Radiologic Clinics Of North America Imaging of the Lower by Kathryn J. Stevens MD

By Kathryn J. Stevens MD

This factor discusses imaging recommendations for universal and demanding reduce extremity accidents and stipulations. Femoral acetabular impingement, gentle tissue pathology round the hip, meniscal accidents and imaging the postoperative meniscus, the ignored corners of the knee (posterolateral / posteromedial nook injuries), the extensor mechanism from best to backside, cysts and bursa round the knee, ligamentous accidents of the ankle and foot, medial longitudinal arch of the foot, ankle impingement syndromes, imaging of the forefoot, overuse accidents of the reduce extremity, imaging of overall hip and knee arthroplasties are all reviewed. also, the applying of complicated imaging options in review of the decrease extremity is mentioned.

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The superficial form in the foot is termed plantar fibromatosis, taking origin from the plantar aponeurosis. The deep (musculoaponeurotic) fibromatoses involve the deep structures, especially the muscles of the trunk and extremities. These lesions are usually larger with a more aggressive biologic behavior. This latter form is also called extra-abdominal desmoid tumor or aggressive fibromatosis. Fig. 8. Neurofibroma in a 74-year-old woman. Axial T2-weighted (A) spin echo MRI through a neurofibroma of the peroneal nerve (arrows) elicits the target sign.

Other studies, however, note that malignant lesions may appear as smoothly marginated, homogeneous masses and MRI cannot reliably distinguish benign from malignant processes [3,13]. This discrepancy likely reflects differences within the studied populations. When MRI of a lesion is not sufficiently characteristic to suggest a specific diagnosis, a conservative approach is warranted. Malignancies, by virtue of their very nature and potential for autonomous growth, are generally larger and more likely to outgrow their vascular supply with subsequent infarction and necrosis and heterogeneous signal intensity on T2-weighted spin echo MRIs.

4. High-grade incomplete tear involving the right quadriceps in a 49-year-old man. (A) Axial modified IR image (3033/48/ 110) demonstrates increased signal consistent with edema in the vastus lateralis, vastus intermedius, and vastus medialis. (B, C) Sagittal inversion recovery image (IR) (3700/30/150) and T1-weighted (500/9) images demonstrate a high-grade partial tear at the myotendinous junction. Note the feathery appearance of the increased signal with IR technique of the distal muscle belly and that the fluid has intermediate to low signal with T1-weighted imaging.

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