OBJECTIVE: To compare inferior capsular redundancy by using magnetic resonance arthrography (MRA) images in patients with multidirectional instability (MDI) of the shoulder and control subjects without instability and thereby develop a screening method to identify the presence of shoulder MDI. MATERIALS AND METHODS: The MRA images of patients with MDI of the shoulder (n = 65, 57 men, 8 women; mean age, 24.5 years; age range, 18–42 years) treated over an eight-year period were retrospectively reviewed; a control group (n = 65, 57 men, 8 women; mean age, 27.4 years; age range, 18–45 years) without instability was also selected. The inferior capsular redundancy was measured using a new method we named the glenocapsular (GC) ratio method. MRA images of both groups were randomly mixed together, and two orthopedic surgeon reviewers measured the cross-sectional areas (CSAs) and sagittal capsule-head ratios on oblique sagittal images, as well as the axial capsule-head ratios on axial images and GC ratios on oblique coronal images. RESULTS: The CSAs and GC ratios were significantly higher in patients than in controls (both, p < 0.001); however, the sagittal capsule-head ratios and axial capsule-head ratios were not significantly different (p = 0.317, p = 0.053, respectively). In addition, GC ratios determined the presence of MDI more sensitively and specifically than did CSAs. A GC ratio of > 1.42 was found to be most suggestive of MDI of the shoulder, owing to its high sensitivity (92.3%) and specificity (89.2%). CONCLUSION: GC ratio can be easily measured and used to accurately screen for MDI of the shoulder.
Arthrography ; Female ; Humans ; Male ; Mass Screening ; Methods ; Orthopedics ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder

OBJECTIVETo explore the diagnostic value of 3D-indirectmagnetic resonance (MR) arthrography in detecting meniscustears of the knees.

METHODSForm January 2013 to January 2014, routine plain MR of the knees followed by the 3D-indirect MR arthrography was performed in 42 patients with suspected meniscal tears clinically. There were 31 males and 11 females, with an average age of 38.4 years old (ranged, 21 to 67 years old). The duration of the course ranged from 2 h to 15 d. The clinical symptom was knee pain. All the patients got subsequently arthroscopic examination or operation. The sensitivity and specificity of routine plain MR and 3D-indirect MR arthrography were compared based on the results of arthroscopic examination or operation.

RESULTSThe signal intensity in the area of meniscal tears on image of 3D-indirect MR arthrography was obviously higher than that of routine plain MR. The sensitivity of 3D-indirect MR arthrography was 85.79% (87/102), while the routine plain MR was 52.94% (54/102), and the specificity improved from 67.78%(61/90) to 86.67%(78/90). The difference was statistically significant (χ2 = 25.90, P < 0.01; χ2 = 9.13, P < 0.01).

CONCLUSIONIn comparison with the routine plain MR findings, 3D-indirect MR arthrography demonstrates meniscus tears of the knee with the better sensitivity and specificity.

Adult ; Aged ; Arthrography ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Knee Injuries ; diagnosis ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Tibial Meniscus Injuries

OBJECTIVETo investigate the diagnostic value of MRI and MR arthrography in the detection of injuries of anterior labrum in shoulder and to evaluate the accuracy of MR arthrography in the classification of anterior labrum lesion.

METHODSSeventy-eight patients with arthroscopically proved anterior labrum lesions(study group) and 75 patients with arthroscopically proved intact anterior labrum (control group) from January 2007 to December 2010 were included to the study. All patients underwent MRI and MR arthrography at our institution prior to shoulder arthroscopy. All MRI and MR arthrography were analyzed by one musculoskeletal radiologists and one sports medicine surgeon who had no knowledge of the clinical histories and arthroscopic results. The same classification system of labrum lesions based on arthroscopy was used in image analysis. Imaging findings and arthroscopic findings were compared in all patients. With arthroscopy used as the standard of reference, the sensitivities, specificities and accuracies of MRI and MR arthrography in the detection of anterior labrum lesions were compared, and the sensitivities, specificities and accuracies of MR arthrography in the correct classification of anterior labrum lesions were calculated.

RESULTSIn arthroscopy, 78 anterior labrum lesions, 67 rotator cuff lesions and 8 SLAP lesions were diagnosed, for the detection of anterior labrum lesions, the sensitivity of MRI and MR arthrography was 80.8% and 92.3%,the specificity was 89.3% and 97.3%,the accuracy was 85.0% and 94.8% respectively. Seventy-eight patients with arthroscopically proved anterior labrum lesions included 39 Bankart lesions, 32 ALPSA lesions and 7 Perthes lesions, with MR arthrography, Bankart, ALPSA, and Perthes lesions were correctly classified in 84.6%, 84.4%, and 57.1% of cases, respectively.

