By Ramón Ribes, Joan C. Vilanova
This creation to musculoskeletal imaging is an extra quantity within the studying Imaging sequence. Written in a ordinary layout, it takes into consideration that musculoskeletal radiology is a subspecialty which has largely accelerated its scope and imaging functions with the arrival of ultrasound, MRI, multidetector CT, and puppy. The booklet is split into ten sections protecting: an infection and arthritis, tumors, tendons and muscle mass, bone marrow, backbone, shoulder, elbow, hand and wrist, hip and pelvis, knee, and ankle and foot. every one bankruptcy is gifted with an advent and ten case reviews with illustrations and reviews from anatomical, physiopathological and radiological standpoints in addition to bibliographic recommendations.
Learning Imaging is a special case-based sequence for these in expert schooling in most cases and for physicians in particular.
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Extra resources for Learning Musculoskeletal Imaging
CT allows definition of the extent of bone and disc destruction and of paravertebral and intraspinal involvement. Gas may be identified in the infected soft-tissue. MRI provides better definition of epidural extension of the inflammatory process and compression of the spinal cord and dural sac than CT does. Most cases are successfully managed with conservative measures, including an appropriate antibiotic and spinal bracing. ) Comments Axial T1-weighted MRI (Fig. 1) at the level of the infected area shows decreased signal intensity in the T6–T7 disk (open arrow) and a hypointense mass surrounding it, corresponding to paravertebral inflammatory extension (arrow).
The most common CT appearance is a soft-tissue mass isodense or slightly hypodense to muscle. CT is especially useful for detecting softtissue calcifications and cortical bone involvement. MRI findings of synovial sarcoma often include a well-defined juxta-articular mass with mainly intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-weighted images. Marked heterogeneity, consisting of hyperintense, hypointense, and isointense intermixed areas (the “triple signal” sign), with presence of fluid levels, hemorrhage, and septa (the “bowl of grapes” sign) on T2-weighted images is the rule in large lesions.
It is more prevalent in women and most commonly presents in the fourth and fifth decades. Clinically, it usually presents as a nonpainful palpable mass. At histological examination, it appears macroscopically as a well-circumscribed, loculated, gelatinous mass; most lesions are less than 10 cm in diameter. The classic histological description is a hypocellular, hypovascular tumor with no mitoses, composed of bland spindle cells embedded in a rich myxoid extracellular matrix. This tumor lacks a true capsule.
Learning Musculoskeletal Imaging by Ramón Ribes, Joan C. Vilanova