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MRI of the scapulothoracic joint: diagnostic features of elastofibroma dorsi and scapulothoracic bursitis with an emphasis on the differential diagnosis    

A. Vidoni, C. Azzopardi, C. Chisholm, M. Davies, S. L. J. James, R. Botchu; Birmingham/UK

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Learning objectives: Review of the anatomy and the function of the scapulothoracic joint with a focus on the appropriate MRI protocol. Evaluation of the most common imaging findings of elastofibroma dorsi and scapulothoracic bursitis as an important differential diagnosis of posterior shoulder pain in the absence of r[...]

Background: The scapulothoracic interface is a relatively neglected anatomic entity, that has not been comprehensively evaluated in the literature. Nonetheless, in our experience as an orthopaedic oncology center, we encounter many different pathologies affecting the scapulothoracic joint. These include inflamm[...]

Findings and procedure details: I. ANATOMY   The ST joint is a non-synovial articulation between two bony structures: the scapula; in particular the anterior concave surface the convex posterior aspect of the upper portion of the rib cage. Two muscles are interposed between these osseous structures the subscapularis on th[...]

Conclusion: We present the imaging features of a wide spectrum of pathologies involving the scapulothoracic joint.

Personal information: Alessandro Vidoni Clinical Fellow at the Musculoskeletal Radiology Department of the Royal Orthopaedic Hospital, Birmingham, UK   For questions and/or comments about this poster, please contact me at: alessandrovidoni@icloud.com        

References: Naylor MF, Nascimento AG, Sherrick AD, McLeod RA. Elastofibroma dorsi: Radiologic findings in 12 patients. Am J Roentgenol. 1996;167(3):683–7. Meis JM. MR and CT Appearance with Radiologic-Pathologic Correlation Elastofibroma : AJR Am J Roentgenol. 1992;159:575–9. Chandrasekar CR, Grimer RJ, Carter [...]


Radiological differences between tuberculous and pyogenic spondylitis

N. Deresh1, O. Sharmazanova2; 1 Kyiv/UA 2 Kharkiv/UA

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Aims and objectives: Differentiation of tuberculous and pyogenic spondylitis is important, because timely and correctly chosen the type of treatment can reduce the rate of disability and functional impairment. The purpose of our study was to highlight the radiological differences between tuberculous (TS) and pyogenic sp[...]

Methods and materials: Retrospectively reviewed medical histories, CT, MRI of 20 adult patients with spondylitis: 13 with pyogenic (7 women, 6 men aged 34-67 years), 7 with tuberculous (6 men, 1 woman, aged 46-66 years). Diagnoses were based on bacteriological and cultural research and were made clinically, because of pos[...]

Results: The results of study were summarized in Table 1.       M. tuberculosis has morphological and cultural differences compared with other pyogenic bacteria. In our opinion, these cultural features largely explain the differences in clinical and radiological manifestations of each type of[...]

Conclusion: Conclusions: tuberculous and pyogenic spondylitis have radiological differences, which can be observed on CT, MRI, considering some clinical features. This may influence the choice of treatment. In our opinion,  cultural features of M. tuberculosis and pyogenic bacteria  largely explain th[...]

Personal information: Deresh Nataliya Volodymyrivna Division of Radiology, Medical Group «Omega- Kyiv», Kyiv, Ukraine    natalka.deresh@gmail.com   Sharmazanova Olena Petrivna, M.D., Ph.D. Head of the Department of Radiology, Kharkiv Medical Academy of Postgraduate Education, Kharkiv,Ukraine  &nb[...]

References: 1. Arizono T. et al. Differentiation of vertebral osteomyelitis and tuberculous spondylitis by magnetic resonance imaging. Int Orthop 1995; 19: 319-322. 2. Kyu Yeol Lee Comparison of Pyogenic Spondylitis and Tuberculous Spondylitis. Asian Spine J. 2014 Apr; 8(2): 216–223. 3. Sharif HS. et al. Role o[...]


Acoustic radiation force impulse elastography as a diagnostic measurement tool in limb lymphedema: correlation with lymphoscintigraphy

W. Chan, Y. Huang, C. Lin, M. Cheng, S. Chu; Taoyuan city/TW

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Aims and objectives: Background Lymphedema is a progressive pathologic condition in which protein-rich fluid accumulates in cutaneous and subcutaneous tissue due to disruption of lymphatic drainage function [1]. Over time, chronic lymphedema leads to inflammation, hypertrophy of adipose tissue and eventually tissue fibr[...]

Methods and materials: Patients Between July 2015 and November 2016, 58 consecutive patients with clinically proved limb lymphedema referred from the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, were recruited for clinical evaluation, ARFI ultrasound elastography and lymp[...]

Results: One hundred and six limbs in 53 patients with lymphedema were evaluated with conventional B-mode ultrasounography and ARFI elastography. The characteristics of the patients were shown in table 1. Mean BMI of the patients was 25.1 (range, 18 – 34). Eighteen patients were in grade I lymphedema, 19 pat[...]

