Imaging of the Musculoskeletal System, 2-Volume Set: Expert Radiology Series 1

An international group of experts brings you an exhaustive full-color two-volume reference to help you effectively select and interpret the best imaging studies for the challenges you face in musculoskeletal diagnosis. They cover every aspect of musculoskeletal radiology, including the latest diagnostic modalities and interventional techniques. Plus, a CD featuring case studies, additional chapters, and valuable appendices enriches your knowledge and gives you step-by-step guidance on all of the most important musculoskeletal procedures. Examples of cutting-edge modalities such as MR, multislice CT, ultrasonography, and nuclear medicine are balanced with conventional radiographic images, enabling you to compare and contrast findings from all imaging modalities. More than 5,300 digital-quality illustrations offer exceptional detail and clarity, and user-friendly features including key points boxes, classic signs, protocols, and ACR guidelines put today's best practices at your fingertips. Offers advice from a diverse group of experts from around the globe, providing you with a wide range of options and perspectives, including the pros and cons of each modality, to help you overcome difficult challenges. Presents radiographic images as well as MR, multislice CT, ultrasonography, and nuclear medicine imaging findings so you can easily compare results. Delivers essential background information to help you fully understand each topic. Integrates protocols, classic signs, and ACR guidelines, ensuring a better decision making process. Structures every chapter consistently to include pathophysiology, imaging techniques, imaging findings, differential diagnosis, and treatment options so you can make the best informed decisions. Provides boxes highlighting what the referring physician needs to know, to assist you with report writing, as well as suggestions for treatment and future imaging studies. Includes a CD of case studies, valuable appendices, and additional chapters that provide step-by-step guidance on all of the most important musculoskeletal procedures. Uses more than 5,300 superior, large digital-quality images depicting all of the musculoskeletal imaging findings you're likely to see, and helping you distinguish between conditions with similar presentations. Features a full-color design throughout, including color-coded tables and bulleted lists that highlight key concepts and get you to the information you need quickly, as well as color artwork that lets you easily find critical anatomic views of diseases and injuries. Cover Introduction and General P rinciples John H. Harris, Jr. PURPOSE OF THE IMAGING REPORT BONE TYPES GEOGRAPHIC ANATOMY OF LONG AND SHORT BONES T YPES OF MUSCULOSKELETAL INJURIES Ligamentous Injuries (Selected Examples) SKELETAL INJURY FRACTURES MUSCULOSKELETAL INJURIES COMMONLY ASSOCIATED WITH NONLIGAMENTOUS SOFT TISSUE SPINAL INJURIES WITH INHERENT SPINAL CORD INJURY Cervical Spine Thoracic and Lumbar Spine SPINAL INJURIES WITH POTENTIAL SPINAL CORD INJURY BENDING FRACTURES MUSCULOSKELETAL INJURIES WITH ASSOCIATED CLINICALLY SIGNIFICANT LIGAMENTOUS W rist Hand P elvis A vulsion Injuries Ankle F oot SUGGESTED READINGS Imaging of Facial and Skull Trauma Lorne Rosenbloom, Bradley N. Delman, and Peter M. Som PREVALENCE, EPIDEMIOLOGY, AND DEFINITIONS ANATOMY AND BIOMECHANICS CLINICAL PRESENTATION Nasal Fractures Orbital Fractures Internal Orbital Fractures Orbital Rim Fractures N aso-Orbito-Ethmoid Fractures Zygomaticomaxillary Complex Fractures Le Fort Fractures F rontal Sinus Fractures T emporal Bone Fractures Skull Base Fractures Cranial Vault Fractures Mandibular Fractures MANIFESTATIONS OF THE DISEASE Radiography Multidetector Computed Tomography Magnetic Resonance Imaging DIFFERENTIAL DIAGNOSIS REFERENCES T emporomandibular Joint Vijay M. Rao and Steven Finden PREVALENCE AND EPIDEMIOLOGY P A