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5. The periosteum: what is it, where is it, and what mimics it in its absence?

Author

Dwek, Jerry R.

Subjects
Medicine & Public Health, Nuclear Medicine, Pathology, Orthopedics, Imaging / Radiology
Abstract

Nearly every bone in the body is invested in periosteum. The periosteum is in some ways poorly understood and has been a subject of controversy and debate. This tissue has a major role in bone growth and bone repair and has an impact on the blood supply of bone as well as skeletal muscle. Despite the importance of the periosteum is has received little attention in the literature in recent years.

Published
2010

6. MR imaging of overuse injuries in the skeletally immature gymnast: spectrum of soft-tissue and osseous lesions in the hand and wrist

Author

Dwek, Jerry R., Cardoso, Fabiano, and Chung, Christine B.

Subjects
Medicine & Public Health, Oncology, Ultrasound, Nuclear Medicine, Neuroradiology, Pediatrics, Imaging / Radiology, Gymnastics, MRI, Overuse, Children
Abstract

In the pediatric gymnast, stress-related physeal injuries have been well described with characteristic imaging findings. However, a spectrum of overuse injuries, some rarely reported in the literature, can be encountered in the gymnast’s hand and wrist.To demonstrate the MR appearance of a spectrum of overuse injuries in the skeletally immature wrist and hand of pediatric gymnasts.A total of 125 MR exams of the hand and wrist in skeletally immature children were performed at our institution during a 2-year period. Clinical histories were reviewed for gymnastics participation. MR studies of that subpopulation were reviewed and abnormalities tabulated.Of the MR studies reviewed, ten gymnasts were identified, all girls age 12–16 years (mean age 14.2 years) who presented with wrist or hand pain. Three of these children had bilateral MR exams. Abnormalities included chronic physeal injuries in three children. Two girls exhibited focal lunate osteochondral defects. Triangular fibrocartilage tears were present in three girls, one of whom had a scapholunate ligament tear. Two girls manifested metacarpal head flattening and necrosis.A variety of soft-tissue and osseous lesions can be encountered in the skeletally immature gymnast. Familiarity with these stress-related injuries is important for accurate diagnosis.

