Mri of the Musculoskeletal System

by Vahlensieck, Martin; Genant, Harry K.; Reiser, Maximilian, M.D.; Winter, Peter; Bollow, M. (CON)

• ISBN13: 9780865778757
• ISBN10: 0865778752
• Edition: 1st
• Format: Hardcover
• Copyright: 2000-01-01
• Publisher: Thieme Medical Pub

Summary

In many cases, MRI is the last and decisive step in diagnostic imaging of the musculoskeletal system. The knowledge necessary to understand normal anatomy and pathological findings has increased exponentially in recent years.In 850 images, with many MR-images supported by explanatory color graphs, this book addresses this issue and the main problems the examining physician encounters, including- the description of all relevant techniques of MRI- suggestions for tabular protocols- the comprehensive presentation of normal sectional anatomy,- tables for differential diagnosis, and- description of state-of-the-art imaging methods.

Table of Contents

Technology of Magnetic Resonance Imaging	1	(18)
M. Vahlensieck
F. Traber
J. Gieseke
Introduction	1	(1)
Spin-Echo (SE) Sequences	1	(1)
T1-weighted Sequences	1	(1)
Proton Density-weighted Sequences	1	(1)
T2-weighted Sequences	2	(1)
Fast (or Turbo) Spin Echo (TSE) Sequences, RARE	2	(1)
Gradient-Echo (GRE) Sequences	2	(5)
Ultra-Fast MR Techniques	7	(1)
Low Field Strength Imaging	7	(2)
Fat Suppression	7	(2)
Contrast Enhancement, Dynamic Enhanced Imaging	9	(1)
Direct MR Arthrography	9	(1)
Indirect MR Arthrography	9	(1)
Magnetization Transfer Contrast (MTC)	10	(3)
Diffusion-weighted and Perfusion-weighted Imaging	13	(1)
MR Angiography	13	(1)
Relaxometry, Relaxation-Time Maps	13	(1)
Three-dimensional Reconstruction	13	(2)
Multiplanar Reformation, Radial Acquisition	15	(1)
Magnetic Resonance Spectroscopy (MRS) and Spectroscopic Imaging (SI)	15	(1)
Cinematic Examinations	16	(3)
References	17	(2)
Spine	19	(28)
G. Lutterbey
G. Layer
Anatomic Basis	19	(2)
Examination Protocol for MRI	21	(3)
Degenerative Conditions of the Spine	24	(10)
Spondylosis Deformans	24	(1)
Degenerative Bone Marrow Changes	24	(3)
Disk Degeneration	27	(1)
Disk Herniation	28	(3)
Spinal Stenosis and Cervical Myelopathy	31	(3)
Spondylitis and Spondylodiskitis	34	(2)
Traumatic Changes of the Spine	36	(4)
Injuries of the Vertebral Body	37	(1)
Ligamentous Instability	38	(1)
Cord Injuries	39	(1)
Postoperative Changes of the Spine	40	(7)
Laminectomy	40	(1)
Diskectomy	41	(1)
Surgical Fusion	41	(3)
References	44	(3)
Shoulder	47	(30)
M. Vahlensieck
Introduction	47	(1)
Examination Technique	47	(2)
Patient Positioning	47	(1)
Surface Coil	47	(1)
Sequences and Parameters	47	(1)
Special Examination Techniques	48	(1)
Anatomy	49	(8)
General Anatomy	49	(1)
Specific MR Anatomy and Variants	50	(7)
Disorders of the Rotator Cuff	57	(6)
Impingement	57	(1)
Degeneration, Tendinitis	58	(1)
Partial-Thickness Tear	58	(1)
Full-Thickness Tear	59	(3)
Enthesopathy	62	(1)
Disorders of the Biceps Muscle	63	(1)
Disorders of the Remaining Musculature	64	(1)