THOPHYSIOLOGY Anatomy P athology Plain Radiography Arthrography Computed Tomography Magnetic Resonance Imaging MANIFESTATIONS OF THE DISEASE COMPLICATIONS OF INTERNAL DERANGEMENT Surgical Management REFERENCES Cervical Spine Injuries Donna G. Blankenbaker, Kirkland W. Davis, and Richard H. Daffner PREVALENCE, EPIDEMIOLOGY, AND DEFINITIONS ANATOMY BIOMECHANICS P A THOLOGY Flexion Extension R otation Shearing IMAGING TECHNIQUES Indications for Imaging MANIFESTATIONS OF THE DISEASE Radiography Flexion-Extension Radiographs Multidetector Computed Tomography Obtunded Patients Recommendations Imaging Findings Radiologic Evaluation Computed Tomographic Evaluation Magnetic Resonance Imaging Evaluation Radiographic Stability versus Instability Normal Variants SPECIFIC CERVICAL SPINE INJURIES C0-C1 A tlanto-occipital Dissociation Occipital Condyle Fractures C1-C2 Lower Cervical Spine Burst Fracture Flexion Teardrop Fracture Extension Teardrop Fracture V ertical Split Fracture F acet Dislocation Hyperflexion Sprain Hyperextension Sprain P osterior Element Fractures Spinous Process Fractures Articular Pillar/Facet/Laminar/Transverse Process Fractures Whiplash Injuries SCIWORA Associated Neurologic Injuries SYNOPSIS OF TREATMENT OPTIONS What the Referring Physician Needs to Know SUGGESTED READINGS Injury to the Thoracic Cage and Thoracolumbar Spine Cornelis van Kuijk and Digna R. Kool ANATOMY BIOMECHANICS MANIFESTATIONS OF THE DISEASE Rib Fractures Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Classic Sign Sternal Fractures Radiography Multidetector Computed Tomography F ractures to the Thoracic and Lumbar Spine Magnetic Resonance Imaging Multidetector Computed Tomography SYNOPSIS OF TREATMENT OPTIONS Medical Treatment Surgical Treatment What the Referring Physician Needs to Know SUGGESTED READINGS REFERENCES Normal Shoulder Qi Chen, Theodore T. Miller, Mario Pardon, and Javier Beltran TECHNICAL ASPECTS Conventional Radiography (Table 6-1, F ig. 6-1) Rationale and Indications A dvantages Computed Tomography (Table 6-2) Rationale and Indications CT Arthrography (Fig. 6-2) Rationale and Indications A dvantages Limitations Method Conventional Magnetic Resonance Imaging (Table 6-3; Fig. 6-3; Table 6-4) Rationale and Indications A dvantages Limitations Method Indirect MR Arthrography (Table 6-5; Fig. 6-4) Rationale and Indications T echnical Aspects A dvantages Direct MR Arthrography (Table 6-6; Fig. 6-5) Rationale and Indications T echnical Aspects A dvantages Ultrasonography Rationale and Indications A dvantages Limitations T echnical Aspects NORMAL ANATOMY Osseous Structures The Labrum The Joint Capsule The Ligaments The Long Head of the Bicipital Tendon The Rotator Cuf f The Deltoid Muscle The Bursae The Neurovascular Bundles MOST SIGNIFICANT NORMAL VARIANTS Shape of the Undersurface of the Acromion Os Acromiale Sublabral Foramen and Sublabral Recess V ariations of the Glenohumeral Ligaments Anterior Capsular Insertion Insertion of the Long Head of the Biceps Tendon B ASIC BIOMECHANICS Normal Biomechanics The Overhead Throwing Mechanism Joint Stability REFERENCES Osseous Injuries of the Shoulder Girdle Joseph S. Yu Anatomy MANIFESTATIONS OF THE DISEASE Acute Osseous Injuries of the Clavicle Radiography Multidetector Computed Tomography Acute Osseous Injuries of the Acromioclavicular Joint Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Acute Osseous Injuries of the Sternoclavicular Joint Radiography Acute Osseous Injuries of the Glenohumeral Joint Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Classic Signs Acute Osseous Injuries of the Scapula Radiography Multidetector Computed Tomography Acute Osseous Injuries of the Proximal Humerus Multidetector Computed Tomography DIFFERENTIAL DIAGNOSIS Classic Signs SYNOPSIS OF TREATMENT OPTIONS Medical Treatment Surgical Treatment What the Referring Physician Needs to Know REFERENCES Shoulder Impingement S y ndromes George C. Nomikos and Mahvash Rafii