Search

To establish the incidence and define the nature of complications occurring following image-guided musculoskeletal injections at our institution.All patients undergoing image-guided musculoskeletal injection during the study period (16/3/2016 to 24/01/2020) were included. Departmental records were reviewed to identify all patients describing possible complications following injection, what therapy was required (if any) and what the outcome was. No patients were excluded. Complications were classified as minor or major. Injections were categorised as follows: cervical spine, lumbar facet joint, lumbar nerve root, caudal epidural and 'other'. The complication rate for each individual category of procedure was compared with the combined complication rate for all other categories by constructing contingency tables and using Fisher's exact test.A total of 8226 patients underwent image-guided musculoskeletal injections within the study period. Exactly 100 patients were identified as having reported a complication, producing an overall complication rate of 1.2%. One complication was categorised as 'major', with the patient requiring expedited surgery. The remainder (99 patients) were categorised as having experienced minor complications. The incidence of complications after 'other' injections was significantly greater than for other categories of injection (1.86%, p = 0.028). There was no significant difference in the complication rate for cervical spine (0.93%, p = 0.257), lumbar nerve root (0.85%, p = 0.401), lumbar facet joint (0.67%, p = 0.326) or caudal epidural (1.29%, p = 0.687) injections. 'Other' injections were subsequently further sub-categorised by anatomical site and imaging modality used. Glenohumeral (2.97%, p = 0.0361) and sacro-iliac (3.51%, p = 0.0498) joint injections were associated with a significantly increased risk of complications. There was no difference in the incidence of complications with fluoroscopic or ultrasound guidance.In conclusion, image-guided musculoskeletal injections are safe and well-tolerated procedures. Complications are rare, occurring in just 1.2% of patients. 99% of complications are minor, either not requiring intervention or resolving with simple supportive treatment.

We report herein a versatile and user-friendly synthetic methodology based on sequential functionalization that enables the synthesis of previously unknown perylene bisimide (PBI) dyes with up to five different substituents attached to the perylene core (e.g., compound 15). The key to the success of our strategy is a highly efficient regiospecific 7-mono- and 7,12-di-phenoxy bay substitution at the "imide-activated" 7- and 12-bay positions of 1,6,7,12-tetrachloroperylene monoimide diester 1. The facile subsequent conversion of the diester groups into an imide group resulted in novel PBIs (e.g., compound 14) with two phenoxy substituents specifically at the 7- and 12-bay positions. This conversion led to the activation of C-1 and C-6 bay positions, and thereafter, the remaining two chlorine atoms were substituted to obtain tetraphenoxy-PBI (compound 15) that has two different imide and three different bay substituents. The methodology provides excellent control over the functionalization pattern, which enables the synthesis of various regioisomeric pairs bearing the same bay substituents. Another important feature of this strategy is the high sensitivity of HOMO-LUMO energies and photoinduced charge transfer toward sequential functionalization. As a result, systematic fluorescence on-off switching has been demonstrated upon subsequent substitution with the electron-donating 4-methoxyphenoxy substituent.

Transketolase catalyzes asymmetric C−C bond formation of two highly polar compounds. Over the last 30 years, the reaction has unanimously been described in literature as irreversible because of the concomitant release of CO2 if using lithium hydroxypyruvate (LiHPA) as a substrate. Following the reaction over a longer period of time however, we have now found it to be initially kinetically controlled. Contrary to previous suggestions, for the non‐natural conversion of synthetically more interesting apolar substrates, the complete change of active‐site polarity is therefore not necessary. From docking studies it was revealed that water and hydrogen‐bond networks are essential for substrate binding, thus allowing aliphatic aldehydes to be converted in the charged active site of transketolase.

Nucleophilic aromatic substitution reactions on 1,7-dibromoperylene-3,4,9,10-tetracarboxylic monoimide dibutylester, using phenol and pyrrolidine reagents, have been exploited to synthesize perylenes with four different substituents at the perylene core. The first substitution is always regiospecific at the imide-activated 7-position. A second substitution reaction does not always replace the bromine at C-1, but may replace a phenol substituent at the highly activated 7-position. Exploiting this reactivity pattern, a “mixed” 1,7-diphenoxy, 1,7-dipyrrolidinyl, and two 1-phenoxy-7-pyrrolidinyl derivatives have been synthesized.

The purpose of this study was to compare metal artifact reduction techniques at 1.5-T and 3-T MRI.A titanium plate with steel screws was placed in a freshly harvested pig leg. The leg was imaged with 1.5-T and 3-T MRI. A T2-weighted turbo spin-echo sequence was used with echo-train lengths of 8, 16, 32, and 64 and a constant readout bandwidth of 31.2 kHz. The images were compared qualitatively, and the optimal echo-train length was selected. Images were acquired at the optimal echo-train length with four different readout bandwidths. Artifact was measured quantitatively, and image quality was ranked qualitatively. The qualitatively best image acquired at 1.5 T was compared with the qualitatively highest-ranked image acquired at 3 T.At both 1.5 T and 3 T, optimal images of equal quality were produced at echo-train lengths of 8 and 16. At higher readout bandwidths, there was quantitatively less artifact. The qualitatively best images were acquired at a readout bandwidth of 31.2 kHz at 1.5 T and 62.5 kHz at 3 T (Cronbach's alpha=1.00). The optimal image at 3 T was qualitatively superior to that at 1.5 T.Optimizing image acquisition parameters in this phantom model resulted in similar quantitative susceptibility artifact at 3 T and 1.5 T and better qualitative images at 3 T than at 1.5 T.

This article outlines basic bone structure and physiology, reviews the fundamental concepts of bone injury, briefly correlates bone edema patterns with mechanism of injury, and finally reviews magnetic resonance imaging during fracture healing.

This article describes the composition of bone marrow and the normal progression of bone marrow changes as they occur throughout the aging process, and provides examples of pitfalls and variants that may simulate disease.

A valuable adjunct to clinical examination When Lauterbur and Damadian described the application of magnetic resonance imaging (MRI) as a clinical imaging tool in the early 1970s the popular belief was that the technique would become the ultimate screening tool for the whole body.1 2 However, similar to other modalities limited by cost, acquisition times, availability, and artefact produced by motion, it evolved as a technique to image stationary body parts. Supported by technical developments in the past decade, improved excitatory pulse sequences, and faster methods of localising derived signal, and by increasing awareness of the hazards of radiation imposed by traditional techniques, the ability to use MRI as a rapid imaging tool for the whole body has now been revisited.3–11 Reduced acquisition times have been mirrored by a logical reduction in acquisition costs, and the recent development of the moving MRI table top has facilitated the clinical introduction of this technique as a practical diagnostic tool.3 The principal application of whole body MRI is in detecting skeletal metastases as an alternative …