Disorders of the Subacromial-Subdeltoid Bursa	65	(1)
Disorders of the Glenoid Labrum and the Joint Capsule	66	(2)
Glenohumeral Arthritis and Other Conditions of the Synovial Membrane	68	(1)
Osseous Disorders	69	(1)
Tumors	70	(1)
Post-therapy Findings	70	(2)
Pitfalls in Interpreting the Images	72	(2)
Clinical Relevance of MRI and Comparison with Other Imaging Modalities	74	(3)
References	75	(2)
Elbow	77	(28)
B. M. Eitel
P. Schnarkowski
Introduction	77	(1)
Examination Technique	77	(1)
Patient Positioning	77	(1)
Coils	77	(1)
Sequences and Parameters	78	(1)
Special Examination Techniques	78	(1)
Anatomy	78	(1)
General Anatomy	78	(1)
Specific MRI Anatomy	79	(1)
Synovitis, Plicae, and Pannus Formation	79	(12)
Bursitis	91	(1)
Osteomyelitis	91	(1)
Enthesopathy	92	(2)
Ligamentous Injuries	94	(1)
Tendon Tears	94	(1)
Nerve Compression Syndromes	94	(3)
Osteochondritis dissecans	97	(1)
Osteonecrosis	97	(2)
Osseous Injuries	99	(1)
Tumors	99	(1)
Soft Tissue and Muscle Injuries	99	(2)
Post-therapy Findings	101	(1)
Pitfalls in Interpreting the Images	101	(1)
Clinical Relevance of MRI and Comparison with Other Imaging Modalities	101	(4)
References	102	(3)
Wrist	105	(32)
A. Stabler
M. Vahlensieck
Introduction	105	(1)
Examination Technique	105	(1)
Positioning	105	(1)
Coil	105	(1)
Sequences and Parameters	105	(1)
Special Examination Techniques	105	(1)
Anatomy	106	(8)
General Anatomy	106	(4)
Specific MRI Anatomy	110	(4)
Spontaneous Avascular Necroses	114	(5)
Avascular Necrosis of the Lunate (Kienbock disease)	114	(3)
Spontaneous Avascular Necrosis of the Scaphoid (Preiser disease, Kohler-Mouchet disease)	117	(2)
Ulnar Compression Syndrome of the Lunate	119	(1)
Traumatic Lesions of the Carpal Bone	119	(5)
Contusion, Occult Fractures	119	(2)
Traumatic Lesions and Postsurgical Findings of the Scaphoid	121	(1)
Scaphoid Fractures	121	(1)
Pseudarthrosis, Fibrous and Partial Osseous Union	121	(1)
Post-traumatic Avascular Necrosis	122	(1)
Postsurgical Findings of the Scaphoid	123	(1)
Diseases of the Interosseous (Intrinsic) Ligaments	124	(1)
Diseases of the Capsular Ligaments (Extrinsic Ligaments)	124	(2)
Ulnar Fibrocartilage Complex	126	(2)
Nerve Compression Syndromes	128	(2)
Carpal Tunnel	128	(2)
Guyon Canal	130	(1)
Tumors	130	(1)
Ganglion Cysts, Other Cysts	130	(3)
Disorders of the Synovial Membrane	133	(1)
Disorders of the Tendons	133	(1)
Pitfalls in Interpreting the Images	134	(3)
References	135	(2)
Hip and Pelvis	137	(26)
M. Reiser
A. Heuck
Introduction	137	(1)
Examination Technique	137	(1)
Anatomy	138	(1)
Avascular Necrosis of the Femoral Head	139	(3)
Indication of MRI in Femoral Head Avascular Necrosis	141	(1)
Transient Osteoporosis	142	(5)
Legg-Perthes Disease	147	(2)
Trauma, Stress and Fatigue Fractures	149	(3)
Hip Dysplasia	152	(1)
Degenerative and Rheumatoid Joint Changes and Other Conditions Arising from the Synovial Membranes	153	(4)
Inflammatory Rheumatoid Diseases	156	(1)
Pigmented Villonodular Synovitis	156	(1)
Synovial Osteochondromatosis	156	(1)