PREVALENCE, EPIDEMIOLOGY, AND DEFINITIONS DEFINITIONS CLASSIFICATION P A THOPHYSIOLOGY Anatomy Biomechanics P athology Magnetic Resonance Imaging T echnical Aspects Rotator Cuff Tendinosis F ull-Thickness Rotator Cuff Tears P artial-Thickness Rotator Cuff Tears C y s t i c Lesions Muscle Atrophy Acromial Morpholog y Pitfalls in Magnetic Resonance Imaging of the Rotator Cuff Multidetector Computed Tomography Ultrasonography Arthroscopy Classic Signs Subcoracoid Impingement and Subscapularis Tendon Tears Radiography Magnetic Resonance Imaging Ultrasonography Arthroscopy Classic Signs Internal (Posterosuperior) Impingement Magnetic Resonance Imaging Anterosuperior (Anterior Internal) Impingement and the Rotator Inter v al Ar DIFFERENTIAL DIAGNOSIS Classic Signs SYNOPSIS OF TREATMENT OPTIONS Medical Treatment Surgical Treatment What the Referring Physician Needs to Know SUGGESTED READINGS Glenohumeral Instability Michael J. Tuite ANATOMY Normal Variations BIOMECHANICS Anterior Instability P osterior Instability Multidirectional Instability Microinstability and Superior Labrum Anterior to Posterior Tears P osterosuperior Labral Tears P A THOLOGY Anterior P osterior Multidirectional Microinstability SLAP Tears P osterosuperior Labral Tears MANIFESTATIONS OF THE DISEASE Anterior Instability Radiography Conventional Magnetic Resonance Imaging versus Magnetic Resonance Arthrograph Magnetic Resonance Imaging Findings Multidetector Computed Tomography Arthroscopy P osterior Instability Radiography Magnetic Resonance Imaging Classic Signs Multidetector Computed Tomography Arthroscopy Multidirectional Instability Radiography Multidetector Computed Tomography Arthroscopy Classic Signs Microinstability Radiography Magnetic Resonance Imaging Superior Labrum Anterior to Posterior T ears Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Arthroscopy P osterosuperior Labral Tears and P aralabral Cysts Magnetic Resonance Imaging Multidetector Computed Tomography Arthroscopy F rom Supportive Diagnostic Techniques SYNOPSIS OF TREATMENT OPTIONS Medical Treatment Surgical Treatment Classic Sign What the Referring Physician Needs to Know SUGGESTED READINGS REFERENCES Normal Elbow Emad Yacoub, Javier Beltran, and Theodore T. Miller TECHNICAL ASPECTS Conventional Radiography 1, 2 Rationale and Indications Projections Computed Tomography (Fig. 10-2) Rationale and Indications CT Arthrography Indications A dvantages Disadvantages Conventional Magnetic Resonance Imaging (Fig. 10-3) Rationale and Indications A dvantages Limitations T echnical Aspects (Table 10-4) MR Arthrography (Fig. 10-4; Table 10-5) Rationale and Indications Indirect Arthrography Direct Arthrography Ultrasonography 4 Rationale and Indications A dvantages and Limitations T echnical Aspects NORMAL ANATOMY Bones Elbow Joint Ligaments Muscles Cubital Fossa Neurovascular Structures Normal Ultrasonographic Anatomy B ASIC BIOMECHANICS A cute Osseous Injury of the Elbow and Forearm Steven Shankman and Brandon Liu ANATOMY (INCLUDING GROSS ANATOMY AND NORMAL VARIANTS) F at Pads Normal Variants MANIFESTATIONS OF THE DISEASE Radiography Imaging Techniques Imaging Findings Radial Head/Neck Olecranon Dislocation Coronoid Process Distal Humerus Capitellum Monteggia Lesion Chronic Injury Magnetic Resonance Imaging Imaging Techniques Multidetector Computed Tomography Imaging Techniques SYNOPSIS OF TREATMENT OPTIONS Medical Radial Head and Neck Fracture Olecranon Fracture Elbow Dislocation Coronoid Fracture Distal Humeral Fracture Capitellum Fracture Monteggia Lesion SUGGESTED READINGS Soft Tissue Injury t o the Elbow Jenny T. Bencardino and Javier Beltran Lateral Epicondylitis Medial Epicondylitis K E Y P O I N T S Biceps Tendon Injuries T riceps Tendon Injuries Ligamentous Injuries and Elbow Instability Ulnar Collateral Ligament Complex Radial Collateral Ligament Complex Elbow Dislocation Entrapment Neuropathy BIOMECHANICS T endons Ligaments Ner v es P A THOLOGY Lateral Epicondylitis