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Background: Dupuytren's contracture (DC) is a fibrosing disor-der that produces pathological subcutaneous nodules and cords in the normal fascia. The isolated occurrence of Dupuytren's disease of the fifth digit is uncommon. This study is aimed to describe the imaging features of an isolated digital cord of the small finger and its relationship with the neurovascular bundle., Methods: A total of 13 hands in 13 patients who were clinically diagnosed with an isolated occurrence of Dupuytren's disease of the small finger were included between October 2008 and October 2013. Two independent radiologists used ultrasound and magnetic reso-nance imaging (MRI) to record size, signal or echogenicity, contrast enhancement or hyperemia, calcification, and anatomical features of the cord and its relationship with the neurovascular bundle., Results: We found that ultrasound and MRI were accurate for the detection of the cords and neurovascular bundles in the small finger. The intermodality agreement between MRI and ultrasound was 100% for the detection of 6 spiraling bundles containing 13 isolated cords (46.2%). Among the subjects examined, 100% of the hands had ab-ductor digiti minimi (ADM) area involvement, and the distal insertion of the cord was on the ulnar side of the base of the middle phalanx. On MRI, all of the cords showed predominantly low signal intensity on both T1- and T2-weighted images. On ultrasound, the ulnar cord showed a hyperechoic or isoechoic appearance in 69.3% of hands and a hypoechoic appearance in 30.7% of hands., Conclusions: The spiraling of the bundle in the isolated occurrence of Dupuytren's disease at the small finger is a frequent occurrence. MRI and ultrasound are good imaging modalities for the evaluation of the relationship between the neurovascular bundle and the isolated cord.

Objectives: We aimed to compare the reliability and performance of MRI measures enhanced with intravenous (IV) injection of gadolinium contrast versus non-enhanced MRI measures for the diagnosis of adhesive capsulitis (AC). We also aimed to examine the association between MRI findings and clinical features in patients with AC., Methods: MRI of 42 patients with a clinical diagnosis of AC confirmed by arthrography and that of 42 patients in a control group were retrospectively studied by 2 blinded readers. Reliability and performance of MRI findings were compared between IV contrast-enhanced measures and non-enhanced MRI measures in T2-weighted fat-saturated and T1-weighted images. MRI findings were correlated with clinical stage, etiology, and pain., Results: Sensitivity (97.6%) and specificity (97.6%) of axillary-recess capsule signal enhancement for AC diagnosis were significantly superior (p = 0.02) to hyperintense signals on T2-weighted fat-suppressed images (sensitivity 90.5%, specificity 92.7%). Measures of the intensity signal in the area of the rotator interval were less performant for AC diagnosis but could be improved with joint capsule enhancement. Moreover, we found very high specificity (100%) of enhancement of the coracohumeral ligament signal for AC diagnosis. The early stage of adhesive capsulitis was positively correlated with joint capsule enhancement in the rotator interval. Secondary etiology of capsulitis was correlated with joint capsule hyperintensity signals of the rotator interval on T2-weighted fat-suppressed images., Conclusion: IV contrast injection with MRI can be helpful for AC diagnosis in difficult cases. The stage of AC seems related to joint capsule enhancement in the rotator interval., Key Points: • IV gadolinium-enhanced MRI can improve the analysis of signal changes in the shoulder synovium and capsule of the shoulder that are related to adhesive capsulitis. • As an original finding, we observed that coracohumeral ligament enhancement had a 100% specificity for the diagnosis of adhesive capsulitis. • The intensity of enhanced signals in the rotator interval seems to be related to the early stage of frozen shoulder.

Purpose: To evaluate whether knee extensor mechanism features are associated with superolateral Hoffa fat pad edema at magnetic resonance imaging., Materials and Methods: Institutional review board approval and written consent from all patients were obtained. Patients with superolateral Hoffa fat pad edema (n = 30) and a control group without edema of the fat pad (n = 60) were evaluated prospectively with magnetic resonance (MR) imaging. Demographic data and extensor mechanism features were compared, including trochlear depth, lateral trochlear inclination, patellar tilt angle, patellar height ratio, distance between patellar ligament and lateral trochlear facet, distance from the tibial tubercle to the trochlear groove, patellar facet asymmetry, and patellar ligament abnormalities., Results: The following variables were associated with superolateral Hoffa fat pad edema in the multivariable models: patellar height ratio (P = .023), shortest distance between patellar ligament and lateral trochlear facet (P < .001), and distance from the tibial tubercle to the trochlear groove (P = .046). Of all demographic and degenerative variables, only age was significantly associated, with younger patients more likely to have superolateral Hoffa fat pad edema (P < .009)., Conclusion: A high-riding patella, a short distance between the patellar ligament and the lateral trochlear facet, and an increased distance from the tibial tubercle to the trochlear groove are associated with superolateral Hoffa fat pad edema at MR imaging. These results are suggestive of impingement between the lateral femoral condyle and the posterior aspect of the patellar ligament in these patients.

The new diagnostic criteria for ankylosing spondylitis include MRI. MRI frequently allows early diagnosis of inflammatory lesions in patients with normal plain films. In addition, MRI is useful for the detection and quantification of inflammatory and structural lesions, and to assess disease activity.

The new diagnostic criteria for spondyloarthropathy include MRI. MRI frequently allows early diagnosis of inflammatory lesions of the spine and sacroiliac joints in patients with normal plain films. Moreover, MRI is useful for the detection and quantification of inflammatory and structural lesions, and to assess disease activity.