Conclusion: Using ARFI, we found that skin and subcutaneous tissue are stiffer in symptomatic limbs than in unaffected limbs in patients with limb lymphedema. Higher tissue stiffness was found in limbs with lymphatic drainage obstruction shown on lymphoscintigraphy. Skin and subcutaneous tissue shear wave veloc[...]

Personal information:

References: 1.Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann Plast Surg. 2007;59(4):464-472. 2.International society of lymphology. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology 2013;46(1):[...]


Quantitative Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI Parameters in the diagnosis of osteomyelitis in the diabetic foot

A. Garcia Diez, D. Fuster, L. Morata, R. Garcia, D. Poggio, X. Tomás, M. del Amo, J. Pomes; Barcelona/ES

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Aims and objectives: Clinical Background   Diagnosis of osteomyelitis is important in diabetic foot, the fact that it has a worse outcome which requires prolonged antibiotic therapy, often surgical resection is necessary, and it is the most common no traumatic cause of amputations, with a mortality about 50% in 2 y[...]

Methods and materials: Study patients   From June 2014 to May 2016, 20 patients with diabetic foot and infected ulcer underwent MRI to diagnose osteomyelitis. Only 13 of them with criteria of osteomyelitis confirmed by bone biopsy (with microbiological or histological analyses) or because a lytic lesion on radiograph[...]

Results: Infected bones showed significant high values of ADC, Ktrans and Ve (P≤0.002), with low values but no significant of Kep (P>0.05). There were no relations among those parameters.   Box plots with values of DWI (a, ADC) and DCE-MRI (b, Ktrans; c, Ve; d, Kep) in osteomyelitis and normal bone, [...]

Conclusion: ADC, Ktrans and Ve measurements show high values in osteomyelitis, with good sensibility and specificity, although only ADC shows more robust results because their adequate reliability, while the variability of the DCE-MRI results can be related to a heterogeneous perfusion in the infected areas. &n[...]

Personal information: Ana I García, M.D., Ph.D. Department of Radiology, Hospital Clinic. Barcelona University. Barcelona, Spain. aigarcia@clinic.ub.es David Fuster, M.D., Ph.D. Department of Nuclear Medicine, Hospital Clinic. Barcelona, Spain.   Laura Morata, M.D. Department of Infectious Diseases, Hospital Clini[...]

References: 1. Schofield CJ, Libby G, Brennan GM, MacAlpine RR, Morris AD, Leese GP. Mortality and hospitalization in patients after amputation: a comparison between patients with and without diabetes. Diabetes Care 2006; 29: 2252-2256. 2. Ranachowska C1, Lass P, Korzon-Burakowska A, Dobosz M. Diagnostic imagin[...]


Hemiplegic knee pain in stroke patients and sonographic soft tissue correlates in a resource poor setting: A pilot study

A. S. Aderibigbe1, O. Famurewa1, M. Komolafe1, a. d. omisore2, V. A. Adetiloye1; 1 Ile-Ife/NG 2 ile ife/NG

Aims and objectives: Stroke frequently causes upper motor neuron syndrome, including weakness, spasticity, and abnormal gait pattern or synergistic movement. The impairment of lower limb function results in an asymmetric and interrupted hemiplegic gait because patients prefer to bear weight on the unaffected limb. Biome[...]

Methods and materials: This is a case-controlled cross-sectional study carried out between March and October 2016 in the Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun-State, South-West, Nigeria. Patient selection Thirty-six stroke patients (confirmed on brain comput[...]

Results: The 36 patients had a median age of 62.0 years (range, 40-86 years) and a male to female ratio of 5:4. The time from stroke onset ranged from 4 to 36months (median= 12.5 months). The 18 control subjects had a median age of 61.5 years (range, 42-78 years) and a male to female ratio of 5:4. There were[...]

Conclusion: This study has shown that hemiplegic knee pain is not uncommon in stroke survivors with a prevalence of 38.9% similar to the prevalence of hemiplegic shoulder pain reported by Lindgren et al.[6] Also, soft tissue arthritic changes were identified in three quarter of stroke survivors studied with sup[...]

Personal information: Aderibigbe Adeniyi Sunday MBBS, MMCR. Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, southwest Nigeria; adeniyiribigbe@gmail.com

References: 1. Richards J, et al. A comparison of knee kinematic characteristics of stroke patients and age-matched healthy volunteers. Clin Rehabil. 2003;17(5):565-571. 2. Chen C-L, et al. Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery. Am J Phys Med [...]


Bone metastases in the peripheral skeleton and impeding fractures: Review of augmented osteoplasty techniques

D. K. Filippiadis1, A. Mazioti1, C. Kwnstantos1, L. Reppas1, E. Brountzos2, N. L. Kelekis1, A. D. Kelekis1, G. Velonakis1; 1 Athens/GR 2 Haidari/GR

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Learning objectives: To introduce Radiologists into the different Interventional augmented osteoplasty techniques for prevention of impeding pathologic fracture and pain reduction To discuss potential advantages of each technique To learn about proper patient selection and therapeutic algorithms

Background: Bone metastases of the peripheral skeleton represent a frequent and serious morbidity in patients with advanced cancer disease. The choice of appropriate treatment depends on life expectancy, fracture risk and pain control and includes medication, radiotherapy, osteoplasty/cementoplasty, or surgical[...]