Medial Epicondylitis Biceps Tendon Injuries T riceps Tendon Injuries Elbow Instability MANIFESTATIONS OF THE DISEASE Lateral Epicondylitis Radiography Magnetic Resonance Imaging Ultrasonography Medial Epicondylitis Radiography Magnetic Resonance Imaging Ultrasonography Biceps Tendon Injuries Radiography Magnetic Resonance Imaging Nuclear Medicine T riceps Tendon Injuries Radiography Ultrasonography Elbow Instability Radiography Magnetic Resonance Imaging Ulnar Collateral Ligament Complex Radial Collateral Ligament Complex Ultrasonography SYNOPSIS OF TREATMENT OPTIONS Lateral Epicondylitis Medical Treatment Surgical Treatment Medial Epicondylitis Medical Treatment Biceps Tendon Injur y Medical Treatment T riceps Tendon Injur y Surgical Treatment Elbow Instability Medical Treatment SUGGESTED READINGS REFERENCES The Normal Wrist Punita Gupta and Louis A. Gilula THE NORMAL WRIST T echnical Aspects Conventional Radiography Fluoroscopy Fluoroscopic Arthrography Computed Tomography K E Y P O I N T T echnical Aspects Computed Tomographic Arthrography Rationale and Indications T echnical Aspects Magnetic Resonance Arthrography (Direct) Magnetic Resonance Imaging T echnical Aspects Magnetic Resonance Arthrography (Indirect—with I n t r a v e n o u s Infusio T echnical Aspects Ultrasonography NORMAL ANATOMY OF THE WRIST AND HAND Osseous Structures Carpal Bones Metacarpals Phalanges Synovial Compartments Joint Anatomy Metacarpophalangeal Joints Metacarpophalangeal Joint of the Thumb Metacarpophalangeal Joints of the Fingers Interphalangeal Joints Interphalangeal Joint of the Thumb Proximal Interphalangeal Joint Distal Interphalangeal Joint Carpal Ligaments Muscles and Tendons Extensor Tendons Flexor Tendons Lumbricals Interosseous Muscles Thenar Muscles Hypothenar Muscles Digital Extensor Hood Mechanism Extrinsic Digital Extensor Mechanism Intrinsic Digital Extensor Mechanism Intrinsic Muscles Extensor Mechanism of the Thumb Extrinsic Extensor Mechanism Intrinsic Extensor Mechanism Digital Flexor Tendon Sheath Flexor Tendon Sheath Fibro-osseous Tunnels Fibro-osseous Tunnels of the Fingers Fibro-osseous Tunnel of the Thumb The Distal Phalanges The Middle and Proximal Phalanges The Metacarpals The Short Hand Bones The Scaphoid PRACTICAL NORMAL VARIANTS Development The Long Hand Bones The Lunate The Triquetrum The Trapezium The Trapezoid The Capitate The Pisiform The Hamate The Distal Forearm Sesamoid Bones BIOMECHANICS W rist Motion Carpal Bone Motion A cute Osseous Injury t o the Wrist Nisha Rao, Peter Hrehorovich, and Manesh Mathew BIOMECHANICS Special Anatomic Considerations ANATOMY (INCLUDING GROSS ANATOMY AND NORMAL VARIANTS) K E Y P O I N T S Scapholunate Angle and the Capitolunate Angle V ariants IMAGING TECHNIQUES MANIFESTATIONS OF THE DISEASE Distal Radius/Ulna Carpal Fractures Dislocations SYNOPSIS OF TREATMENT OPTIONS Surgical Treatment Tr a p e z i u m a n d t r a p e z o i d f r a c t u r e s : Cast i m mobi Per i lunate i n st a bi l ity t reat ment : See references 1 1 and REFERENCES Internal Derangement o f the Wrist T ravis Snyder and Andrew Haims ANATOMY T riangular Fibrocartilage Complex V ascular Supply Central Disc or Triangular Fibrocartilage Dorsal and Volar Radioulnar Ligaments Ulnocarpal Ligaments Ulnar Collateral Ligament Complex Scapholunate Ligament Lunotriquetral Ligament Extrinsic Ligaments BIOMECHANICS Scapholunate Ligament Lunotriquetral Ligament Carpal Instability P A THOLOGY T riangular Fibrocartilage Complex Scapholunate Ligament Lunotriquetral Ligament Scapholunate Dissociation and Rotatory Subluxation of the Scaphoid Dorsif lexed Intercalated Segment Instability V olarf lexed Intercalated Segment Instability MANIFESTATIONS OF THE DISEASE Radiography Ulnar Impaction Syndrome Scapholunate Ligament W rist Arthrography Magnetic Resonance Imaging Class 1: Traumatic Lesions of the TFCC Class 2: Degenerative Lesions of the TFCC Articular Cartilage Evaluation Ulnar Impaction