Osteomyelitis and Septic Arthritis	157	(1)
Pitfalls in Interpreting the Images	158	(5)
Transcortical Synovial Herniation	158	(1)
Bursitis	158	(2)
References	160	(3)
Knee	163	(50)
M. Reiser
M. Vahlensieck
Introduction	163	(1)
Examination Technique	163	(1)
Patient Positioning and Coil Selection	163	(1)
Sequences	163	(1)
Anatomy	164	(3)
General Anatomy	164	(1)
Specific MR Anatomy	165	(2)
Meniscal Lesions	167	(7)
Degenerative Changes and Tears	167	(5)
Postsurgical Changes	172	(1)
Discoid and Ring Meniscus	173	(1)
Meniscal Cysts and Parameniscal Cysts	173	(1)
Injuries of the Cruciate Ligaments	174	(8)
Postsurgical Changes of the Cruciate Ligament	182	(1)
Injuries of the Collateral Ligaments	182	(3)
Dyskinesias of the Femoropatellar Articulation and Patellar Dislocations	185	(1)
Lesions of the Patellar Tendon	185	(1)
Cartilaginous Lesions	186	(4)
Bone Marrow Edema	190	(4)
Osteochondritis Dissecans and Avascular Necroses	194	(3)
Changes of the Synovial Membrane and Joint Capsule	197	(5)
Synovial Plicae	202	(1)
Synovial Popliteal Cysts and Bursitis	203	(2)
Ganglion Cysts (Excluding So-called Meniscal Cysts)	205	(2)
Pitfalls in Interpreting the Images	207	(1)
Clinical Relevance of MRI and Comparison with Other Imaging Modalities	207	(6)
References	208	(5)
Ankle and Foot	213	(28)
M. Steinborn
M. Vahlensieck
Introduction	213	(1)
Examination Technique	213	(1)
Patient Positioning	213	(1)
Coil Selection	213	(1)
Sequences and Parameters	213	(1)
Special Examination Technique	213	(1)
Anatomy	213	(8)
General Anatomy	213	(2)
Specific MR Anatomy	215	(1)
Foot	215	(6)
Disorders of the Bone	221	(6)
Osteochondral Injuries and Osteochondritis Dissecans	221	(3)
Other Osteonecroses	224	(1)
Stress Fractures and Occult Fractures	224	(1)
Synostoses of the Tarsal Bones (Tarsal Coalitions)	225	(2)
Disorders of the Tendon	227	(2)
Achilles Tendon	227	(1)
Tear	227	(1)
Partial Tear	228	(1)
Tendinitis	228	(1)
Peroneal Tendons	229	(1)
Deep Flexor Tendons	229	(2)
Tibialis Posterior	229	(1)
Flexor Digitorum Longus	230	(1)
Flexor Hallucis Longus	230	(1)
Extensor Group	230	(1)
Ligamentous Injuries	231	(2)
Talocrural Articulation	231	(1)
Sinus Tarsi Syndrome	231	(2)
Diseases of the Plantar Aponeurosis	233	(2)
Plantar Fasciitis	233	(1)
Plantar Fibromatosis	234	(1)
Disorders of the Nerves	235	(1)
Tarsal Tunnel Syndrome	235	(1)
Morton's Neuroma	235	(1)
Diabetic Foot	236	(1)
Bursitis	236	(1)
Pitfalls in Interpreting the Images	237	(4)
Accessory Muscles	237	(1)
References	238	(3)
Temporomandibular Joint	241	(16)
R. Fischbach
Introduction	241	(1)
Examination Technique	241	(2)
Patient Positioning	241	(1)
Coil Selection	241	(1)
Sequences and Parameters	241	(1)
Special Examination Techniques	242	(1)
Dynamic Studies	242	(1)
Anatomy	243	(3)
General Anatomy	243	(1)
Specific MR Anatomy and Variants	244	(2)
Disorders of the Articular Disk	246	(5)
Abnormal Structure and Form of the Disk	246	(1)
Disk Displacement	247	(1)
Anterior Disk Displacement	247	(1)
