Faculty Bibliography

OBJECTIVE. The purpose of this study was to define and correlate the appearance of the rotator cable on MRI with arthroscopy, band-saw cadaveric sections, and histology. MATERIALS AND METHODS. Two cadaveric shoulders underwent 3-T MRI, band-sawing, and histologic evaluation. Three readers evaluated the MRI for the presence of the cable, and the same readers and a pathologist reviewed the macroscopic and microscopic specimens for a structure that corresponded to the cable. Cadaver 1 underwent arthroscopic evaluation to evaluate for the presence of a cable. Seventy consecutive shoulders that underwent 1.5- or 3-T MRI were also reviewed for the presence of the cable and evaluation of its characteristics (location, thickness, and width). RESULTS. A linear band of hypointense signal intensity was found along the undersur-face of the supraspinatus and infraspinatus tendons on both cadaveric MR images, which correlated to a linear band of tissue in the same location on macroscopic and microscopic evaluation and linear thickening along the cuff articular surface on arthroscopy consistent with the cable. The cable was seen in 74.3% of the MRI studies in both sagittal and coronal planes with a mean (+/- SD) distance of the cable from the medial margin of the enthesis of 1.33 +/- 0.27 cm, a mean width of the cable of 1.24 +/- 0.31 cm, and a mean thickness of 0.19 +/- 0.05 cm. CONCLUSION. The rotator cable is a structure that can be consistently seen on gross anatomic and histologic analysis, arthroscopy, and MRI in the intact rotator cuff. Familiarity with the typical location and morphology of the cable may allow easier characterization of disease that can involve the cable, such as rotator cuff tears.

A 29-year-old female presented with pain and a palpable mass in the left wrist. Imaging demonstrated a multiloculated cystic mass adjacent to the radial aspect of the scaphoid, which was intimately associated with and appeared to arise from the wall of the radial artery and its dorsal branch. The mass was surgically resected. The histological analysis confirmed the presence of adventitial cystic disease (ACD) of the radial artery. In addition, within a year time span, a second 34-year-old male patient presented with a palpable mass in the right hand. Imaging demonstrated a cystic mass encasing the dorsal carpal branch of the radial artery and its terminal vessels to the thumb and index finger. The diagnosis of ACD was raised based on MR imaging. Histological analysis confirmed the presence of an adventitial cyst. ACD of the arteries is a rare disorder of unknown etiology, which usually involves the popliteal artery. Less common sites of involvement include the external iliac, common femoral, radial, and ulnar arteries. To our knowledge, there have only been six previous case reports of adventitial cystic disease involving the radial artery. The imaging features, histology, differential diagnosis, pathogenesis, and treatment are discussed.

We retrospectively analyzed 97 total knee arthroplasty cases with medial osteoarthritis from seven participating surgeons in our teaching hospital to determine the percentage of patients who met the following eligibility criteria for unicompartmental knee arthroplasty (UKA): healthy cartilage in the lateral compartment based on (1) visual analysis, (2) histological analysis and (3) absence of UKA contraindications based on clinical analysis. The cases with healthy lateral cartilage, intact anterior cruciate ligament and posterior cruciate ligament, lack of patello-femoral arthritis, preoperative range of motion (ROM) greater than 90, and genu varum less than 10 degrees represented 21% of the 97 cases studied. This percentage would likely have been higher had the cases been assessed earlier in the disease process. It was concluded that there is the potential to utilize UKA more frequently in the future

We present a case of intraarticular myositis ossificans in the right knee of a child. Myositis ossificans (MO), though relatively rare in childhood and even more uncommon within a joint, should be included in the differential diagnosis of an intra-articular mass when indicated by the typical clinical, radiographic, and histologic findings. An 11-year-old male presented with a history of trauma to his right knee. Four weeks after the initial injury, an MRI demonstrated evidence of an ACL rupture with a 'cystic mass' within the intercondylar notch along the anterior surface of the torn ligament. At subsequent arthroscopy, the mass noted on MRI was removed. The histology was consistent with MO. The authors believe this to be the first case of MO in the intercondylar notch detected by MRI, treated by arthroscopy, and confirmed by histology