Syndrome Scapholunate Ligament Lunotriquetral Ligament DIFFERENTIAL DIAGNOSIS SYNOPSIS OF TREATMENT OPTIONS Ulnar Impaction Syndrome Scapholunate Ligament P artial Tears Complete Tears Lunotriquetral Ligament What the Referring Physician Needs to Know A cute Osseous Trauma t o the Hand Joshua Owen, Richard Oh, Peter Hrehorovich, and Manesh Mathew PREVALENCE, EPIDEMIOLOGY, AND DEFINITIONS P A THOLOGY R outine Imaging Additional Imaging MANIFESTATIONS OF THE DISEASE F ractures of the Thumb Radiography Bennett’s Fracture Rolando’s Fracture Ulnar Collateral Ligament Avulsion (Skier’s Thumb) Extra-articular Fractures of Thumb Second through Fifth Metacarpal F ractures Metacarpal Neck Fractures (Boxer’s Fracture) M e t a c a rpal Diaphyseal Fractures Intra-articular Basilar Fractures of Metacarpals T raumatic Injuries to the Proximal Phalanx T raumatic Injury to the Middle Phalanx Radiography V olar Base Fractures Dorsal Base Fractures Comminuted or “Pilon” Fractures of the Base T raumatic Injury to the Distal Phalanx Radiography Dorsal Base Fracture (Baseball or Mallet Finger) V olar Base Fractures Epiphyseal Fractures Dislocations Involving the Metacarpals Radiography Dislocations of the Interphalangeal Joints Radiography Proximal Interphalangeal Joint Distal Interphalangeal Joint SYNOPSIS OF TREATMENT OPTIONS Medical Treatment SUGGESTED READINGS REFERENCES Soft Tissue Injuries of the Hand and Wrist Luis Cerezal, Eva Llopis, Ana Canga, Faustino Abascal, and Alejandro Rolón ULNAR-SIDED IMPACTION SYNDROMES K E Y P O I N T S : U L N A R - S I D E D I M PAC T I O Ulnar Impingement Syndrome Prevalence, Epidemiology, and Definitions P athology Manifestations of the Disease Radiography Computed Tomography N u c l e a r Medicine Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Ulnar Styloid Impaction Syndrome Prevalence, Epidemiology, and Definitions Anatomy P athology Manifestations of the Disease Multidetector Computed Tomography N u c l e a r Medicine Magnetic Resonance Imaging Arthroscopy Differential Diagnosis Synopsis of Treatment Options Hamatolunate Impaction Syndrome Prevalence, Epidemiology, and Definitions Anatomy P athology Manifestations of the Disease Radiography Multidetector Computed Tomography N u c l e a r Medicine Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options What the Referring Physician Needs to Know: Ulnar-Sided Impaction Syndromes WRIST INSTABILIT Y Prevalence, Epidemiology, and Definitions P athology Classification Manifestations of the Disease Additional Views M e a s u r e m e n t of Carpal Bone Alignment Fluoroscopy S t r e s s Views Cineradiography or Fluoroscopy with Videotape Arthrography Multidetector Computed Tomography N u c l e a r Medicine Magnetic Resonance Imaging Magnetic Resonance Arthrography Arthroscopy Differential Diagnosis What the Referring Physician Needs to Know: Wrist Instability P athology Synopsis of Treatment Options LESIONS OF THE LIGAMENTS OF THE FINGERS Metacarpophalangeal Joint of the Thumb Prevalence, Epidemiology, and Definitions Manifestations of the Disease Radiography Ultrasonography Multidetector Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Basal Joint of the Thumb Prevalence, Epidemiology, and Definitions Anatomy P athology Manifestations of the Disease Radiography Magnetic Resonance Imaging Synopsis of Treatment Options Proximal Interphalangeal Joint Prevalence, Epidemiology, and Definitions P athology Manifestations of the Disease Multidetector Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options Metacarpophalangeal Joint Prevalence, Epidemiology, and Definitions K E Y P O I N T S : L I G A M E N T L E S I O N S Anatomy Manifestations of the Disease Radiography Magnetic Resonance Imaging Synopsis of Treatment Options EXTENSOR TENDON INJURIES Anatomy First Extensor Compartment (de Quer v ain’s Disease) Prevalence, Epidemiology, and Definitions Manifestations of the Disease Ultrasonography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Second