Adventitial cystic disease of the popliteal artery is a rare disorder that causes localized stenosis or occlusion by compression of the vessel lumen. The disease produces lower extremity claudication, typically in young and middle-aged men. We report a case of the adventitial cystic disease of the popliteal artery in a 55-year-old man with symptom of left calf claudication. Diagnosis was done by ultrasound, angiography, and magnetic resonance imaging. The patient was treated with resection of the diseased popliteal artery followed by interposition of saphenous vein graft. Postoperatively, the symptom and sign resolved completely.
Angiography ; Constriction, Pathologic ; Diagnosis ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Popliteal Artery* ; Saphenous Vein ; Transplants ; Ultrasonography

PURPOSE: To compare lumbar disc changes between initial lumbar spine (L-spine) MRI and follow-up (f/u) MRI that were performed due to recurred backaches. MATERIALS AND METHODS: A total 50 patients who had undergone f/u L-spine MRI were retrospectively reviewed. Five discs (L1-S1) were surveyed in each f/u MRI. Lumbar disc changes were defined as no change, aggravations, or improvements compared to initial disc states. These states were defined on the basis of morphologic status and disc levels. RESULTS: In a total of 250 discs in 50 patients, 31 discs (12.4%) showed morphologic changes of disc lesions, whereas 219 discs (87.6 %) showed no changes. Among the 31 disc lesions, 24 were aggravated and 7 were partially improved. And on the basis of disc status, initially abnormal discs revealed any morphologic changes of the degree of disc herniation. A total of 33.3% of the morphologic changes are noted in initially extruded discs. Fifteen morphologic changes of disc lesions were located at the L4-5 level. CONCLUSION: Our results suggest that correlations between lumbar disc herniations and back pain symptoms are limited, and that evaluations of extra disc lesions are required.
Back Pain ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Low Back Pain ; Natural History ; Retrospective Studies ; Spine

Purpose: To assess and compare the diagnostic efficacies of magnetic resonance arthrography (MRA) and computed tomography arthrography (CTA) in identifying labral and chondral lesions within the hip joints. To analyze the diagnostic confidence levels of radiologists when interpreting images obtained from MRA and CTA. Materials and Methods: Labral and chondral lesions in 100 hips of 95 patients on 3.0 tesla MRA, CTA (128- and 160-slice multi-detector computed tomography), and arthroscopic findings were retrospectively reviewed by three radiologists. We analyzed the sensitivity, specificity, accuracy, positive predictive value, and area under the curve (AUC) using receiver operating characteristic curves. The diagnostic confidence of the radiologists was also assessed during image interpretation. Results: Both MRA and CTA showed good diagnostic performances in the assessment of labral and chondral lesions. MRA showed higher sensitivity and accuracy, with a higher AUC for labral lesions than CTA (MRA/CTA: 97.3%/84.8% [p < 0.001], 93.8%/89.8%, and 0.945/0.896 [p = 0.003], respectively). CTA outperformed MRA in diagnostic performance in terms of sensitivity, specificity, accuracy, and AUC in acetabular cartilage lesions (MRA/ CTA: 75.8%/93.9% [p = 0.020], 67.6%/88.2% [p < 0.001], 73.0%/92.0% and 0.717/0.911 [p < 0.001], respectively) and sensitivity, accuracy and AUC in femoral cartilage lesions (60.5%/78.9% [p = 0.020], 80.0%/87.0%, and 0.762/0.854 [p = 0.018], respectively). The diagnostic confidence was higher with MRA for labral lesions (p = 0.002) and with CTA for chondral lesions (p < 0.001). Conclusion Both MRA and CTA showed strong diagnostic abilities for hip joint lesions, with MRA being better for labral lesions and CTA for chondral lesions. Radiologists showed greater confidence in diagnosing labral lesions using MRA and chondral lesions using CTA.

Migraine equivalents include cyclic vomiting, acute confusional states, and benign paroxysmal vertigo. Cyclic vomiting is characterized by recurrent, sometimes monthly, boults of severe vomiting that may be so intense dehydration and electrolyte abnormalities occur, particularly in an infact. We experienced a 3-year-old girl who showed manifestations of cyclic vomiting and abdominal pain. We report this case with a review of related literatures.
Abdominal Pain ; Child, Preschool ; Dehydration ; Female ; Humans ; Migraine Disorders* ; Vertigo ; Vomiting

Fat tissue is a unique component of the soft tissue, and this fat tissue lies primarily in the spaces beneath the normal subcutaneous tissue, and within or around the organs. An entire lesion, or just a part of it, can be composed of these fat tissues. Therefore, it plays an important role in the diagnostic workup of suspected musculoskeletal diseases as well as in the differentiation between them. Fat tissue is shown as low density on plain radiographs, decreased attenuation on CT images, high signal intensity on T1-weighted images and it is hypoechoic on sonography. Because of its distinctive features, fat tissue is easy to verify on various modalities.?In addition, recent image studies like fat-suppressed imaging and STIR imaging provide more precise information of the lesion that involve fat tissue. In this article, we have reviewed the differentiation of musculoskeletal diseases, including the various tumorous lesion and tumor-like lesions involving the fat tissue.
Diagnosis* ; Musculoskeletal Diseases ; Subcutaneous Tissue

