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To prospectively compare magnetic resonance (MR) imaging-defined abnormalities of osteoarthritis (OA) of the knee with radiographic severity measurements of OA of the knee and self-reported pain.This study was approved by the institutional review board of University of Michigan. Informed consent was obtained for this HIPAA-compliant study. Knee MR imaging was performed in 117 women (mean age, 46 years; range, 32-56 years) from a community-based arthritis study (n = 1053) with 30 women in each of four categories: (a) no pain and no OA of the knee, (b) no pain and OA of the knee, (c) pain and no OA of the knee, and (d) pain and OA of the knee. OA of the knee was defined from radiographs. Two hundred thirty-two eligible knees had Kellgren-Lawrence scores for OA of the knee as follows: grade 0, 115 (49.6%); grade 1, 33 (14.2%); grade 2, 66 (28.4%); grade 3, 17 (7.3%); and grade 4, one (0.4%). MR images were assessed for location and severity of defects of cartilage, bone marrow edema (BME), osteophytes, subchondral cysts, sclerosis, meniscal and/or ligamentous tears, joint effusion, synovial cysts, and synovitis. MR imaging findings were compared with radiographic severity of OA of the knee (Kellgren-Lawrence scale) and self-reported pain with analysis of variance, t tests, and contingency table analyses.Defects of cartilage (higher than grade IIA) were found in 75% of knees; BME was found in 57% of knees (1 cm, 41%;1 cm, 16%). Large BME lesions were common in the pain and OA of the knee group (P = .001); this group was significantly more likely to have defects of cartilage (P = .001); meniscal tears (P = .001); and osteophytes, subchondral cysts, sclerosis, joint effusion, and synovitis (P.001). Defects of cartilage, osteophytes, sclerosis, meniscal or ligamentous tears, joint effusion, and synovitis were strongly related to increasing Kellgren-Lawrence grade (P.001).In middle-aged women, there were significant associations between pain, radiographic severity of OA of the knee, and seven MR imaging-identified parameters.

To describe the radiographic appearance of extracorporeal membrane oxygenation (ECMO) in adults and to correlate lung opacity with physiologic parameters and mortality.Chest radiographs of 50 adults treated with ECMO were reviewed; pre-ECMO radiographs were available in 35 patients. Lung opacity was assigned a score of 0-4. Complications of ECMO seen at chest radiography were recorded.The lung opacity scores of the first post-ECMO radiographs were higher than those of the pre-ECMO radiographs in 17 of 35 patients (P = .0005). Maximum opacity score was significantly lower for patients who survived compared with those who died (P = .001). Twelve of 14 patients (86%) with a maximum opacity score of 4 died, compared with eight of 29 patients (28%) with a maximum score of 3. Sixteen of 26 patients (61%) with evidence of baro-trauma died, compared with six of 24 patients (25%) without pneumothorax (P = .02). Four patients developed hemothorax.Lung opacity increases immediately after initiation of ECMO. Increased opacity corresponds to decreased pulmonary function, and severe opacity correlates strongly with mortality.

To characterize the ultrasonographic (US) appearance of the rotator cuff cable in asymptomatic shoulders and in cadaveric specimens, with histologic comparison for the latter.The cadaveric portion of this study was approved by the institution's Anatomical Donations Department. Institutional review board approval and informed consent were obtained from asymptomatic volunteers and clinical patients for the HIPAA-compliant portion of the study. Four fresh cadaveric shoulder specimens (two male subjects, 40 and 50 years old) were dissected, assessed for the presence of the rotator cable, and imaged with 12-MHz US. Histologic slides (hematoxylin-eosin stain) from three resected rotator cuff tendons were inspected for fibers in the expected location and orientation of the rotator cuff cable. The shoulders in 17 asymptomatic volunteers (seven men, two women; age range, 27-66 years; mean, 41 years) and contralateral asymptomatic shoulders in 10 patients (six men, four women; age range, 24-78 years; mean, 49 years) were scanned and evaluated for the presence and appearance of the rotator cable.The rotator cable was identified at gross dissection. Histologic examination and US of the cadaveric shoulders demonstrated an articular-sided fibrillar structure perpendicular to the rotator cuff tendon (average thickness and width, 1.2 mm and 4.5 mm, respectively). US of asymptomatic shoulders depicted a similar fibrillar structure in three (11%) shoulders up to 1.1-1.5 cm medial to the greater tuberosity (average thickness and width, 1.2 mm and 4.5 mm respectively).The rotator cable can be depicted with US.