Extensor Compartment (Intersection Syndrome) Prevalence, Epidemiology, and Definitions P athology Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Third Extensor Compartment Prevalence, Epidemiology, and Definitions Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging Synopsis of Treatment Options F ourth and Fifth Extensor Compartments: Lacerations Ultrasonography and Magnetic Resonance Imaging Synopsis of Treatment Options Mallet Finger Prevalence, Epidemiology, and Definitions Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging Synopsis of Treatment Options Boutonnière Deformity Prevalence, Epidemiology, and Definitions Manifestations of the Disease Magnetic Resonance Imaging Synopsis of Treatment Options Medical Treatment Surgical Treatment Metacarpophalangeal (Zone V) Subluxation or Dislocation Prevalence, Epidemiology, and Definitions Manifestations of the Disease Magnetic Resonance Imaging Synopsis of Treatment Options Sixth Extensor Compartment Prevalence, Epidemiology, and Definitions P athology Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging Synopsis of Treatment Options FLEXOR TENDON INJURIES Open Injuries Manifestations of the Disease Magnetic Resonance Imaging Synopsis of Treatment Options Closed Injuries Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging Synopsis of Treatment Options Digital Flexors Flexor Pollicis Longus Flexor Carpi Radialis Flexor Carpi Ulnaris Pulley System Injuries Prevalence, Epidemiology, and Definitions Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging K E Y P O I N T S : T E N D O N I N J U R I E S Synopsis of Treatment Options What the Referring Physician Needs to Know: T endon Injuries GANGLION CYST Prevalence, Epidemiology, and Definitions P athology Manifestations of the Disease Radiography Ultrasonography Magnetic Resonance Imaging Arthroscopy Differential Diagnosis Synopsis of Treatment Options F OREIGN BODIES Prevalence, Epidemiology, and Definitions P athology Manifestations of the Disease K E Y P O I N T S : G A N G L I O N C YS T Radiography Ultrasonography Multidetector Computed Tomography K E Y P O I N T S : FO R E I G N B O D I E S Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options What the Referring Physician Needs to Know: F oreign Bodies REFERENCES P elvis-Hip: Technical A spects, Normal Anatomy, Common Variants, and Basic Biomechanics Eva Llopis, Pilar Ferrêr, and Francisco Aparisi TECHNICAL ASPECTS T echniques and Relevant Aspects Conventional Radiography Measurements from an Anteroposterior View 1,2 Acetabular Measurements Femoral Head Proximal Head Multidetector Computed Tomography Rationale and Indications (Fig. 18-8) T echnical Aspects See Table 18 - 2. 3,4 Computed Tomographic Arthrography 6 Magnetic Resonance Imaging: Conventional P elvis Imaging Limitations Expensive T echnical Aspects Dedicated Hip Magnetic Resonance Imaging Rationale and Indications Advantages Measurements Indirect Magnetic Resonance Arthrography Limitations Direct Magnetic Resonance Arthrography Rationale and Indications Advantages Ultrasonography Advantages NORMAL ANATOMY Osseous Structures F emoral Head P elvis and Acetabulum Bone Marrow Cartilage Labrum Joint Capsule Ligaments Muscles and Tendons Anterior Quadrant Lateral Quadrant P osterior Quadrant Bursae Neurovascular Bundles COMMON VARIANTS Cystic Changes in the Femoral Neck, Herniation Pits Labral Signal Sublabral Sulcus V ariations of the Labrum T rabecular Bars Iliopsoas Bursa Communication Anterior Capsule Variants Os Acetabuli Otto Pelvis, Protrusio Acetabuli B ASIC BIOMECHANICS SUGGESTED READINGS A cute Osseous Injury to the P elvis and Acetabulum Eva Llopis, Victoria Higueras, Pilar Aparisi, José M. Mellado, and Francisco A PELVIC RING INJURIES Prevalence, Epidemiology, and Def initions Anatomy Biomechanics Imaging Techniques Radiography Anteroposterior Radiographs of the Pelvis Inlet Radiographs of the Pelvis Outlet Radiographs