Objective: The purpose of this study was to retrospectively determine the accuracy of MRI in identification of the morphologic features of median nerve dysfunction after surgical release of the median nerve for carpal tunnel syndrome., Materials and Methods: Two blinded readers independently evaluated axial 1.5-T MR images for retinacular regrowth, morphologic characteristics of the median nerve, and presence of mass effect, fibrosis, and carpal tunnel decompression. All 47 patients (11 men, 36 women; mean age, 55 years; range, 27-81 years) had undergone open surgical release of the median nerve for carpal tunnel syndrome. Thirty-five patients had electromyographic evidence of recurrent carpal tunnel syndrome. The other 12 patients did not have electrophysiologic evidence of recurrent carpal tunnel syndrome and were the control group., Results: A statistically significant difference between the recurrent carpal tunnel syndrome and control groups was found for fibrosis (p = 0.009), nerve enhancement (p = 0.04), and median nerve width (p = 0.008) and ratio (p = 0.01) at the pisiform level., Conclusion: MRI may be used in association with electromyography for accurate postoperative evaluation of the carpal tunnel.

Objective: The purpose of this article is to illustrate the spectrum of MDCT and MRI appearances of spinal fractures in ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis., Conclusion: Spinal fractures associated with ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis usually involve the three columns of the spine, and injury to the posterior osteoligamentous component is the hallmark of these fractures. Osseous and ligamentous injuries can be accurately visualized and analyzed with MDCT with multiplanar reformation and with MRI.

Metastatic disease, myeloma, and lymphoma are the most common malignant spinal tumors. Hemangioma is the most common benign tumor of the spine. Other primary osseous lesions of the spine are more unusual but may exhibit characteristic imaging features that can help the radiologist develop a differential diagnosis. Radiologic evaluation of a patient who presents with osseous vertebral lesions often includes radiography, computed tomography (CT), and magnetic resonance (MR) imaging. Because of the complex anatomy of the vertebrae, CT is more useful than conventional radiography for evaluating lesion location and analyzing bone destruction and condensation. The diagnosis of spinal tumors is based on patient age, topographic features of the tumor, and lesion pattern as seen at CT and MR imaging. A systematic approach is useful for recognizing tumors of the spine with characteristic features such as bone island, osteoid osteoma, osteochondroma, chondrosarcoma, vertebral angioma, and aneurysmal bone cyst. In the remaining cases, the differential diagnosis may include other primary spinal tumors, vertebral metastases and major nontumoral lesions simulating a vertebral tumor, Paget disease, spondylitis, echinococcal infection, and aseptic osteitis. In many cases, vertebral biopsy is warranted to guide treatment.

Radiographs (XR), computed tomography (CT) or magnetic resonance imaging (MRI) are regularly analyzed to determine whether a bone lesion is benign or malignant. An online quiz was created providing 15 cases with a clinical summary, MRI, CT, and XR. After each image, participants were asked to rate the probability (0–100%) the bone tumor was malignant. Order and difficulty of the images were randomly determined. Probability statements regarding the diagnosis were actualized along the sequence of exam, to quantify how the degree of belief changed to account for evidence from those exams. 64 physicians participated and provided 154 assessments from 1 (n = 18) to 3 (n = 44) different cases. After the first image, participants favored the correct malignancy status at 70%; 80% after the second and 80% after the third one. Participants were more likely to favor the correct malignancy status when the lesion was malignant and when first confronted with XR or CT, rather than MRI, though the most predictive factor of correct diagnosis was the difficulty of the case. In conclusion, the additional information provided by successive imaging studies was moderate. XR or CT seemed more appropriate than MRI as first imaging study. Bypassing XR should be discouraged. [ABSTRACT FROM AUTHOR]

Background. Dupuytren's contracture (DC) is a fibrosing disorder that produces pathological subcutaneous nodules and cords in the normal fascia. The isolated occurrence of Dupuytren's disease of the fifth digit is uncommon. This study is aimed to describe the imaging features of an isolated digital cord of the small finger and its relationship with the neurovascular bundle. Methods. A total of 13 hands in 13 patients who were clinically diagnosed with an isolated occurrence of Dupuytren's disease of the small finger were included between October 2008 and October 2013. Two independent radiologists used ultrasound and magnetic resonance imaging (MRI) to record size, signal or echogenicity, contrast enhancement or hyperemia, calcification, and anatomical features of the cord and its relationship with the neurovascular bundle. Results. We found that ultrasound and MRI were accurate for the detection of the cords and neurovascular bundles in the small finger. The intermodality agreement between MRI and ultrasound was 100% for the detection of 6 spiraling bundles containing 13 isolated cords (46.2%). Among the subjects examined, 100% of the hands had abductor digiti minimi (ADM) area involvement, and the distal insertion of the cord was on the ulnar side of the base of the middle phalanx. On MRI, all of the cords showed predominantly low signal intensity on both T1- and T2-weighted images. On ultrasound, the ulnar cord showed a hyperechoic or isoechoic appearance in 69.3% of hands and a hypoechoic appearance in 30.7% of hands. Conclusions. The spiraling of the bundle in the isolated occurrence of Dupuytren's disease at the small finger is a frequent occurrence. MRI and ultrasound are good imaging modalities for the evaluation of the relationship between the neurovascular bundle and the isolated cord. [ABSTRACT FROM AUTHOR]