Findings and procedure details: Pain pathophysiology in metastatic bone disease includes tumor driven osteolysis and microfractures, chronic neuronal stimulation with altered neurotransmitter express and neuropathic pain. In order to avoid post-therapeutic pathologic fractures, systematic analyses of the literature advocate augmen[...]

Conclusion: Percutaneous augmented peripheral osteoplasty combining cement to instrumentation for symptomatic malignant lesions and pathologic fracture prevention in long bones seems to be a possible new technique for bone stabilization. Which patients will benefit from which technique variation still remains a[...]

Personal information: Dimitrios K Filippiadis MD, PhD, MSc, EBIR Assistant Professor of Diagnostic and Interventional Radiology 2nd Radiology Dpt, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens Addr.: 1 Rimini str, 12462 Haidari/Athens, Greece Tel.: +30 210 5831812 Fa[...]

References: 1. Kelekis A, Filippiadis D, Anselmetti G, Brountzos E, Mavrogenis A, Papagelopoulos P, Kelekis N, Martin JB. Percutaneous Augmented Peripheral Osteoplasty in Long Bones of Oncologic Patients for Pain Reduction and Prevention of Impeding Pathologic Fracture: The Rebar Concept. Cardiovasc[...]


Study of bipolar bone defects in unstable shoulder: From "engaging / non-engaging" to "on-track / off-track".

E. Jose Salgado Ribeiro1, B. C. S. Rabelo2, R. NOBRE RODRIGUES1, A. Moura Abuhid Lopes1, V. BARROS MACHADO1, F. Oliveira Franca1, A. Couto Godinho1, P. Couto Godinho1, G. Gomes Godinho1; 1 Belo Horizonte/BR 2 Itauna/BR

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Learning objectives: - To describe Hill-Sachs fracture evaluation concepts and techniques for the identification of "engaging" or "non-engaging" injuries. - Demonstrate techniques of quantification of glenoid bone loss.   - Review surgical techniques for correction of traumatic anterior instability, with emphasis[...]

Background: Traumatic anterior glenohumeral instability is associated with bone lesions (Hill-Sachs), glenoid lip (Bankart), and antero-inferior ligaments. One of the predisposing factors for the occurrence of dislocation is the association with large bone defects (humeral head and glenoid). The morphologi[...]

Findings and procedure details: Hill-Sachs lesion   - Impaction fracture on the posterior-superior-lateral aspect of the humeral head.   - X ray is useful for initial search (internal rotation).   - CT and RM are better for location and depth.   - The contribution of the Hill-Sachs lesion to glenohumeral[...]

Conclusion: - CT and MRI are important imaging methods in the preoperative planning of the previous traumatic instability, providing a morphological study of the Hill-Sachs fracture and allowing the quantification of glenoid bone loss.   - "Engaging" Hill-Sachs depends more on the position of the defe[...]

Personal information:

References: 1. Provencher MT, Frank RM, LeClere LE, Metzger PD, Bernhardson A, Romeo AA. The Hill-Sachs lesion: diagnosis, classification and management. J Am Acad Orthop Surg 2012; 20: 242-252. 2. Yamamoto N, Itoi E, Abe H, Kikuchi K, Seki N, Minagawa H, Tuoheti Y. Effect of an anterior glenoid defect on ant[...]


Relationship Between Sound Quality And Lip Muscle Density In French Horn Players

M. Flores de la Torre, G. Guillem, M. Armengot, J. Vucetic, G. Jimenez Payá, G. Juan Samper, J. Limerâ Dus; Valencia/ES

Aims and objectives: 1.1What is embouchure to wind players (Fig 1)   Embouchure is the mechanism to form the lips in order to correctly insert the mouthpiece while playing a wind instrument.    Fruncht defines  this concept like “ a well-organized collection of perioral and  jaw muscles used to[...]

Methods and materials: METHODOLOGY:Population, procedures. 4.1 Design of study Two trials were conducted, one medical and another acoustic, both complementary, using different methods and materials. Population: The study was conducted on 16 adult horn students’ players. In the few references to similar studies, the samp[...]

Results:          1. Of ultrasounds           2. The spectral decomposition of sound 5.1. ULTRASOUNDS     5.1.1. COMPARISON amount greater / lower lip is inside the mouthpiece. Various types of sections were used t[...]

Conclusion: There is a coincidence that the samples nos. 4 and 5 received a lower percentage muscle in the analysis using ultrasound. Therefore, as CONCLUSIONS in both analysis, we can say that: (fig. 21 and 22)   Most of the students are placed in a standard regarding the spectral decomposition (no huge d[...]

Personal information:

References: 1. GROVE MUSIC ONLINE: www.grovemusic.com. 2 STEVEN FRUCHT ET AL: "The natural History of Embouchure Dystonia", 899. 3. ILTIS P.W and GIVENS M. W: “EMG Characterization of Embouchure Muscle Activity: Reliability and application to embouchure Dystonia" , Medical Problems of Performing Artist 20; nº1,[...]

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