Published
2009

24. CONTRIBUTORS

Author

Adams, Denise, primary, Adler, Brent H., additional, Applegate, Kimberly E., additional, Armstrong, Derek, additional, Azouz, E. Michel, additional, Babyn, Paul S., additional, Backstrom, James W., additional, Bates, D. Gregory, additional, Becker, Cristie J., additional, Bedard, Mary P., additional, Ben-Ami, Tamar E., additional, Benya, Ellen C., additional, Berdon, Walter E., additional, Binkovitz, Isaac, additional, Binkovitz, Larry A., additional, Bloom, David A., additional, Boal, Danielle K.B., additional, Booth, Timothy N., additional, Brkljacic, Boris, additional, Bulas, Dorothy I., additional, Caré, Marguerite M., additional, Cecil, Kim M., additional, Cervantes, Luisa F., additional, Chan, Frandics P., additional, Chugani, Harry T., additional, Cohen, Harris L., additional, Cohen, Ronald A., additional, Coley, Brian D., additional, Condon, Virgil R., additional, Connolly, Bairbre L., additional, Cooper, Moira L., additional, Crowley, John J., additional, Culham, J.A. Gordon, additional, Daneman, Alan, additional, Delaney, Jeffrey W., additional, Demarchi, Guilherme T.S., additional, DiPietro, Michael A., additional, Donaldson, James S., additional, Donofrio, Mary T., additional, Donovan, F. Daniel, additional, Druhan, Stephen M., additional, Dubois, Josée, additional, Dwek, Jerry R., additional, Ecklund, Kirsten, additional, Effmann, Eric L., additional, Egelhoff, John C., additional, El-Helw, Tamer, additional, Emani, Sitaram M., additional, Emery, Kathleen H., additional, Faerber, Eric N., additional, Farmer, Diana L., additional, Feinstein, Kate A., additional, Feola, G. Peter, additional, Fernbach, Sandra K., additional, Fletcher, Barry D., additional, Frush, Donald P., additional, Gaca, Ana Maria, additional, Gaca, Jeffrey G., additional, Goske, Marilyn J., additional, Grant, P. Ellen, additional, Greenberg, S. Bruce, additional, Guillerman, R. Paul, additional, Hall, Eric J., additional, Haller, Jack O., additional, Halperin, Edward C., additional, Harcke, H. Theodore, additional, Hedlund, Gary L., additional, Helton, Kathleen Jacobson, additional, Henesch, Stephen M., additional, Herlong, J. René, additional, Herman, Thomas E., additional, Hernanz-Schulman, Marta, additional, Hill, Jeanne G., additional, Hoeg, Karin L., additional, Hogan, Mark J., additional, Humes, Richard A., additional, Jaffe, Richard B., additional, Jaggers, James, additional, James, Charles A., additional, Jaramillo, Diego, additional, Junewick, Joseph J., additional, Kanter, Ronald J., additional, Kaste, Sue Creviston, additional, Keats, Theodore E., additional, Kim, Stanley T., additional, Kronemer, Keith A., additional, Kuhn, Jerald P., additional, Lachman, Ralph S., additional, Laor, Tal, additional, Larrier, Nicole, additional, Lawrence, Theodore, additional, Lederman, Henrique M., additional, Lodge, Andrew J., additional, Long, Frederick R., additional, Lowe, Lisa H., additional, MacDonald, Cathy, additional, Markowitz, Richard I., additional, Mawson, John B., additional, Maxfield, Charles M., additional, McAlister, William H., additional, McLaren, Clare A., additional, Meyer, James S., additional, Mody, Swati, additional, Mooney, James F., additional, Moore, Charlotte Waugh, additional, Moore, Kevin R., additional, Moore, Mary Beth, additional, Morello, Frank P., additional, Muzik, Otto, additional, Navarro, Oscar, additional, Neel, Michael D., additional, Nelson, Marvin D., additional, Newman, Beverley, additional, O'Donovan, Julie Currie, additional, Piatt, Joseph H., additional, Pollock, Avrum N., additional, Poussaint, Tina Young, additional, Racadio, John M., additional, Ranson, Marilyn D.E., additional, Rhodes, John F., additional, Riccabona, Michael, additional, Rigsby, Cynthia K., additional, Roebuck, Derek J., additional, Rorke-Adams, Lucy B., additional, Rozzelle, Arlene A., additional, Sable, Craig A., additional, Sagar, Pallavi, additional, Saker, Martha C., additional, Medina, L. Santiago, additional, Schlesinger, Alan E., additional, Schirf, Brian E., additional, Schwartz, Erin Simon, additional, Shore, Richard M., additional, Sivit, Carlos J., additional, Slovis, Thomas L., additional, Smith, Jennifer D., additional, Sood, Sandeep, additional, Spottswood, Stephanie E., additional, Stauss, Jan, additional, Steen, R. Grant, additional, Stein, Sharon M., additional, Strain, John, additional, Strouse, Peter J., additional, Swartz, Joel D., additional, Towbin, Alexander J., additional, Traubici, Jeffrey, additional, Treves, S. Ted, additional, Walters, Henry L., additional, Wells, Robert G., additional, Wyers, Mary R., additional, and Young, Adam S., additional

Published
2008
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26. CONTRIBUTORS

Author

Adler, Ronald S., primary, Akeson, Wayne H., additional, Boutin, Robert Downey, additional, Bugbee, William, additional, Chu, Constance R., additional, Chung, Christine B., additional, Coumas, James M., additional, Dalinka, Murray K., additional, Dwek, Jerry R., additional, Fallon, Michael D., additional, Feldman, Frieda, additional, Garfin, Steven R., additional, Goergen, Thomas G., additional, Goldman, Amy Beth, additional, Greenway, Guerdon D., additional, Guilford, W. Bonner, additional, Haghighi, Parviz, additional, Haygood, Tamara Miner, additional, Herman, Thomas E., additional, Howard, Brian A., additional, Kaplan, Phoebe A., additional, Kyriakos, Michael, additional, Mack, Laurence A., additional, Madewell, John E., additional, Manolagas, Stavros C., additional, McAlister, William H., additional, Murphy, William A., additional, Ozonoff, M.B., additional, Pathria, Mini N., additional, Pitt, Michael J., additional, Ross, Jeffrey S., additional, Rubin, David A., additional, Sartoris, David J., additional, Scheible, F. William, additional, Schneider, Robert, additional, Sofka, Carolyn M., additional, Sweet, Donald E., additional, and Weissman, Barbara N., additional

Published
2005
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33. Progressive Elbow Magnetic Resonance Imaging Abnormalities in Little League Baseball Players Are Common: A 3-Year Longitudinal Evaluation.

Author

Holt, Joshua B., Pedowitz, Jason M., Stearns, Philip H., Bastrom, Tracey P., Dennis, M. Morgan, Dwek, Jerry R., and Pennock, Andrew T.

