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Chronic triangular fibrocartilage complex tears with distal radioulna joint instability: A new method of triangular fibrocartilage complex reconstruction.  [cached]
Shih JT,Hou YT,Lee HM,Tan CM
Journal of Orthopaedic Surgery , 2000,
Abstract: From September 1996 to September 1997, 27 adult patients were diagnosed with chronic triangular fibrocartilage complex (TFCC) tears with distal radioulna joint (DRUJ) instability in our clinic. They all received the procedure of TFCC reconstruction with partial extensor carpi ulnaris (ECU) tendon combined with or without ulnar shortening. There were 26 males and one female in the study with a mean age of 22.4 years. The follow-up period ranged from 22 to 28 months with a mean of 26.2 months. 24 patients who had positive or zero ulnar variance received the procedure of ulnar shortening. Three patients who had minus ulnar variance only received TFCC reconstruction. After the operation, the DRUJ was fixed by a 2.0 mm K-wire for 4 weeks. All patients underwent a rehabilitation program and they were reexamined at our outpatient department (OPD). The results were graded according to the Mayo Modified Wrist Score. Five of the 27 patients rated their wrists 'excellent', 18 rated 'good', and 4 rated 'fair. Overall, a total of 23 patients (85%) rated satisfactorily and returned to work or sport activities. In the 4 patients rated 'fair', mild pain at work and/or exercise, and mildly limited supination were found; however their grip strength was improved at least by 65% compared to the opposite hand. Therefore, as suggested by this study, TFCC reconstruction with partial ECU tendon combined with the ulnar shortening procedure is an alternative method for chronic TFCC tears with DRUJ instability.
Osteoid Osteoma Mimicking Triangular Fibrocartilage Complex Injury: Diagnosis and Review of Treatment  [PDF]
J. M. Lamo-Espinosa,A. González,S. Amillo
Case Reports in Surgery , 2012, DOI: 10.1155/2012/612106
Abstract: We report the case of osteoid osteoma (OO) with ulnar styloid involvement. A review of the literature has been made with the aim of defining the special behaviour of OO when it is near the articular surface. That behaviour can affect the diagnosis, masking the real etiology of the pain, delaying the diagnosis, missing the diagnosis, or what is more serious, conducting an inadequate treatment. We propose a treatment algorithm conducted based on the localization near or far from articular surface and the superficial or deep localization. 1. Introduction Bergstrand made the first description of osteoid osteoma (OO) in 1930 and Jaffe described it as an independent identity in 1935. The OO accounts for 4% of all primary bone tumours with a male?:?female ratio of 2?:?1 being most frequently diagnosed in the second decade of life. Any bone can be affected by OO. The proximal femur and tibia are the most often involved, being the location in the hand and wrist rare [1]. Some studies suggest a frequency of upper extremity of 19% to 31%. The etiology of OO has not been yet clarified. Histologically we highlight a nidus, with high amount of prostaglandins within highly vascularized, surrounded by a thin but dense layer of reactive bone [1]. Pain is the first symptom of this tumour, which subsides with most NSAID, explained perhaps by the amount of prostaglandins containing in the nidus. 2. Clinical Case A 37-years-old right-handed man with pain in his right wrist of 3 years evolution, signed a fingertip on the ulnar side, constant with inflammatory characteristics, which wakes him up at night. He does not associate pain with any movement of the wrist although it calms temporarily with NSAIDs. He correlated the onset of pain with an overload made at the same time of the onset of pain. Diagnosed in another center of triangular fibrocartilage complex injury, he was operated one year ago with arthroscopic technique without improvement of symptoms. Physical examination revealed an articular balance preserved with a wrist flexion of 88°, an extension of 70°, 45° of ulnar deviation, 25° of radial deviation, and a pronation-supination movement of 90°. He had no trophic changes and shows intense pain with the palpation of right ulnar styloid. The force was preserved with a normal neurovascular examination. Anteroposterior and lateral wrist radiographs are performed objectifying a lytic lesion of 0.4?mm diameter with sclerotic line surrounding in the ulnar styloid apophyses (Figure 1). The patient provided a wrist arthroresonance where in T2-weighted sequence revealed a
Diagnostic accuracy of diffusion-weighted imaging with conventional MR imaging for differentiating complex solid and cystic ovarian tumors at 1.5T  [cached]
Zhang Ping,Cui Yanfen,Li Wenhua,Ren Gang
World Journal of Surgical Oncology , 2012, DOI: 10.1186/1477-7819-10-237
Abstract: Background Preoperative characterization of complex solid and cystic adnexal masses is crucial for informing patients about possible surgical strategies. Our study aims to determine the usefulness of apparent diffusion coefficients (ADC) for characterizing complex solid and cystic adnexal masses. Methods One-hundred and 91 patients underwent diffusion-weighted (DW) magnetic resonance (MR) imaging of 202 ovarian masses. The mean ADC value of the solid components was measured and assessed for each ovarian mass. Differences in ADC between ovarian masses were tested using the Student’s t-test. The receiver operating characteristic (ROC) was used to assess the ability of ADC to differentiate between benign and malignant complex adnexal masses. Results Eighty-five patients were premenopausal, and 106 were postmenopausal. Seventy-four of the 202 ovarian masses were benign and 128 were malignant. There was a significant difference between the mean ADC values of benign and malignant ovarian masses (p < 0.05). However, there were no significant differences in ADC values between fibrothecomas, Brenner tumors and malignant ovarian masses. The ROC analysis indicated that a cutoff ADC value of 1.20 x10-3 mm2/s may be the optimal one for differentiating between benign and malignant tumors. Conclusions A high signal intensity within the solid component on T2WI was less frequently in benign than in malignant adnexal masses. The combination of DW imaging with ADC value measurements and T2-weighted signal characteristics of solid components is useful for differentiating between benign and malignant ovarian masses.