CONCLUSIONMR arthrography has a higher sensitivity, specificity and accuracy than MRI in the detection of anterior labrum injuries. MR arthrography was useful in the classification of different variants of anterior labrum injuries before operations. It may directly influence the surgeon's strategy and is useful in preoperative planning of arthroscopic reconstructions.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthrography ; methods ; Arthroscopy ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Shoulder Joint ; injuries

Femora acetabular impingement (FAI) is thought as the major reason leds to hip osteoarthritis. FAI results to destruction of the arthrodial cartilage. Prognoses of hip osteoarthritis is affected by the degree of arthrodial cartilage destruction. The hip osteoarthritis could be prevented if FAI is diagnosed and treated in earlier period. How can we diagnose FAI in earlier period? Recent studies showed that MRI was the best way for FAI diagnosis. It has higher resolution and signal-noise ratio. Cartilage and gleniod labrum of hip could be shown by MRI. The paper reviewed the standard and difficulties of diagnosis about FAI. High magnet MRI maybe is one way to solve the problems.
Arthrography ; methods ; Femoracetabular Impingement ; diagnosis ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; methods ; Syndrome

OBJECTIVETo assess the value of dual energy computed tomography (DECT) for the detection of uric acid (UA) deposition in patients with gout.

METHODSA total of 37 patients with tophaceous gout (including 8 crystal-proven cases) and 10 control patients (5 with unknown arthropathy, 3 with rheumatoid arthritis, and 2 with osteoarthritis) were included. DECT was performed for all peripheral joints (wrists, hands, elbows, knees, ankles and feet) . Color coding was used to display the localization of UA deposition. Images were reviewed independently by two trained radiologists.

RESULTSWith DECT, patients with gout were found to have UA deposits in hands and wrists 46% (17/37) , elbows 16% (6/37) , knees 27% (10/37) , ankles and feet 89% (33/37) . No UA deposit was observed in all 10 control patients (P=0.000) . Among the 37 patients with gout, the number of UA deposition sites detected by DECT (n=297) was 2.25 times of that detected by physical examinations (n=132) (P=0.000) .

CONCLUSIONSDECT allows the visualization of UA deposition in gouty arthropathy. Even subclinical disease can be delineated with this technique. However, the accuracy of DECT requires further investigations.

Adult ; Aged ; Aged, 80 and over ; Arthrography ; methods ; Extremities ; diagnostic imaging ; Female ; Gout ; diagnostic imaging ; metabolism ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods ; Uric Acid ; metabolism

OBJECTIVE: According to the features of epiphyseal development of knee and ankle joints in male and female teenagers, the trend of epiphyseal development was analyzed and the possibility of its application in age estimation was discussed. METHODS: Firstly, radiographs of adem position were taken from both sides of knee and ankle joints from 1709 individuals from Eastern China, Central China, and Southern China (Age: 11-21 years old). Secondly, 5 osteal loci were selected as bone age markers from the two joints. Thirdly, characteristics of epiphyseal development were observed systematically and comprehensively. Fourthly, the proportions of "epiphyseal fusion" in different age groups were calculated, and confirmed the numbers of people which were included by epiphyseal fusion of knee and ankle joints. Finally, age range of each epiphyseal fusion was calculated by mathematical statistical analysis. RESULTS: Compared with the data of 1960s', the age of 5 epiphyseal fusions was earlier about 2-3 years. However, the results were basically the same as the recent studies. CONCLUSION The data on the time of epiphyseal fusion were updated. It is important to determine the accuracy in age estimation in male and female teenagers.
Adolescent ; Age Determination by Skeleton/methods* ; Ankle Joint/diagnostic imaging* ; Arthrography ; Bone Development/physiology* ; Child ; China/epidemiology* ; Epiphyses/diagnostic imaging* ; Female ; Forensic Anthropology/methods* ; Humans ; Knee Joint/diagnostic imaging* ; Male ; Young Adult

OBJECTIVETo investigate the method of MR guided anterior direct arthrogaphy of shoulder and its clinical applications.

METHODSFrom 2008.4 to 2008.10, 40 patients with rotator-cuff tear (29 males and 11 females, ranging in age from 22 to 70 years, with an average of 35 years) underwent MR guided anterior direct arthrogaphy of shoulder, so as to diagnosis shoulder wound. The results were compared to that of arthroscopy.

