J. Ghany, K. Lam, Abhishek Jain, A. Dunn, A. Mistry
This narrative review presents a series of cases of less common incidental findings discovered on magnetic resonance imaging of elite athletes, who have presented for investigation of either muscle or joint sports-related injuries or for presigning imaging. The presented incidental findings include anatomical variants of osseous structures and muscles; incidental bone lesions; examples of systemic disease, and nonorthopedic findings found within the imaging field of view. This review will emphasize to the reader about the importance of interrogating the imaging in its entirety and avoiding the common pitfall of “satisfaction of search” within diagnostic radiology.
{"title":"Incidental findings in sports imaging","authors":"J. Ghany, K. Lam, Abhishek Jain, A. Dunn, A. Mistry","doi":"10.4103/jajs.jajs_13_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_13_23","url":null,"abstract":"This narrative review presents a series of cases of less common incidental findings discovered on magnetic resonance imaging of elite athletes, who have presented for investigation of either muscle or joint sports-related injuries or for presigning imaging. The presented incidental findings include anatomical variants of osseous structures and muscles; incidental bone lesions; examples of systemic disease, and nonorthopedic findings found within the imaging field of view. This review will emphasize to the reader about the importance of interrogating the imaging in its entirety and avoiding the common pitfall of “satisfaction of search” within diagnostic radiology.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44309917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Narang, Gabriele Clemente, H. Aniq, R. Campbell, A. Mistry
Ultrasonography is a well-established musculoskeletal imaging technique with a multitude of advantages when compared to other modalities. It provides great spatial resolution in the evaluation of superficial articular and peri-articular structures including tendons, ligaments, bursae, and nerves. Given that it is the only modality which allows dynamic assessment, it also plays a crucial role in diagnosing impingement, subluxation/dislocation, and instability. The purpose of this article is to review the settings and indications of US in the imaging of shoulder, foot, and ankle in particular. Relevant literature, predominantly in the form of peer-reviewed journal articles was obtained from the electronic databases such as PubMed and MEDLINE and reviewed in a structured manner. This was combined with background knowledge and expertise in this field.
{"title":"Settings and indications of ultrasound in imaging of shoulder, foot, and ankle","authors":"Y. Narang, Gabriele Clemente, H. Aniq, R. Campbell, A. Mistry","doi":"10.4103/jajs.jajs_11_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_11_23","url":null,"abstract":"Ultrasonography is a well-established musculoskeletal imaging technique with a multitude of advantages when compared to other modalities. It provides great spatial resolution in the evaluation of superficial articular and peri-articular structures including tendons, ligaments, bursae, and nerves. Given that it is the only modality which allows dynamic assessment, it also plays a crucial role in diagnosing impingement, subluxation/dislocation, and instability. The purpose of this article is to review the settings and indications of US in the imaging of shoulder, foot, and ankle in particular. Relevant literature, predominantly in the form of peer-reviewed journal articles was obtained from the electronic databases such as PubMed and MEDLINE and reviewed in a structured manner. This was combined with background knowledge and expertise in this field.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45798902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joint injections have emerged as a crucial aspect of a radiologist's role, regularly employed for both diagnostic and therapeutic purposes. Ultrasound guidance is an invaluable tool in this regard, due to its accessibility, low cost, and absence of radiation. Pain relief through the use of corticosteroids, local anesthetics, or viscosupplements, joint aspiration in cases of suspected infection, and contrast injection for arthrography are all common indications for these procedures. In this article, we aim to provide guidance for common joint procedures (as well as one nonjoint but frequently performed procedure) while also revealing some valuable trade secrets and tips.
{"title":"Ultrasound-guided joint injections: Tips and tricks","authors":"Pablo Lorenzzoni, Sanjay Patel","doi":"10.4103/jajs.jajs_20_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_20_23","url":null,"abstract":"Joint injections have emerged as a crucial aspect of a radiologist's role, regularly employed for both diagnostic and therapeutic purposes. Ultrasound guidance is an invaluable tool in this regard, due to its accessibility, low cost, and absence of radiation. Pain relief through the use of corticosteroids, local anesthetics, or viscosupplements, joint aspiration in cases of suspected infection, and contrast injection for arthrography are all common indications for these procedures. In this article, we aim to provide guidance for common joint procedures (as well as one nonjoint but frequently performed procedure) while also revealing some valuable trade secrets and tips.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48400233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Second issue – From the desk of the guest editors","authors":"Sanjay Patel, K. Iyengar, R. Botchu","doi":"10.4103/jajs.jajs_50_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_50_23","url":null,"abstract":"","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43987898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thickened A1 pulley is the most common cause of trigger finger. The patient complains of snapping and locking of finger like a trigger as the gliding of the flexor tendon become harder through the thickened pulley during flexion and superadded development of nodule on the surface of the tendon proximal to pulley. In severe cases or failed conservative/steroid injection cases, real-time percutaneous release of pulley under ultrasound (US) guidance can be considered. The percutaneous pulley release is a minimally invasive procedure compared to open surgical release and more accurate than blind percutaneous release with overall minimal complications. The US-guided percutaneous A1 pulley release has been described in the literature and done by knife, straight needles, and acutely bent needles with variable results. We describe the curved needle technique of percutaneous pulley release. The curved needle technique for US-guided A1 pulley release is novel and has the advantage of easy maneuverability over acutely bent needle and minimal chances of complications. The cutting edge of the curved needle scores through the thickened pulley with effective release and easy maneuverability.
