- Email: [email protected]
Computed tomographic assessment of soft tissue abnormalities following calcaneal fractures
264
CLINICAL IMAGING VOL. 16, NO. 4
ABSTRACTS
Damm 130, D-1000 Berlin, Germany). 1992;156:135-141.
RijFo
The value of sonography in demonstrating cervical lymph node metastases has been studied using longitudinal and transverse measurements as criteria for malignancy. A transverse/longitudinal quotient greater than 2 indicates the presence of metastases with a 96% assurance. Using only longitudinal measurements, lymph node metastases can be excluded with only a 36% assurance. The sensitivity of both methods also differs (95% for the maximal transverse quotient as against 99% for longitudinal measurements). The use of the maximal transverse quotient increases specificity from 36 to 96%. This gives sonography an accuracy of 95%. Authors’ Summary
COMPUTED TOMOGRAPHIC ASSESSMENT OF SOFT TISSUE ABNORMALITIES FOLLOWING CALCANEAL FRACTURES Bradley SA, Davies AM. (A.M. Davies: Department of Radiology, Birmingham Accident Hospital, Bath Row, Birmingham, U.K.). Br J Radio1 1992:65:105-111. Computed tomography (CT) examinations of 50 acute calcaneal fractures were compared with a further series of 77 fractures in which the date of injury preceded the CT by 6 months or more. Forty-two (84%) of the fractures in the acute group and 55 (71%) in the chronic group were classified as intra-articular and they form the basis of this study. The alteration in the position of the peroneal tendons in the two groups was similar, with a 5% or less difference in each category. In the acute group the peroneal tendons were normally located in 40.4% of the cases, entrapped by bone in 11.9% subluxed in 33.3% and dislocated in 14.2%. Structural abnormalities of the peroneal tendons and surrounding soft tissues were identified in 52.4% of the acute group and in 61.1% of the chronic group. The incidence of partial rupture of the peroneal tendons in the chronic group was approximately one-third that in the acute group, but the low incidence of complete tendon rupture remained unchanged. The inference from these observations is that, in the majority of cases, partial peroneal tendon rupture is reversible, whereas complete rupture is not. Seven fractures were common to both series, and from this limited group the identification of hemorrhage around the peroneal tendons in the acute phase was shown not to be related to the subse-
quent development of chronic stenosing tenosynovitis. Various abnormalities of the medial tendons of the hindfoot were identified in 17% of the acute group and in 18% of the chronic group. Following calcaneal fracture, CT in both the immediate post-fracture period and in the late phase can be used to detect and classify the soft tissue changes. The limitations of comparing the two groups in this study are discussed. Authors’ Summary
CURRENT STATUS OF MAGNETIC RESONANCE IMAGING OF THE ANKLE AND HINDFOOT Munk PL, Vellet AD, Levin MF, Helms CA. (Department of Diagnostic Radiology, University Hospital, PO Box 5339, London, ON N6A 5A5, Canada). Can Assoc Radio1 J 1992;43:19-30. With the increasing use of magnetic resonance imaging (MRl) for examining the musculoskeletal system, numerous applications have been found in the evaluation of ankle and hindfoot problems. For example, MRl is ideal for assessing tendon disorders, which are common in this region. In addition, the technique allows accurate staging of osteochondral fractures, as well as both soft-tissue and bony neoplasms. Tarsal coalition can be readily evaluated and the type determined. Increasingly, arthritis and synovial abnormalities are coming under scrutiny with MRI; this is currently an area of avid interest. In this article the authors review the current status of MRI of the ankle and the hindfoot and illustrate a variety of these disorders. Authors’ Summary [Both articles by PL Munk et al. are enriched numerous and clear illustrations, A.F.G.)
by
CURRENT STATUS OF MAGNETIC RESONANCE IMAGING OF THE WRIST Munk PL, Vellet AD, Levin MF, et al. (Department of Diagnostic Radiology, University Hospital, PO Box 5339, London, ON N6A 5A5, Canada). Can Assoc Radio1 J 1992;43:8-18. Conventional imaging of the wrist has relied heavily on plain radiography, tomography, fluoroscopy, and arthrography. More recently, computed tomography and magnetic resonance imaging (MRI) have been added to this armamentarium. In this article the authors review the anatomy of the normal wrist and demonstrate a variety of pathologic conditions that
CLINICAL IMAGING VOL. 16, NO. 4
ABSTRACTS
Damm 130, D-1000 Berlin, Germany). 1992;156:135-141.