of the Pelvis Lateral Projection Ultrasonography Computed Tomography Angiography Manifestations of the Disease Anteroposterior Compression Injury Lateral Compression Injury V ertical Shear Injury Complex Injury Synopsis of Treatment Options K E Y P O I N T S : P E L V I C R I N G I N J U R I E S Provisional Stabilization Definitive Stabilization Anteroposterior Compression Injuries Lateral Compression Injuries A CETABULAR FRACTURES Prevalence, Epidemiology, and Def initions Anatomy Imaging Techniques Radiography P osterior Wall Fracture T r ansverse Fracture Anterior Column P osterior Column Anterior Wall Associated Fractures T r ansverse and Posterior Wall Fractures F r actures of Both Columns T -Shaped Fractures Anterior Wall or Anterior Column with T r ansverse Fracture P osterior Column and Posterior Wall Fracture Synopsis of Treatment Options K E Y P O I N T S : A C E T A B U L A R F R AC T U R E S BONE STRESS FRACTURES OF THE PELVIS Prevalence, Epidemiology, and Def initions Biomechanics and Pathology Manifestations of the Disease Radiography Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options A VULSION FRACTURES Prevalence, Epidemiology, and Def initions Anatomy Biomechanics Imaging Techniques Manifestations of the Disease Radiography A vulsion Fractures of the Ischial Tuberosity A vulsion Fractures of the Anterior-Inferior Iliac Spine A vulsion Fractures of the Anterior-Superior Iliac Spine A vulsion Fractures of the Pubic Bones A vulsion Fractures of the Iliac Crest Differential Diagnosis Surgical Treatment A cute Osseous Injury to the Hip and Proximal Femur José M. Mellado, Ana M. Hualde, Jorge Albareda, and Eva Llopis TRAUMATIC HIP DISLOCATIONS AND FEMORAL HEAD FRACTURES Prevalence, Epidemiolo Anatomy Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Computed Tomography Classic Signs: Hip Dislocation Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment SUBCHONDRAL INSUFFICIENCY FRACTURES OF THE FEMORAL HEAD Prevalence, Epidemio Anatomy Biomechanics P athology Manifestations of the Disease Magnetic Resonance Imaging Nuclear Medicine Classic Signs: Subchondral Insufficiency Fractures o f the Femoral Head Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment TRAUMATIC FRACTURES OF THE FEMORAL NECK Prevalence, Epidemiology, and Def i Anatomy Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Computed Tomography Nuclear Medicine Classic Signs: Traumatic Fractures of the Femoral Neck Differential Diagnosis K E Y P O I N T S : T R A U M A T I C F R A C T U R E Synopsis of Treatment Options Medical Treatment Surgical Treatment STRESS FRACTURES OF THE FEMORAL NECK Prevalence, Epidemiology, and Def initions Anatomy Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Differential Diagnosis Classic Signs: Stress Fractures of the Femoral Neck Synopsis of Treatment Options Medical Treatment Surgical Treatment ISOL A TED FRACTURES OF THE GREATER AND LESSER TROCHANTERS Prevalence, Epide Radiography Magnetic Resonance Imaging K E Y P O I N T S : S T R E S S F R A C T U R E S Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment INTERTROCHANTERIC FRACTURES Prevalence, Epidemiology, and Def initions K E Y P O I N T S : I S O L A T E D F R A C T U R E S O F T H E G R E A T E R A N D L E S S Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging K E Y P O I N T S : I N T E R T RO C H A N T E R I C F R AC T U R E Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Classic Signs: Intertrochanteric Fractures Surgical Treatment SUBTROCHANTERIC FRACTURES Prevalence, Epidemiology, and Def initions Biomechanics Manifestations of the Disease Radiography K E Y P O I N T S : S U B T R O C H A N T E R I C F Classic Signs: Subtrochanteric Fractures Synopsis of Treatment Options Medical Treatment Surgical Treatment SUGGESTED READINGS Internal Derangements o f the Hip and Proximal F emur (Including Intra- and Josef Kramer, Christian Czerny, Christian W. Pfirrmann, Sigfried Hofmann, and Anna