Avalia??o artroscópica e macroscópica do complexo da fibrocartilagem triangular do punho. Estudo em cadáveres
Souza, Fabiano Inácio de;Zumiotti, Arnaldo Valdir;Mattar Jr, Rames;Resende, Marcelo Rosa de;Torres, Luciano Ruiz;Imoto, Fábio Sano;
Acta Ortopédica Brasileira , 2006, DOI: 10.1590/S1413-78522006000300008
Abstract: the triangular fibrocartilage complex plays a key role on wrist biomechanics. an accurate injuries diagnosis is paramount for a successful treatment. there are controversies regarding specificity and sensitiveness of imaging methods employed today. wrist arthroscopy is a method uncommonly used for diagnosing tfcc injuries in our environment, although it presents good advantages, such as the potential of direct viewing injuries, and treatment at the same surgical time. the objective of this study was to evaluate the role of wrist arthroscopy for inspecting tfcc, as well as for detecting potential injuries, comparing those data to gross dissection. fifteen wrists of male cadavers (mean age: 56.1 years old) were assessed. arthroscopy showed the presence of injuries in 33.3% of the assessed wrists. those findings showed consistency after an anatomical study with broad dissection. we concluded that an absolute correlation existed between arthroscopic test and gross dissection in detecting tfcc injuries.
Osteoid Osteoma Mimicking Triangular Fibrocartilage Complex Injury: Diagnosis and Review of Treatment
J. M. Lamo-Espinosa,A. González,S. Amillo
Case Reports in Surgery , 2012, DOI: 10.1155/2012/612106
Abstract: We report the case of osteoid osteoma (OO) with ulnar styloid involvement. A review of the literature has been made with the aim of defining the special behaviour of OO when it is near the articular surface. That behaviour can affect the diagnosis, masking the real etiology of the pain, delaying the diagnosis, missing the diagnosis, or what is more serious, conducting an inadequate treatment. We propose a treatment algorithm conducted based on the localization near or far from articular surface and the superficial or deep localization.
Integrin Targeted MR Imaging
Mingqian Tan, Zheng-Rong Lu
Theranostics , 2011,
Abstract: Magnetic resonance imaging (MRI) is a powerful medical diagnostic imaging modality for integrin targeted imaging, which uses the magnetic resonance of tissue water protons to display tissue anatomic structures with high spatial resolution. Contrast agents are often used in MRI to highlight specific regions of the body and make them easier to visualize. There are four main classes of MRI contrast agents based on their different contrast mechanisms, including T1, T2, chemical exchange saturation transfer (CEST) agents, and heteronuclear contrast agents. Integrins are an important family of heterodimeric transmembrane glycoproteins that function as mediators of cell-cell and cell-extracellular matrix interactions. The overexpressed integrins can be used as the molecular targets for designing suitable integrin targeted contrast agents for MR molecular imaging. Integrin targeted contrast agent includes a targeting agent specific to a target integrin, a paramagnetic agent and a linker connecting the targeting agent with the paramagnetic agent. Proper selection of targeting agents is critical for targeted MRI contrast agents to effectively bind to integrins for in vivo imaging. An ideal integrin targeted MR contrast agent should be non-toxic, provide strong contrast enhancement at the target sites and can be completely excreted from the body after MR imaging. An overview of integrin targeted MR contrast agents based on small molecular and macromolecular Gd(III) complexes, lipid nanoparticles and superparamagnetic nanoparticles is provided for MR molecular imaging. By using proper delivery systems for loading sufficient Gd(III) chelates or superparamagnetic nanoparticles, effective molecular imaging of integrins with MRI has been demonstrated in animal models.
