Physiological and anatomical basis of muscle magnetic resonance imaging.
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Biomedical subjects
Publications and source records attributed to Russell C Fritz.
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Snow skiing has been called "the world's oldest sport," "the fastest non-motorized sport on Earth," and "the riskiest sport undertaken by adults on a routine basis." This article discusses the common mechanisms for orthopedic injuries occurring in two of the most popular winter sports in the world that have a reputation for an inherently high risk of injury: alpine skiing and snowboarding. The emphasis herein is on magnetic resonance imaging of characteristic injuries in skiers (knee, thumb, shoulder) and in snowboarders (wrist, forearm, ankle). Spine injuries in snowboarders and skiers are also discussed.
Advanced imaging techniques such as computed tomography, ultrasound, and magnetic resonance imaging provide clinically useful information by detecting and characterizing pathologic conditions of the elbow. The information provided by these techniques can help establish an anatomic diagnosis in a noninvasive fashion. A timely and accurate imaging diagnosis may be an important piece of the puzzle in a diagnostic workup that allows implementation of proper treatment and improved outcome. In this article, the authors focus on recent advances in diagnostic imaging of the elbow joint.
Shoulder pain and injuries are common in athletes. Overhead athletes, in particular, place great demands on the shoulder and supporting structures. Magnetic resonance (MR) imaging is well suited to evaluation of the osseous structures and soft tissues of the shoulder and plays an important role in evaluation of shoulder pain in athletes. Primary extrinsic impingement is well evaluated on MR imaging as are the less common posterior superior glenoid impingement and subcoracoid impingement. Rotator cuff tendinosis as well as partial- and full-thickness tears are frequently encountered in the athletic shoulder. The biceps tendon and rotator interval capsular structures are important sources of shoulder pain. Glenohumeral instability that results from a traumatic event or atraumatic multidirectional recurrent instability is assessed. The biceps labral complex is a source of considerable anatomic variability and pathology.
MR imaging provides clinically useful information in detecting and characterizing sports-related pathology of the menisci and cruciate ligaments in a noninvasive fashion. Meniscal tears can also be detected and characterized with regard to extent and tear stability with MR imaging. Acute and chronic tears of the anterior and posterior cruciate ligaments can be accurately identified and evaluated with MR imaging.
Muscle derangements in athletes have a wide variety of causes, treatments, and prognoses. Given that the cause and severity of sports-related injuries may be difficult to determine clinically in some cases, MR imaging is utilized increasingly to evaluate muscle injuries in athletes. After reviewing useful MR imaging techniques, this article focuses on MR imaging of the most common causes of muscle pain and disability in athletes, including myotendinous strain, delayed onset muscle soreness, muscle contusion, myositis ossificans, muscle laceration, muscle herniation, and compartment syndrome. The differential diagnosis of various signal intensity abnormalities in muscle also is reviewed.
MR imaging provides clinically useful information in detecting and characterizing sports-related pathology of the rotator cuff and other shoulder disorders in a non-invasive fashion. Complete and partial tears of the rotator cuff, as well as factors contributing to impingement, can be detected and characterized with MR imaging. The size and location of complete tears of the rotator cuff can be accurately determined with MR imaging.
Spinoglenoid notch cysts were identified by magnetic resonance imaging in 73 patients. Posterosuperior labral tears were identified in 65 patients who had spinoglenoid notch cysts. Patient follow-up was available on 88% of patients at a mean of 20.5 months after treatment. There were 52 men and 11 women, with a mean age of 39 years (range, 19-76 years). All patients reported shoulder pain. Infraspinatus atrophy occurred in 25 patients, weakness with external rotation in 43, and posterior shoulder tenderness in 30. Nineteen patients underwent nonoperative management of the cyst (group I). Eleven underwent attempted needle aspiration of the cyst (group II). Six had isolated arthroscopic treatment of a labral defect with no cyst excision (group III). Twenty-seven were treated with surgical cyst excision with the cyst and superior labral tear fixed arthroscopically or with an open approach in various combinations (group IV). Of the patients, 53% were satisfied in group I, 64% in group II, 67% in group III, and 97% in group IV.