To retrospectively evaluate the imaging features of os peroneum fractures and associated peroneus longus tendon injuries at radiography and ultrasonography (US) and to retrospectively compare these imaging features with those of multipartite os peroneum.Institutional review board approval was obtained and informed consent was waived for this HIPAA-compliant study. Retrospective review of findings in nine patients (five men, four women; age range, 35-59 years) with os peroneum fracture at radiography and lateral foot pain after injury who had undergone US of the foot was performed. Three patients underwent magnetic resonance (MR) imaging, and two underwent surgery. Os peroneum fragment separation and displacement relative to the calcaneocuboid joint were measured on radiographs. Os peroneum fracture and peroneus longus tendon injuries were characterized with US and MR imaging. Review of 43 foot radiographs obtained in 36 control subjects (eight men, 28 women; age range, 18-84 years) who were found to have an os peroneum at radiography but were asymptomatic in that area was completed to measure os peroneum distance from the calcaneocuboid joint and bipartite os peroneum fragment distraction.Os peroneum fragment separation of 6 mm or more or displacement of the proximal fragment by 10 mm or more on a lateral radiograph or 20 mm or more on an oblique radiograph was associated with full-thickness peroneus longus tendon tear in seven of seven patients (100%). Os peroneum fragment separation of 2 mm or less or proximal displacement of 8 mm or less was associated with normal tendons, partial-thickness tears, or tendinosis. In the control subjects, os peroneum location ranged from 7 mm proximal to 8 mm distal to the calcaneocuboid joint on lateral radiographs and from 9 mm proximal to 8 mm distal to the joint on oblique radiographs. Bipartite os peroneum fragment separation was 2 mm or less.Os peroneum fragment separation of 6 mm or more suggests os peroneum fracture and associated full-thickness peroneus longus tendon tear. Separation of 2 mm or less may be seen with nondisplaced os peroneum fractures and bipartite os peroneum.

The rotator interval and the long head of the biceps brachii tendon are anatomically closely associated structures believed to confer stability to the shoulder joint. Abnormalities of the rotator interval may be acquired or congenital and are associated with instability of the long head of the biceps brachii tendon. Clinical and arthroscopic diagnoses of rotator interval abnormalities and subtle instability patterns of the long head of the biceps brachii tendon are difficult. Magnetic resonance arthrography, owing to its superior depiction of ligaments with distention of the joint capsule, may be the procedure of choice, barring open surgery, for help in diagnosis of these conditions.

To characterize the ultrasonographic (US) appearance of the anterior bundle of the ulnar collateral ligament of the elbow by comparing US images with magnetic resonance (MR) arthrograms and anatomic slices.The ulnar collateral ligament in four cadavers (eight elbows) was blindly evaluated with US by one musculoskeletal radiologist with experience in musculoskeletal US. These results were compared with standard arthrograms, MR arthrograms, and anatomic slices by consensus reading of two musculoskeletal radiologists. The criteria for an abnormal ulnar collateral ligament included contrast material extension into the ligament or fiber discontinuity, as documented by MR arthrography and anatomic slices.Standard arthrography, MR arthrography, and anatomic slices demonstrated the ulnar collateral ligament to be unequivocally normal in three specimens and abnormal in two. The remaining three elbows did not meet the criteria for classification as either normal or abnormal, and thus they were excluded from the study. With US, the normal ulnar collateral ligament was fibrillar and hyperechoic between the medial epicondyle and proximal ulna. In the two abnormal cases, abnormal hypoechogenicity and ligament fiber disruption were noted. In addition, the proximal aspect of the ulnar collateral ligament varied from a cordlike structure to a broad attachment to the undersurface of the medial epicondyle with variable fat.In this small sample, the anterior bundle of the ulnar collateral ligament is identified with US by its hyperechoic and compact fibrillar echotexture. The proximal attachment of the ulnar collateral ligament has a variable appearance. Hypoechogenicity and fiber disruption indicated ulnar collateral ligament abnormality.