Sideways Disk Displacements	247	(2)
Posterior Disk Displacements	249	(1)
Nomenclature of Disk Displacements	249	(1)
Disk Adhesions	250	(1)
Disk Perforation	250	(1)
Malpositions of the Condyle	251	(1)
Arthritis and Other Synovial Disorders	251	(1)
Arthritis	251	(1)
Synovial Chondromatosis	251	(1)
Disorders of the Bone	252	(1)
Osteoarthritis	252	(1)
Tumors	252	(1)
Benign Tumors	252	(1)
Malignant Tumors	253	(1)
Post-therapeutic Findings	253	(1)
Clinical Relevance of MRI and Comparison with Other Imaging Methods	253	(4)
References	254	(3)
Musculature	257	(26)
M. Vahlensieck
G. Layer
Introduction	257	(1)
Examination Technique	257	(1)
Specific MR Spectroscopy of the Muscles	257	(3)
Basics of Energy Metabolism of the Muscles	257	(1)
MR Spectroscopy of Muscular Energy Metabolism	258	(1)
McArdle Syndrome	259	(1)
Phosphofructokinase Deficiency	259	(1)
Respiratory Chain Defects	259	(1)
Mitochondrial Myopathies	259	(1)
Muscular Dystrophies	259	(1)
Myositis	259	(1)
Anatomy	260	(7)
General Anatomy	260	(1)
Specific MRI and Functional Anatomy	260	(7)
MRI Pattern of Muscular Lesions	267	(1)
Hypertrophy	267	(1)
Hypotrophy	267	(1)
Atrophy	268	(1)
Pseudohypertrophy	268	(1)
Edema	268	(1)
Necrosis	268	(1)
Fibrosis	268	(1)
Neuropathy	268	(2)
Myotonic Disorders	270	(1)
Myopathies	270	(11)
Dystrophic Myopathies	270	(1)
Inflammatory Myopathies	271	(2)
Muscle Changes after Radiotherapy or Local Chemotherapy	273	(1)
Traumatic Myopathies	274	(4)
Muscle Fibrosis	278	(1)
Compartment Syndrome	278	(1)
Rhabdomyolysis	278	(1)
Symptomatic Myopathies	279	(2)
Muscle Tumors	281	(1)
Pitfalls in Interpreting the Images	281	(1)
Clinical Relevance of MRI and Comparison with Other Imaging Methods	281	(2)
References	281	(2)
Bone Marrow	283	(26)
M. Vahlensieck
G. Layer
Examination Technique	283	(1)
Anatomy	284	(5)
General Anatomy	284	(1)
Specific MR Anatomy	285	(4)
Generalized Disorders	289	(1)
Reconversion, Hyperplasia	289	(1)
Cellular Infiltration, Displacement	289	(3)
Polycythemia	290	(2)
Malignant Diffuse Infiltrates	292	(1)
Hypoplasia, Fatty Replacement	292	(4)
Panmyelopathy (Aplastic Anemia)	294	(1)
Postchemotherapy Changes	294	(1)
Marrow Fibrosis	294	(1)
Storage Diseases	294	(1)
Gaucher Disease	294	(1)
Hemosiderosis	295	(1)
Amyloidosis	295	(1)
Marrow Changes after Transplant	295	(1)
Focal Disorders	296	(9)
Edema	296	(1)
Ischemia	296	(1)
Osteonecrosis	296	(1)
Bone Infarction	296	(1)
Transient Osteoporosis	297	(1)
Postradiation Changes	298	(1)
Inflammation	298	(1)
Acute Osteomyelitis	299	(1)
Chronic osteomyelitis	300	(1)
Noninfectious Inflammations	300	(1)
Trauma	300	(1)
Bone Bruises	300	(2)
Occult Fractures	302	(2)
Complete Fractures	304	(1)
Stress Fracture	304	(1)
Clinical Role of MRI and Comparison with Other Imaging Modalities	305	(4)
References	305	(4)
Bone and Soft-Tissue Tumors	309	(40)
P. Lang
M. Vahlensieck
J. O. Johnston
H. K. Genant
General Section	309	(13)
Coils, Sequence Protocols	309	(1)
Comparison between Benign and Malignant Tumors	309	(2)