{"title":"Ultrasound-guided percutaneous release of pulley in trigger finger: A curved needle technique","authors":"D. Singh, B. Chari","doi":"10.4103/jajs.jajs_22_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_22_23","url":null,"abstract":"Thickened A1 pulley is the most common cause of trigger finger. The patient complains of snapping and locking of finger like a trigger as the gliding of the flexor tendon become harder through the thickened pulley during flexion and superadded development of nodule on the surface of the tendon proximal to pulley. In severe cases or failed conservative/steroid injection cases, real-time percutaneous release of pulley under ultrasound (US) guidance can be considered. The percutaneous pulley release is a minimally invasive procedure compared to open surgical release and more accurate than blind percutaneous release with overall minimal complications. The US-guided percutaneous A1 pulley release has been described in the literature and done by knife, straight needles, and acutely bent needles with variable results. We describe the curved needle technique of percutaneous pulley release. The curved needle technique for US-guided A1 pulley release is novel and has the advantage of easy maneuverability over acutely bent needle and minimal chances of complications. The cutting edge of the curved needle scores through the thickened pulley with effective release and easy maneuverability.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48939650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The field of modern medical science has been revolutionized by magnetic resonance imaging (MRI) which is the preferred modality for the investigation of a whole spectrum of musculoskeletal (MSK) conditions. MRI is a careful interplay between the temporal, spatial, and contrast resolution which forms the foundation for its improved diagnostic performance and value. There are a lot of aspects that improve the image quality and diagnostic performance, however, a higher magnet strength of 3-Tesla has the biggest impact within the current diagnostic range. However various advancements in the hardware and software parameters such as multichannel multi-phased array coils, advanced gradient systems and better post processing techniques have significantly improved image quality at 1.5T scanners as well. All the leading manufacturers offer MRI systems with a higher field strength of 3T which are increasingly being used in recent clinical settings. Scanning at 3T has the advantage of a better signal-to-noise ratio which translates into better spatial and temporal resolution with the added advantage of faster acquisition. Challenges of 3T scanning include higher magnetic susceptibility, chemical shift, and higher radiofrequency energy deposition. This is particularly important in the presence of orthopedic implants because of the two-fold increase in susceptibility artifacts resulting in significant periprosthetic signal loss, signal displacements with voids and pileups, and failed spectral fat suppression. Various modifications are needed to minimize the artifacts at 3T scanners to better utilize the improved spatial and contrast resolution achieved as a result of scanning at a higher field strength. This review discusses the technical features of scanning at 1.5 and 3T scanners along with their clinical implications and diagnostic usefulness in MSK imaging.
{"title":"Musculoskeletal magnetic resonance imaging revisited – Does tesla of magnetic resonance imaging machines matter?","authors":"Simranjeet Kaur, B. Tins, N. Winn, K. Ganga","doi":"10.4103/jajs.jajs_15_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_15_23","url":null,"abstract":"The field of modern medical science has been revolutionized by magnetic resonance imaging (MRI) which is the preferred modality for the investigation of a whole spectrum of musculoskeletal (MSK) conditions. MRI is a careful interplay between the temporal, spatial, and contrast resolution which forms the foundation for its improved diagnostic performance and value. There are a lot of aspects that improve the image quality and diagnostic performance, however, a higher magnet strength of 3-Tesla has the biggest impact within the current diagnostic range. However various advancements in the hardware and software parameters such as multichannel multi-phased array coils, advanced gradient systems and better post processing techniques have significantly improved image quality at 1.5T scanners as well. All the leading manufacturers offer MRI systems with a higher field strength of 3T which are increasingly being used in recent clinical settings. Scanning at 3T has the advantage of a better signal-to-noise ratio which translates into better spatial and temporal resolution with the added advantage of faster acquisition. Challenges of 3T scanning include higher magnetic susceptibility, chemical shift, and higher radiofrequency energy deposition. This is particularly important in the presence of orthopedic implants because of the two-fold increase in susceptibility artifacts resulting in significant periprosthetic signal loss, signal displacements with voids and pileups, and failed spectral fat suppression. Various modifications are needed to minimize the artifacts at 3T scanners to better utilize the improved spatial and contrast resolution achieved as a result of scanning at a higher field strength. This review discusses the technical features of scanning at 1.5 and 3T scanners along with their clinical implications and diagnostic usefulness in MSK imaging.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46112048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Shojaie, M. Afzali, N. Nischal, K. Iyengar, M. Yousef, R. Botchu
Radiological imaging forms an integral part in the diagnostic and management algorithm of patients with bone tumors. Although plain radiography tends to be the first line of imaging in a patient with suspected bone tumor, advances in technology, computer software, physics and techniques have expanded the modalities available to us in the form of computed tomography (CT), magnetic resonance imaging, and various scintigraphy techniques. These imaging modalities in combination with a clinician led multi-disciplinary team help in the exact diagnosis, appropriate management, and monitoring of patients for recurrence. In this narrative review, we highlight the current applications of conventional imaging, the emerging role of hybrid imaging, and explore the future directions of radiological imaging in the management of patients with bone tumors.