RESULTSShoulder arthrography showed lesons in 36 patients, and failure in 2 patients, including contrast media extravasation in 1 patient, and gas entry to joint cavity in 1 patient. Two patients showed no rotator cuff injuries. Twenty-eight patients were confirmed by arthroscopy as rotator-cuff injured in different degree. Twenty-six patients were confirmed injuries by both arthroscopy and MR guided anterior direct arthrogaphy.

CONCLUSIONMR guided anterior direct arthrogaphy of shoulder as a minimally invasive method in displaying the rotator-cuff tear has higher accuracy and wide clinical application prospect.

Adult ; Aged ; Arthrography ; methods ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Shoulder Joint ; diagnostic imaging ; Young Adult

Computed tomographic arthrography (CTA) of four cadaveric canine stifles was performed before and after partial cranial cruciate ligament rupture in order to verify the usefulness of CTA examination for the diagnosis of partial cranial cruciate ligament rupture. To obtain the sequential true transverse image of a cranial cruciate ligament, the computed tomography gantry was angled such that the scanning plane was parallel to the fibula. True transverse images of cranial cruciate ligaments were identified on every sequential image, beginning just proximal to the origin of the cranial cruciate ligament distal to the tibial attachment, after the administration of iodinated contrast medium. A significant decrease in the area of the cranial cruciate ligament was identified on CTA imaging after partial surgical rupture of the cranial cruciate ligament. This finding implies that CTA can be used for assessing partial cranial cruciate ligament ruptures in dogs.
Animals ; Anterior Cruciate Ligament/*injuries/*radiography ; Arthrography/methods/veterinary ; Contrast Media/*pharmacology ; Dog Diseases/*radiography ; Dogs ; Hindlimb ; Predictive Value of Tests ; Stifle/radiography ; Tomography, X-Ray Computed/methods/*veterinary

OBJECTIVE: To establish staging criteria for teenager's skeletal growth by examining osteoarticular X-rays. METHODS: Review publications on skeletal growth staging systems by domestic and overseas authorities. Abided by the staging principles on theory of cartilage epiphyseal growth and X-ray images of skeletal growth, X-ray imaging characteristics were studied through three hundred male and female teenagers epiphyseal growth of both sternal ends of clavicle and the left side of shoulder, elbow, carpal, hip, knee and ankle joints transversally and longitudinally. The subjects were from 11 to 20 years old, selected from Henan, Hainan and Zhejiang province in China. Twenty-four skeletal growth indexes were selected closely related to age. RESULTS: Based on regular changing characteristics of epiphyseal growth at different joints, 24 skeletal development indexes were divided into 2 to 8 stages. The stage number of different indexes of the single joint were similar. It was shown that the time of different epiphyseal growth in identical joints had isochromism. CONCLUSION These staging criteria have merits of extensive skeletal growth indexes, and are applicable to wide age range with a strong maneuverability. It provides a favorable fundamental platform for forensic evaluating skeletal age in living subjects in China.
Adolescent ; Age Determination by Skeleton/methods* ; Arthrography ; Bone Development/physiology* ; Bone and Bones/diagnostic imaging* ; Child ; Epiphyses/diagnostic imaging* ; Female ; Forensic Anthropology/methods* ; Humans ; Male ; Young Adult

OBJECTIVETo investigate the diagnostic value of lumbar discography in discogenic low back pain and the effects of intervertebral fusion surgery.

METHODSForty-five cases with 101 discs underwent discography, 360 degree fusion manipulation were performed on 18 discography abnormal cases, 27 cases were treated conservatively. Discography, MRI and provocative pain were observed and all the cases were followed up.

RESULTSTwenty-one cases showed positive provocative pain (21/45, 47%), and 21 discs of 101 were concordant discography (21/101, 21%). All cases were followed up for an average 16 months (15 to 23 months), the satisfactory rate was 83% (15/18) in the surgery group and 41% (11/27) in the conservative group.

CONCLUSIONSIt is concluded that the discography is moderately sensitive in the diagnosis of discogenic low back pain. Furthermore, the short term follow-up reveals that operative group has better pain relief than conservative group.

Adult ; Aged ; Arthrography ; methods ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc ; diagnostic imaging ; Low Back Pain ; diagnosis ; etiology ; surgery ; Lumbar Vertebrae ; diagnostic imaging ; Male ; Middle Aged ; Sensitivity and Specificity ; Spinal Diseases ; complications ; Spinal Fusion