Search

The purpose of this study was to assess the reliability of Direct Magnetic Resonance Arthography (MRA) and Conventional Magnetic Resonance Imaging (MRI) in diagnosing labral lesions in patients with symptoms of femoroacetabular impingement (FAI). Materials and methods: Imaging and surgical data (n=490) were retrospectively collected from 5 high-volume centres providing arthroscopic treatment of FAI patients. Preoperative magnetic resonance imaging findings were compared with the actual surgical findings regarding labral condition in order to assess the effectiveness of MRI and MRA in identifying the presence of labral tears in patients with FAI. The results of this study indicate that MRI and MRA may both be useful for the diagnosis of acetabular labral lesions. The accuracy is slightly higher for MRI (71,4 %) compared to MRA (68,2 %), although MRA has higher sensitivity (74.4%,) as compared to MRI (66,9%). Conclusions: In a clinically suspected labral tear MRA has higher sensitivity than MRI. Further studies on asymptomatic patients may be needed to determine the specificity of different MRI techniques.

Parsonage-Turner syndrome (PTS) is a distinct clinical syndrome, characterized by acute and severe (mostly) unilateral shoulder pain, followed by paresis and atrophy of the shoulder girdle, while the pain decreases. Most authors consider it as an immune-mediated disorder. PTS is notoriously unrecognised and is usually diagnosed with delay. A PTS may also occur following a surgical procedure. Postsurgical PTS is an under-recognised and challenging clinical entity, as illustrated in the case reported here of a 59-year-old man, 4 weeks after anterior discectomy and fusion C5C7. In such cases, the differential diagnosis must be made with a complication of surgery, such as postoperative C5 palsy due for instance to a migrated bone graft. Arguments for PTS are: a certain delay between surgery and symptoms, intolerable pain followed by weakness and improvement of pain complaints, divergent distribution of weakness, sensory deficit and pain, which may be confirmed by electrodiagnosis. Early recognition of postsurgical PTS may avoid unnecessary investigations or surgical exploration. It allows to treat the patient properly, leading to greater satisfaction of both surgeon and patient; pain management, physical therapy and reassurance are the cornerstones.