RijFo
The value of sonography in demonstrating cervical lymph node metastases has been studied using longitudinal and transverse measurements as criteria for malignancy. A transverse/longitudinal quotient greater than 2 indicates the presence of metastases with a 96% assurance. Using only longitudinal measurements, lymph node metastases can be excluded with only a 36% assurance. The sensitivity of both methods also differs (95% for the maximal transverse quotient as against 99% for longitudinal measurements). The use of the maximal transverse quotient increases specificity from 36 to 96%. This gives sonography an accuracy of 95%. Authors’ Summary
COMPUTED TOMOGRAPHIC ASSESSMENT OF SOFT TISSUE ABNORMALITIES FOLLOWING CALCANEAL FRACTURES Bradley SA, Davies AM. (A.M. Davies: Department of Radiology, Birmingham Accident Hospital, Bath Row, Birmingham, U.K.). Br J Radio1 1992:65:105-111. Computed tomography (CT) examinations of 50 acute calcaneal fractures were compared with a further series of 77 fractures in which the date of injury preceded the CT by 6 months or more. Forty-two (84%) of the fractures in the acute group and 55 (71%) in the chronic group were classified as intra-articular and they form the basis of this study. The alteration in the position of the peroneal tendons in the two groups was similar, with a 5% or less difference in each category. In the acute group the peroneal tendons were normally located in 40.4% of the cases, entrapped by bone in 11.9% subluxed in 33.3% and dislocated in 14.2%. Structural abnormalities of the peroneal tendons and surrounding soft tissues were identified in 52.4% of the acute group and in 61.1% of the chronic group. The incidence of partial rupture of the peroneal tendons in the chronic group was approximately one-third that in the acute group, but the low incidence of complete tendon rupture remained unchanged. The inference from these observations is that, in the majority of cases, partial peroneal tendon rupture is reversible, whereas complete rupture is not. Seven fractures were common to both series, and from this limited group the identification of hemorrhage around the peroneal tendons in the acute phase was shown not to be related to the subse-
quent development of chronic stenosing tenosynovitis. Various abnormalities of the medial tendons of the hindfoot were identified in 17% of the acute group and in 18% of the chronic group. Following calcaneal fracture, CT in both the immediate post-fracture period and in the late phase can be used to detect and classify the soft tissue changes. The limitations of comparing the two groups in this study are discussed. Authors’ Summary
CURRENT STATUS OF MAGNETIC RESONANCE IMAGING OF THE ANKLE AND HINDFOOT Munk PL, Vellet AD, Levin MF, Helms CA. (Department of Diagnostic Radiology, University Hospital, PO Box 5339, London, ON N6A 5A5, Canada). Can Assoc Radio1 J 1992;43:19-30. With the increasing use of magnetic resonance imaging (MRl) for examining the musculoskeletal system, numerous applications have been found in the evaluation of ankle and hindfoot problems. For example, MRl is ideal for assessing tendon disorders, which are common in this region. In addition, the technique allows accurate staging of osteochondral fractures, as well as both soft-tissue and bony neoplasms. Tarsal coalition can be readily evaluated and the type determined. Increasingly, arthritis and synovial abnormalities are coming under scrutiny with MRI; this is currently an area of avid interest. In this article the authors review the current status of MRI of the ankle and the hindfoot and illustrate a variety of these disorders. Authors’ Summary [Both articles by PL Munk et al. are enriched numerous and clear illustrations, A.F.G.)
by
CURRENT STATUS OF MAGNETIC RESONANCE IMAGING OF THE WRIST Munk PL, Vellet AD, Levin MF, et al. (Department of Diagnostic Radiology, University Hospital, PO Box 5339, London, ON N6A 5A5, Canada). Can Assoc Radio1 J 1992;43:8-18. Conventional imaging of the wrist has relied heavily on plain radiography, tomography, fluoroscopy, and arthrography. More recently, computed tomography and magnetic resonance imaging (MRI) have been added to this armamentarium. In this article the authors review the anatomy of the normal wrist and demonstrate a variety of pathologic conditions that