MR Imaging of Ankle Impingement Syndromes
Seyed Hassan Mostafavi
Iranian Journal of Radiology , 2010,
Abstract: Ankle impingement syndromes are characterized by painful friction of joint tissues. This is both the cause and the effect of altered joint biomechanics. The leading causes of impingement lesions are posttraumatic ankle injuries, usually ankle sprains, resulting in chronic ankle pain. "nBased on anatomic and clinical viewpoints, there are five types of ankle impingement syndromes:"n1. Anterolateral"n2. Anterior"n3. Anteromedial"n4. Posteromedial"n5. Posterior"nCareful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. MR imaging and MR arthrography are the most useful imaging methods for detecting the osseous and soft-tissue abnormalities present in these syndromes and for ruling out other potential causes of chronic ankle pain. "nThis presentation summarizes the MR imaging, and MR arthrography findings of ankle impingement syndromes.
Quantum Imaging and Selection Rules in Triangular Quantum Corrals  [PDF]
Nikolaos A. Stavropoulos,Dirk K. Morr
Physics , 2004, DOI: 10.1103/PhysRevB.71.140501
Abstract: We study quantum imaging in a triangular quantum corral that is embedded in a superconducting host system with s-wave symmetry. We show that the corral acts as a quantum copying machine by creating multiple images of a quantum candle. We obtain new selection rules for the formation of quantum images that arise from the interplay of the corral's geometry and the location of quantum candles. In more complex corral structures, we show that quantum images can be projected "around the corner".
Tuberculous spondylodiscitis: MR imaging findings
Y?k?lmaz, A.,Co?kun, A.,Ko?, K.,Durak, A., C.
Erciyes Medical Journal , 2004,
Abstract: Purpose: To evaluate the MR imaging findings of tuberculous spondylodiscitis. Materials and Methods: We retrospectively evaluated the MR images of 15 patients who were diagnosed as tuberculous spondylodiscitis with percutaneous or intraoperative biopsy. Tl and T2-weighted axial and sagittal and post-contrast axial and sagittal Tl-weighted spin-echo sequences were reviewed. Results: Involvement of the vertebrae and discs were seen in all patients. The most common involvement site was thoracolumbar region. Typically, affected vertebrae and discs were hyperintense on T2-weighted images, hypointense on Tl-weighted images and showed contrast enhancement. There were paravertebral soft tissue masses in 14, vertebral body compression in 12, epidural extension in ten, kyphosis in seven, involvement of the posterior vertebral elements in two and skip lesions in three patients. Conclusion: The characteristic MR imaging features of tuberculous spondylodiscitis include Tl and T2 prolongation of the affected vertebrae and discs with contrast enhancement, vertebral bony destruction with associated paravertebral soft tissue mass, often abscess formation, epidural extension, and kyphosis. MR imaging is a reliable modality in demonstrating and characterizing the spinal tuberculosis.
Athletic Pubalgia and "Sports Hernia" Optimal MR Imaging Technique and Findings
Iranian Journal of Radiology , 2009,
Abstract: "nGroin injuries are common in athletes who participate in sports that require twisting at the waist, sudden and sharp changes in direction, and side-to-side ambulation. Such injuries frequently lead to debilitating pain and lost playing time, and they may be difficult to diagnose. Diagnostic confusion often arises from the complex anatomy and biomechanics of the public symphysis region, the large number of potential sources of groin pain, and the similarity of symptoms in athletes with different types or sites of injury. Many athletes with a diagnosis of "sports hernia" or "athletic pubalgia" have a spectrum of related pathologic conditions resulting from musculotendinous injuries and subsequent instability of the public symphysis without any finding of inguinal hernia at physical examination. The actual causal mechanisms of athletic pubalgia are poorly understood, and imaging studies have been deemed inadequate or unhelpful for clarification. However, a large-field-of-view magnetic resonance (MR) imaging survey of the pelvis, combined with high-resolution MR imaging of the public symphysis, is an excellent means of assessing various causes of athletic pubalgia, providing information about the location of injury, and delineating the severity of the disease. Familiarity with the pubis anatomy and with MR imaging findings in athletic pubalgia and other confounding causes of groin pain allows accurate imaging-based diagnoses and helps in planning the treatment that targets specific pathologic conditions.
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