Subjects
ANALYSIS of variance, ARM, ATHLETES, BASEBALL, COMPARATIVE studies, STATISTICAL correlation, ELBOW, LONGITUDINAL method, MAGNETIC resonance imaging, MEDICAL history taking, PAIN, PEDIATRICS, PHYSICAL diagnosis, SURGICAL plaster casts, SPORTS medicine, STATISTICS, DATA analysis, MULTIPLE regression analysis, QUANTITATIVE research, SPORTS participation, THROWING (Sports), REPEATED measures design, DATA analysis software, DESCRIPTIVE statistics, ODDS ratio
Abstract

Background: Prior studies have revealed magnetic resonance imaging (MRI) evidence of elbow pathology in single-season evaluation of competitive youth baseball players. The natural history of these findings and risk factors for progression have not been reported. Purpose: To characterize the natural history of bilateral elbow MRI findings in a 3-year longitudinal study and to correlate abnormalities with prior MRI findings, throwing history, playing status, and physical examination. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective study of Little League players aged 12 to 15 years was performed. All players had preseason and postseason bilateral elbow MRI performed 3 years before this study. Players underwent repeat bilateral elbow MRI, physical examination, and detailed assessment of throwing history, playing status, and arm pain. Imaging was read by a blinded musculoskeletal radiologist and compared with prior MR images to assess for progression or resolution of previously identified pathology. Results: All 26 players who participated in the previous single-season study returned for a 3-year assessment. At the completion of the study, 15 players (58%) had dominant arm MRI pathology. Eighty percent (12/15 players) of MRI findings were new or progressive lesions. Players with postseason MRI pathology at the beginning of the study were more likely to have MRI pathology at the 3-year follow-up than players with previously normal postseason MRI (P <.05), although 6 of the 14 players (43%) with previously normal MRI developed new pathology. Year-round play was a significant predictor of tenderness to elbow palpation (P =.027) and positive MRI findings at 3 years (P =.047). At the 3-year follow-up, 7 players (27%) reported having throwing elbow pain and 3 had required casting. Additionally, differences were noted in the dominant arm's internal and external rotation in those that continued to play baseball (P <.05). Conclusion: Dominant elbow MRI abnormalities are common in competitive Little League Baseball players. Year-round play imparts significant risk for progression of MRI pathology and physical examination abnormalities. [ABSTRACT FROM AUTHOR]

Published
2020
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34. Altered Disc Compression in Children with Idiopathic Low Back Pain: An Upright MRI Backpack Study

Author

Shymon, Stephen J., Yaszay, Burt, Dwek, Jerry R., Proudfoot, James A., Donohue, Michael, and Hargens, Alan R.

Subjects
Male, Lumbar Vertebrae, Adolescent, Compressive Strength, Posture, Magnetic Resonance Imaging, Article, Biomechanical Phenomena, Radiography, Weight-Bearing, Humans, Female, Child, Intervertebral Disc, Low Back Pain
Abstract

This study is a repeated measures design to measure the lumbar spine's response to common backpack loads in children with idiopathic low back pain (ILBP) using upright magnetic resonance imaging (MRI).The purpose of this study is to analyze the lumbar spine's response to backpack loads with upright MRI in children with ILBP to compare their results with previously published normal child data under the same conditions. We hypothesize that typical backpack loads will have a different effect on the lumbar spine of normal children and children with ILBP.Research in normal children shows that backpack loads compress the lumbar intervertebral discs (IVDs), increase lumbar coronal deformity, and increase pain.Fifteen pediatric and adolescent patients with ILBP were selected. Patients were excluded if a spinal deformity, an underlying pathology, or known injury was identified. A 0.6-T upright MRI scanner imaged the subjects while in supine and standing positions wearing 0-kg, 4-kg, and 8-kg backpacks. IVD height, lumbar lordosis, lumbar coronal deformity, and pain score were recorded after each condition and compared using analysis of variances. We compared the above-mentioned variables between ILBP and normal subjects using generalized least squares models.The cohort's mean age was 13 ± 3 years. The 4-kg and 8-kg backpacks only compressed the L5-S1 IVD relative to upright with no load. Subjects experienced increasing pain with increasing load. Load had no effect on lumbar lordosis or lumbar coronal deformity. Compared with normal children, children with ILBP experience significantly less disc compression at T12-L1 to L4-L5, less lumbar lordosis, and more pain with increasing load.In children with ILBP, increasing backpack load compresses only the L5-S1 IVD. Compared with normal children, children with ILBP experience less lumbar IVD compression, less lumbar lordosis, and more pain due to increasing load suggesting altered mechanisms for load tolerance in children with ILBP.3.

Published
2014

38. Osteochondritis Dissecans

Author

Scalcione, Luke R., primary, Flug, Jonathan A., additional, Katz, Douglas S., additional, Chen, Karen C., additional, Dwek, Jerry R., additional, and Chung, Christine B., additional

Published
2013
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