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Imaging of Hip Arthroplasties: Normal Findings and Hardware Complications
Deshmukh, Swati; Omar, Imran M
Hip arthroplasty is a common and largely successful surgical procedure, often used for the treatment of advanced osteoarthritis. Imaging plays a key role in routine postoperative imaging surveillance as well as the evaluation of post-arthroplasty pain. Radiographs are the first-line imaging modality and may be followed by computed tomography (CT), ultrasound, and/or magnetic resonance imaging (MRI). Recent advancements in imaging techniques allow for metal artifact reduction on CT and MRI. A variety of complications can arise in the setting of arthroplasty: mechanical loosening, component wear-induced synovitis and osteolysis, adverse local tissue reaction, infection, periprosthetic fracture, implant dislocation and/or component displacement, tendinopathy, and neurovascular injury. This article reviews normal and abnormal imaging findings of hip arthroplasty.
PMID: 30925629
ISSN: 1098-898x
CID: 5761162
MR neurography (MRN) of the long thoracic nerve: retrospective review of clinical findings and imaging results at our institution over 4 years
Deshmukh, Swati; Fayad, Laura M; Ahlawat, Shivani
OBJECTIVE:Long thoracic nerve (LTN) injury can result in ipsilateral serratus anterior palsy and scapular winging. Traditional means of evaluating patients with suspected LTN injury include physical examination and electrodiagnostic studies. The purpose of our study is to describe high-resolution magnetic resonance (MR) findings in patients with clinical suspicion of LTN neuropathy. METHODS:In this HIPAA-compliant, IRB-approved, retrospective study, two radiologists reviewed MR imaging performed for long thoracic neuropathy. Clinical presentation, electrodiagnostic studies and MR imaging of 20 subjects [mean age 37 ± 13 years; 25% (5/20) female] were reviewed. Observers reviewed MR imaging for LTN signal intensity, size, course, presence or absence of mass and secondary findings [skeletal muscle denervation (serratus anterior, trapezius, rhomboid) and scapular winging]. Descriptive statistics were reported. RESULTS:Clinical indications included trauma (n = 5), hereditary neuropathy (n = 1), pain (n = 8), winged scapula (n = 6), brachial plexitis (n = 4) and mass (n = 1). Electrodiagnostic testing (n = 7) was positive for serratus anterior denervation in three subjects. Abnormal LTN signal intensity, size, course or mass was present in 0/20. Secondary findings included skeletal muscle denervation in the serratus anterior in 40% (8/20), trapezius in 20% (4/20) and rhomboid in 20% (4/20). In 5% (1/20), an osteochondroma simulated a winged scapula, and in 2/20 (10%) MR showed scapular winging. CONCLUSIONS:High-resolution MR imaging is limited in its ability to visualize the long thoracic nerve directly, but does reveal secondary signs that can confirm a clinical suspicion of LTN injury.
PMID: 28770311
ISSN: 1432-2161
CID: 5666112
Pins and Needles From Fingers to Toes: High-Resolution MRI of Peripheral Sensory Mononeuropathies
Deshmukh, Swati; Carrino, John A; Feinberg, Joseph H; Wolfe, Scott W; Eagle, Sonja; Sneag, Darryl B
OBJECTIVE:The purpose of this article is to review advanced MRI techniques and describe the MRI findings of pure sensory mononeuropathy with relevant clinical and anatomic correlation. CONCLUSION/CONCLUSIONS:Peripheral sensory mononeuropathy can be challenging to evaluate with MRI because of the small caliber of pure sensory nerves and the lack of changes in secondary muscular denervation. Advances in MRI afford the necessary signal-intensity contrast and resolution for adequate evaluation of many of these small peripheral nerves.
PMID: 27824488
ISSN: 1546-3141
CID: 5761152