Scheurecker ANATOMY OF THE HIP JOINT RADIOLOGIC METHODS Magnetic Resonance Arthrography of the Hip K E Y P O I N T S OSTEONECROSIS OF THE HIP Prevalence, Epidemiology, and Def initions P A THOLOGY Imaging Findings by Stage S tage 0 S tage I Radiography and Computed Tomography N u c l e a r Medicine Magnetic Resonance Imaging S tage II Radiography and Computed Tomography S tages III and IV Radiography and Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options N u c l e a r Medicine Magnetic Resonance Imaging LEGG-CALVÉ-PERTHES DISEASE Prevalence, Epidemiology, and Def initions P athology Imaging Findings by Catterall Classif ication Radiology Grade I Grade II Grade III Grade IV Magnetic Resonance Imaging TRANSIENT OSTEOPOROSIS OF THE HIP (BONE MARROW EDEMA SYNDROME) Prevalence, Epidemiology, and Def initions P athology Imaging Findings Radiography and Computed Tomography Nuclear Medicine Synopsis of Treatment Options BONE CONTUSION/MICROFRACTURES Prevalence, Epidemiology, and Def initions P athology Radiography and Computed Tomography Nuclear Medicine Magnetic Resonance Imaging STRESS/INSUFFICIENCY FRACTURES Prevalence, Epidemiology, and Def initions Imaging Findings LESIONS OF THE ACETABULAR L ABRUM Anatomy P athology Imaging Findings Radiography and Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options FEMOROACETABULAR IMPINGEMENT Prevalence, Epidemiology, and Def initions Biomechanics Imaging Findings Radiography Magnetic Resonance Imaging and Computed T omography Synopsis of Treatment Options SYNOVIAL OSTEOCHONDROMATOSIS Prevalence, Epidemiology, and Def initions Anatomy Computed Tomography Magnetic Resonance Imaging ILIOPSOAS BURSITIS Prevalence, Epidemiology, and Def initions Synopsis of Treatment Options SNAPPING (EXTERNAL) HIP Prevalence, Epidemiology, and Def initions Synopsis of Treatment Options SEPTIC ARTHRITIS RAPID DESTRUCTIVE HIP DISEASE REFERENCES Knee: Technical Aspects, Normal Anatomy, Common V ariants, and Basic Biomechanics Michel O. De Maeseneer and Maryam Shahabpour IMAGING TECHNIQUES T echnical Aspects Controversies NORMAL ANATOMY BIOMECHANICS A cute Osseous Injury t o the Knee Adam C. Zoga and David Karasick P A THOPHYSIOLOGY Anatomy P athology Radiographic Diagnosis of Fractures Radiographic Findings That Warrant A dditional Imaging Internal Derangement of the Knee: Meniscal Injuries Linda J. Probyn and Lawrence M. White NORMAL ANATOMY K E Y P O I N T S BIOMECHANICS Meniscal Function IMAGING TECHNIQUES MANIFESTATIONS OF THE DISEASE Magnetic Resonance Imaging Meniscal Tears Oblique or Horizontal Tears V ertical Longitudinal Tears and Bucket Handle Tears Radial and Parrot Beak Tears P eripheral Tears Meniscal Extrusion/Meniscal Root Tears Complex Tears S y m p t o m a t i c versus Asymptomatic Meniscal Tears Errors and Pitfalls of Interpretation Anterior Horn of the Lateral Meniscus Meniscal Flounce Meniscofemoral Ligament T r ansverse Meniscal Ligament P opliteus Tendon V olume Averaging Chondrocalcinosis Magic-Angle Phenomenon Computed Tomography Arthrography Ultrasonography Miscellaneous Meniscal Conditions Meniscal Cysts Meniscal Contusion Discoid Meniscus Meniscocapsular Separation Meniscal Ossicle SYNOPSIS OF TREATMENT OPTIONS Surgical Treatment P ostoperative Meniscus What the Referring Physician Needs to Know REFERENCES Internal Derangement of the Knee: Ligament Injuries Eugene G. McNally THE ANTERIOR CRUCIATE LIGAMENT Prevalence, Epidemiology, and Def initions Biomechanics P athology Manifestations of the Disease Radiography Magnetic Resonance Imaging Primary Signs Secondary Signs Bony Injuries Associated with Anterior Cruciate Ligament Rupture Soft Tissue Secondary Signs Secondary Signs due to Tibial Translation Computed Tomography Ultrasonography Nuclear Medicine Synopsis of Treatment Options Classic Signs THE POSTERIOR CRUCIATE LIGAMENT Prevalence, Epidemiology, and Def initions Anatomy Biomechanics P athology Manifestations of the Disease Radiography Magne