 50 patients (36 men, 14 women; age range, 18–62 years). First, we compared the diagnostic performance of routine sagittal (3 mm) and additional oblique coronal images (1 mm) for ACL tears. Then, we compared the tear types (AMB or PLB) and grade presumed from oblique coronal MR imaging with arthroscopy.Results
Arthroscopy revealed ACL tear in 24 (48%) patients. There was significant difference between sagittal images and arthroscopy results for ACL tear recognition (p < 0.001). No significant difference was detected for oblique coronal images when compared with arthroscopy results (p = 0.180). Sensitivity and specificity values for ACL tear diagnosis were 37.04% and 95.65% for sagittal images; 74.07% and 91.30% for oblique coronal images. There was no significant difference between arthroscopy and oblique coronal MR images in grading AMB and PLB injuries (p > 0.05).Conclusion
Addition of thin slice oblique coronal images to conventional sequences could better contribute to better verifying the presence of ACL tear and in determining its grade. 相似文献15.
Kakigi T Hosono M Shimono T Hiraoka T Nishimura K 《European journal of radiology》2012,81(9):2348-2352
Purpose
To prospectively evaluate the feasibility of using the “iliac wing sign (IWS)” as an indicator of bone and/or soft-tissue injury of the pelvis and hips on magnetic resonance (MR) imaging. IWS means edema of the iliacus muscle attachment entering the iliac wing that is visualized as a linear high signal intensity on fat-suppressed T2-weighted MR images.Methods
Consecutive 106 patients who complained of hip pain were enrolled in this study. We evaluated the correlation between IWS and bone and/or soft-tissue injury of the pelvis and hips using Fisher's exact test. Further, performance parameters of sensitivity, specificity, accuracy, the positive predictive value (PPV), and negative predictive value (NPV) of IWS were calculated.Results
Thirty-eight of the 106 (36%) patients had bone and/or soft-tissue injury. Twenty-seven of these 38 (71%) patients with injury showed a positive IWS, while only 11 of 68 (16%) patients without injury showed a positive IWS (p < .0001). IWS, thus, yielded a sensitivity of 71%, specificity of 84%, accuracy of 79%, positive predictive value (PPV) of 71%, and negative predictive value (NPV) of 84%.Conclusion
In cases with a positive IWS, the careful interpretation of MR images is needed because injury presence is highly likely, as suggested by the relatively high sensitivity and PPV. IWS absence may mean a low probability of injury because of the high specificity and NPV. 相似文献16.
Kassarjian A Tomas X Cerezal L Canga A Llopis E 《AJR. American journal of roentgenology》2011,197(1):170-174
OBJECTIVE: The purpose of this review is to describe the gross anatomic and MRI appearance of the quadratus femoris muscle and the MRI appearance of common lesions of the quadratus femoris. CONCLUSION: Lesions of the quadratus femoris have been implicated as a cause of hip pain. It therefore is important to be familiar with the anatomy of the quadratus muscle and to be able to diagnose the causes of abnormal signal intensity in the quadratus femoris, which include tears and impingement. 相似文献
17.
Fotiadou AN Vlychou M Papadopoulos P Karataglis DS Palladas P Fezoulidis IV 《European journal of radiology》2008,68(1):174-179
Purpose
To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears.Materials and methods
Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery.Results
Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98 and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87 and 90% for ultrasonography and magnetic resonance imaging, respectively.Conclusions
In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears. 相似文献18.
Robert Jordan Edward Dickenson Daniel Westacott Njalalle Baraza Kuntrapka Srinivasan 《European journal of radiology》2013
Background
Early diagnosis in neck of femur fractures has been shown to improve outcome. The National Institute for Clinical Excellence recommends if an occult hip fracture is suspected then an MRI should be performed and if not available within 24 h a CT should be considered. At our centre, emergency MRI is rarely available and so CT is commonly used.Objectives
Our study aims to analyse the trends in CT use over a five year period for the diagnosis of neck of femur fractures.Methods
Both the number of patients with a hip fracture and those undergoing a CT hip to diagnose an occult injury were identified across two district general hospitals between 2006–2007 and 2010–2011. The time from initial radiograph to CT and initial radiograph to operation were calculated.Results
In 2006–2007, of 547 hip fractures, 20 CT hips were performed and 6 reported as a fractured neck of femur (30%). In 2010–2011, of 499 hip fractures, 239 CT hips were performed and 65 fractures were recognised (27%). The mean time from radiograph until CT scan was 2.0 days in 2007 and 3.2 days in 2011, which was a statistically significant difference (p < 0.001). For those diagnosed using a CT scan the mean time from admission X-ray to surgery was 1.2 days in 2007 and 3.6 days in 2011.Conclusion
Clinicians are becoming increasingly reliant on CT for the diagnosis of hip fractures with our data suggesting further imaging is one factor that can delay time to diagnosis and theatre. 相似文献19.
Mohamed Ahmed Youssef Atef Hammad TeimaYaser Elsayed Abduo Logain Nabeel Salem 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
Objective
To evaluate the role and efficacy of U/S and MR in diagnosis of rotator cuff disorders and shoulder joint instability.Patients and methods
This study included 30 patients with shoulder pain and/or movement limitation. They underwent shoulder U/S examination followed by MR examination. The U/S & MR diagnostic criteria of each patient were analyzed, compared and correlated with arthroscopic and/or orthopedic surgical findings.Results
15 patients had with rotator cuff disorders 15/30 (50%) and 11 patients had shoulder instability 11/30 (36.7%). Out of 15 patients with rotator cuff disorders, 12 patients had rotator cuff tears 12/15 (80%) and 3 patients had tendenosis 3/15(20%). The supraspinatus muscle was involved in all cases (100%), without a significant comparable difference between U/S and MR. Out of 11 patients with shoulder instability 8 patients had anterior labral tear 8/11 (72.7%); 2 patients had superior labral tear 2/11 (18.2%) and only one patient with posterior labral tear.Conclusion
U/S and MRI are valid diagnostic modalities in detecting, characterizing and discriminating the rotator cuff disorders, with no significant comparable difference. U/S has many challenges in patients with shoulder instability, while MR provides accurate diagnosis even without contrast. 相似文献20.