{"title":"Bone tumor imaging: An update on modalities and radiological findings","authors":"P. Shojaie, M. Afzali, N. Nischal, K. Iyengar, M. Yousef, R. Botchu","doi":"10.4103/jajs.jajs_31_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_31_23","url":null,"abstract":"Radiological imaging forms an integral part in the diagnostic and management algorithm of patients with bone tumors. Although plain radiography tends to be the first line of imaging in a patient with suspected bone tumor, advances in technology, computer software, physics and techniques have expanded the modalities available to us in the form of computed tomography (CT), magnetic resonance imaging, and various scintigraphy techniques. These imaging modalities in combination with a clinician led multi-disciplinary team help in the exact diagnosis, appropriate management, and monitoring of patients for recurrence. In this narrative review, we highlight the current applications of conventional imaging, the emerging role of hybrid imaging, and explore the future directions of radiological imaging in the management of patients with bone tumors.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47305091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medial tibia cortex transosseous sling fixation for various arthroscopic procedures in the knee: A technical note","authors":"Narendran Pushpasekaran, RachamallaSivashanakara Krishna Vamsi, Soundararajan Karuppanan, KandasamyMeenakshi Sundaram, AllagapuramEllapan Manoharan","doi":"10.4103/jajs.jajs_39_23","DOIUrl":"https://doi.org/10.4103/jajs.jajs_39_23","url":null,"abstract":"","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135494963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intraoperative radiological imaging plays a key role in the management algorithm of patient care. Different intraoperative modalities have applications in the diagnosis, treatment, and monitoring of patient affected by various medical or surgical conditions. Advances in technology, computer software, and integration of various radiological modalities have extended the applications of intraoperative imaging in health care. Intraoperative radiological imaging have evolved from the initial use of conventional fluoroscopy to current innovations of computed tomography (CT) such as three-dimensional cone-beam CT and magnetic resonance-based imaging. In fact, intraoperative imaging has become integral to most of trauma and orthopedic procedures. Apart from their role in diagnosis of a spectrum of orthopedic conditions like prosthetic joint infection, imaging systems assist orthopedic surgeons to perform minimally invasive procedures, improving patient safety and also enabling higher accuracy and lower revision rates. More importantly, advances in technologies are essential in safeguarding radiation safety regulations, thereby reducing the radiation dose to the patient and surgical team. Integration of various imaging technologies, improving quality of image acquisition, reduction of radiation dose, and seamless image transfer to allow decision-making process are crucial in the delivery of effective patient care.
{"title":"Intraoperative radiological imaging: An update on modalities in trauma and orthopedic surgery","authors":"Rajesh Botchu, Mahtab Afzali, Parham Shojaie, KarthikeyanP Iyengar, Neha Nischal","doi":"10.4103/jajs.jajs_143_22","DOIUrl":"https://doi.org/10.4103/jajs.jajs_143_22","url":null,"abstract":"Intraoperative radiological imaging plays a key role in the management algorithm of patient care. Different intraoperative modalities have applications in the diagnosis, treatment, and monitoring of patient affected by various medical or surgical conditions. Advances in technology, computer software, and integration of various radiological modalities have extended the applications of intraoperative imaging in health care. Intraoperative radiological imaging have evolved from the initial use of conventional fluoroscopy to current innovations of computed tomography (CT) such as three-dimensional cone-beam CT and magnetic resonance-based imaging. In fact, intraoperative imaging has become integral to most of trauma and orthopedic procedures. Apart from their role in diagnosis of a spectrum of orthopedic conditions like prosthetic joint infection, imaging systems assist orthopedic surgeons to perform minimally invasive procedures, improving patient safety and also enabling higher accuracy and lower revision rates. More importantly, advances in technologies are essential in safeguarding radiation safety regulations, thereby reducing the radiation dose to the patient and surgical team. Integration of various imaging technologies, improving quality of image acquisition, reduction of radiation dose, and seamless image transfer to allow decision-making process are crucial in the delivery of effective patient care.","PeriodicalId":38088,"journal":{"name":"Journal of Arthroscopy and Joint Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135357854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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