Characteristic Signal Intensity Pattern	311	(1)
Staging	311	(3)
Intramedullary Involvement	314	(2)
Epiphyseal Involvement	316	(1)
Intra-articular Involvement	316	(1)
Cortical Destruction, Periosteal Reaction	316	(1)
Soft-tissue Extension	317	(1)
Involvement of Neurovascular Bundles	317	(1)
Differentiation between Peritumoral Edema and Extraosseous Tumor	318	(2)
Differentiation between Viable and Necrotic Tumor	320	(1)
Monitoring the Effect of Therapy	320	(2)
Recurrent Tumor and Postoperative Fibrosis or Edema	322	(1)
Specific Section	322	(7)
Malignant Bone Tumors	322	(1)
Osteosarcoma	322	(3)
Ewing Sarcoma	325	(1)
Chondrosarcoma	325	(1)
Fibrosarcoma and Malignant Fibrous Histiocytoma	325	(1)
Angiosarcoma	326	(1)
Primary Lymphoma	326	(1)
Benign Bone Tumors	326	(1)
Giant Cell Tumor	326	(2)
Fibrous Bone Tumors	328	(1)
Fibrous Dysplasia	328	(1)
Nonossifying Fibroma (benign Fibrous Cortical Defect, Fibroxanthoma)	329	(1)
Desmoplastic Fibroma (Desmoid)	329	(1)
Intraosseous Lipoma	329	(1)
Eosinophilic Granuloma	329	(13)
Cartilaginous Bone Tumors	330	(1)
Chondroma (Enchondroma and Exostosis)	330	(1)
Chondroblastoma	331	(1)
Chondromyxoid Fibroma	331	(1)
Osteochondroma	332	(1)
Aneurysmal Bone Cyst	333	(2)
Unicameral Bone Cyst	335	(1)
Hemangioma	335	(1)
Osteogenic Tumors	335	(1)
Osteoid Osteoma	335	(2)
Osteoblastoma	337	(1)
Osteoma	337	(1)
Malignant Soft-Tissue Tumors	337	(1)
Malignant Fibrous Histiocytoma	337	(1)
Liposarcoma	337	(1)
Synovial Sarcoma	338	(1)
Angiosarcoma	338	(1)
Benign Soft-Tissue Tumors	338	(1)
Lipoma	338	(1)
Intramuscular Myxoma	339	(1)
Desmoid (Extra-abdominal Desmoid, Aggressive Fibromatosis)	340	(2)
Vascular Tumors: Hemangioma, Angiomatosis, Hemangioendothelioma, Lymphangioma, Angiolipoma	342	(7)
Schwannoma (Neurinoma, Neurilemoma) and Neurofibroma	342	(1)
Pigmented Villonodular Synovitis	343	(1)
Giant Cell Tumor of Tendon Sheath	343	(1)
Myogenic Tumors	344	(1)
Metastases	344	(2)
References	346	(3)
Osteoporosis	349	(6)
S. Grampp
M. Vahlensieck
P. Lang
H. K. Genant
Introduction	349	(1)
MR Imaging of Osteoporosis	349	(2)
Osteoporotic Fractures	349	(1)
High Resolution Imaging of the Trabecular Pattern	350	(1)
MR Relaxometry	351	(1)
Current Role of Relaxometry	352	(3)
References	353	(2)
Sacroiliac Joints	355	(22)
M. Bollow
J. Braun
Introduction	355	(1)
Examination Technique	355	(1)
Anatomy	356	(4)
General Anatomy	356	(1)
Specific MRI Anatomy	356	(4)
Inflammatory Rheumatoid Conditions	360	(7)
Classification and Clinical Findings	360	(1)
MRI Findings	361	(4)
Index of Chronicity and Activity	365	(2)
Degenerative Changes	367	(1)
Osteitis Condensans Ilii	367	(1)
Infectious Sacroiliitis	368	(2)
Traumatic Changes	370	(1)
Tumors and Tumor-like Conditions of the Joint Pitfalls	370	(7)
References	373	(4)
Appendix	377	(8)
M. Vahlensieck
Differential Diagnosis of the Swollen Extremity by MRI	377	(1)
Magic-Angle Phenomenon	378	(1)
Use of Dedicated MRI Systems	379	(1)
Examination Protocols (Tables)	379	(6)
References	383	(2)
Index	385