OBJECTIVE: To evaluate whether an early bone marrow edema pattern predicts vertebral deformity types and prognosis in osteoporotic vertebral compression fracture (OVCF). METHODS: This retrospective study enrolled 64 patients with 75 acute OVCFs who underwent early MRI and followed up MRI. On early MRI, the low SI pattern of OVCF on T1WI were assessed and classified into 3 types (diffuse, globular or patchy, band-like). On followed up MRI, the vertebral deformity types (anterior wedge, biconcave, crush), degree of vertebral body height loss, incidence of vertebral osteonecrosis and spinal stenosis were assessed for each vertebral fracture types. RESULTS: According to the early bone marrow edema pattern on T1WI, 26 vertebrae were type 1, 14 vertebrae were type 2 and 35 vertebrae were type 3. On followed up MRI, the crush-type vertebral deformity was most frequent among the type 1 OVCFs, the biconcave-type vertebral deformity was most frequent among the type 2 OVCFs and the anterior wedge-type vertebral deformity was most frequent among the type 3 OVCFs (p<0.001). In addition, type 1 early bone marrow edema pattern of OVCF on T1WI were associated with higher incidence of severe degree vertebral body height loss, vertebral osteonecrosis and spinal stenosis on the follow up MRI. CONCLUSION: Early bone marrow edema pattern of OVCF on T1WI, significant correlated with vertebral deformity types on the follow up MRI. The severe degree of vertebral height loss, vertebral osteonecrosis, and spinal stenosis were more frequent in patients with diffuse low SI pattern.
Body Height ; Bone Marrow* ; Congenital Abnormalities* ; Edema* ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Magnetic Resonance Imaging ; Osteonecrosis ; Osteoporosis ; Prognosis* ; Retrospective Studies ; Spinal Stenosis ; Spine

PURPOSE: To compare the MR findings of a sequestered disc with an extruded disc. MATERIALS AND METHODS: MR images of 28 patients with a sequestered disc and 18 patients with an extruded disc were retrospectively reviewed. Patients with sequestered discs were divided into two groups whether definite separation from the parent disc was or was not seen. In the latter group (definite separation not seen) and the extruded disc group of patients, the signal intensities of the herniated discs were compared with the signal intensities of the parent discs and were evaluated on T1- and T2-weighted images. We also assessed the presence of a notch within the herniated disc. RESULTS: In the sequestered disc group of patients (28 discs), only 5 discs (18%) showed obvious separation from the parent disc. Among the remaining 23 discs with indefinite separation, the notch was visible in 14 discs (61%) and 9 discs (39%) had no notch. In the extruded disc group (18 discs), the notch was visible in 2 (11%) discs and the difference between the two groups was statistically significant (p = 0.0002). The signal intensities of the herniated discs on T1-weighted images were isointense in both the sequestered and extruded discs. The difference of incidence of high signal intensities on T2-weighted images was not statistically significant (p = 0.125). CONCLUSION: It is necessary to consider the possibility of the presence of a sequestered disc when a herniated disc material shows a notch.
Humans ; Incidence ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging* ; Parents ; Retrospective Studies ; Spine*

PURPOSE: To correlate the plain radiographic findings of a supraspinatus tear with the degree and extent of a supraspinatus tear on MR images. MATERIALS AND METHODS: We retrospectively reviewed the plain radiographs of 35 patients with a supraspinatus tendon tear confirmed by MRI and surgery from July 2004 to June 2006. On the plain radiographs, degenerative changes of acromion and the greater tuberosity and acromiohumeral distance were evaluated. Patients were divided into groups according to the degree and size of the supraspinatus tendon tear and the duration of symptoms. We compared the degenerative changes score and acromiohumeral distance among the groups. RESULTS: There was no statistically significant difference for the degenerative changes score for acromion and greater tuberosity among the groups classified by the degree and size of the supraspinatus tendon tear. However, the acromiohumeral distance was shorter as the extent of the tear was larger; this finding was statistically significant. There was no statistical correlation for the degenerative changes score and the acromiohumeral distance with the duration of symptoms. CONCLUSION: On plain radiographs of the shoulder joint, a decreased acromiohumeral distance is useful to predict the degree and size of a supraspinatus tear, but degenerative changes are not useful to predict the degree and size of a supraspinatus tear and do not correlate with symptom duration.
Acromion ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Rotator Cuff ; Rupture ; Shoulder Joint ; Tendons

Malignant melanoma develops from melanocytes and frequently metastases to other organs. Common metastatic sites are other skin, lymph nodes, lung, liver, brain and bone in decreasing order of frequency. Malignant pleural effusion is less frequent manifestation of thoracic metastasis. We experienced a 57-year-old man with pleural effusion who received radical resection with local flap on left foot due to acral lentiginous melanoma 3 years ago. He had progressive chest pain and left massive pleural effusion. The pleural cytology and biopsy showed malignant melanoma. After closed thoracostomy and talc pleurodesis, he refused further immunotherapy and chemotherapy and discharged.
Biopsy ; Brain ; Chest Pain ; Drug Therapy ; Foot ; Humans ; Immunotherapy ; Liver ; Lung ; Lymph Nodes ; Melanocytes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis* ; Pleural Effusion* ; Pleural Effusion, Malignant ; Pleurodesis ; Skin ; Talc ; Thoracostomy

Diabetes mellitus (DM) can accompany many musculoskeletal (MSK) diseases. It is difficult to distinguish the DM-related MSK diseases based on clinical symptoms alone. Sonography is frequently used as a first imaging study for these MSK symptoms and is helpful to differentiate the various DM-related MSK diseases. This pictorial essay focuses on sonographic findings of various MSK diseases that can occur in diabetic patients.
Adult ; Cellulitis/ultrasonography ; Diabetes Mellitus, Type 2/*complications ; Diabetic Neuropathies/ultrasonography ; Female ; Humans ; Male ; Musculoskeletal Diseases/complications/*diagnosis/ultrasonography ; Pyomyositis/microbiology/ultrasonography ; Tenosynovitis/microbiology/ultrasonography ; Vascular Diseases/ultrasonography