Faculty Bibliography

OBJECTIVE: Our objective was to determine MRI findings in sarcoidosis patients with musculoskeletal symptoms. CONCLUSION: In sarcoidosis patients with musculoskeletal complaints, MRI reveals marrow and soft-tissue lesions that are occult or underestimated on radiographs. Axial and large-bone lesions may resemble osseous metastases on MRI. Most lesions detected are nonspecific in appearance, except nodular muscle lesions. MRI reveals features suggesting the diagnosis, but with standard protocols, no pathognomonic MRI features were determined

We describe a case of a surgically proven intraosseous venous anomaly of the fibula in a patient who presented with ankle pain and swelling with deep venous thrombosis. MRI, including gadolinium-enhanced MR angiography, provides a less invasive means than conventional venography for diagnosing these lesions and assessing venous patency while also allowing for evaluation of extravascular structures

Familiarity with normal anatomy and pathologic features of the capsulolabral complex as well as high resolution imaging are important factors in achieving a consistently high accuracy rate in diagnosis of glenohumeral instability by conventional MR imaging. In this article, the pathophysiology of glenohumeral instability and the various MR imaging findings are discussed and illustrated

The metacarpophalangeal joint complex represents an articulation not only between the metacarpal and proximal phalanx but in the case of the thumb also between the metacarpal and sesamoids. The collateral ligaments and volar plate contribute significantly to the stability of the metacarpophalangeal joints. Detailed knowledge of the anatomy of the articulations and soft-tissue supports of this complex is necessary for MR imaging detection of subtle injuries to these structures. The role of MR imaging in both acute and chronic trauma to the collateral ligaments and in the often difficult diagnosis of chronic thumb sesamoiditis is presented, with illustrative examples of the normal and pathologic conditions of metacarpophalangeal joints

MR imaging is extremely well suited to detection of early phases of avascular necrosis, permitting diagnosis before collapse of the carpal bones has occurred. The sensitivity of this imaging modality allows differentiation of subtle changes in the bone marrow signal. This is used as criteria for a new stage classification of Kienbock's disease based on MR imaging appearance. The prognosis of scaphoid fractures and estimation of likelihood of avascular necrosis of the proximal fragment can be inferred by using gadolinium enhancement to evaluate the bone marrow vascularity

This article discusses the anatomy of the menisci and various signal abnormalities. Morphologic changes indicative of degenerative disease, degenerative tear, intra- and para-meniscal cysts, and traumatic tear are also covered

Familiarity with normal anatomy and pathologic features of the capsulolabral complex as well as high resolution imaging are important factors in achieving a consistently high accuracy rate in diagnosis of glenohumeral instabilities by conventional MR imaging. The various types of glenoid labrum lesions and features that are most often associated with glenohumeral instability are defined

The signal intensity patterns of rotator cuff lesions at magnetic resonance (MR) imaging were evaluated in 80 patients who had surgical correlation and in 13 asymptomatic individuals (14 shoulders). Six cadaver shoulders were examined with MR, and histologic correlation was obtained in four. All studies were performed at 1.5 T with a flexible circular surface coil. The accuracy of MR imaging in detection of full-thickness cuff tears (31 patients) was 0.95 and of partial thickness tears (16 patients), 0.84. The most common and accurate pattern for full-thickness cuff tears (22 of 31 tears) was a region of intense signal seen on T2-weighted images. Less often the torn region consisted of an extremely degenerated and attenuated tendon with moderate signal intensity or was obscured by low-signal-intensity scar. The intense signal pattern on T2-weighted images was also accurate, although a less common finding (seven of 16 cases), in the diagnosis of partial tears. Tendinitis was recognized as focal or diffuse regions of increased signal intensity or a nonhomogeneous pattern of increased signal often associated with tendinous enlargement. In some patients, manifestations of subacromial-subdeltoid bursitis was present. Tendon degeneration was also manifested as regions of increased signal intensity. Some similarity and overlap of signal patterns of partial interstitial tears, tendinitis, and tendon degeneration are observed