Dynamic MR imaging of the glenohumeral joint is possible over a wide range of physiologic motion in vertically open systems. Use of an MR tracking coil enabled accurate tracking of the anatomy of interest. These preliminary measurements of normal glenohumeral motion patterns begin to establish normal ranges of motion and constitute a necessary first step in characterizing pathologic motion in patients with common clinical problems such as instability and impingement.
A case of a progressive pathologic compression fracture of L2 due to polyostotic fibrous dysplasia is presented. Such unusually severe involvement, requiring decompression and surgical fusion, in the absence of significant recent or remote trauma, has not previously been reported.
Fig. 1. Anteroposterior radiograph of the proximal left femur shows lytic lesions (arrows), some with surrounding sclerosis, and mildly expansile cortical lesions in the subtrochanteric region medially (open arrow) Fig. 2A, B. Coronal Tl-weighted (A) and T2-weighted fat saturated (B) spin-echo magnetic resonance images, obtained 1 day after the radiographs, show extensive lesions in the marrow space of the subtrochanteric region and the femoral neck. The expansile lesions in the medial cortex are well seen (arrow), as are also linear and serpiginous lesions in the femoral neck, suggesting a vascular component Fig. 3. Anterior view 99myc bone scan of pelvis and proximal femora, obtained the same day as the radiographs, demonstrates no evidence of increased uptake at the lesions in the proximal left femur. There is slight asymmetry between left and right, which is attributed to patient positioning
Clinical informationA previously healthy 8-year-old girl was referred for evaluation of a lesion of the left femur. She had never complained of any symptoms, but for approximately the past 9 months her parents had noticed occasional left-sided limping of variable intensity. Soon after the limp presented, the patient had been brought to the hospital for examination. The patient could not localize any site of pain causing her limp, and radiographs of the foot and ankle were normal. Due to persistent symptoms, another radiographic examination of the left hip was carried out several months later and demonstrated a lytic lesion in the proximal femur (Fig: 1). The patient was referred to our medical center for further evaluation. On examination here, an antalgic gait was noted, as well as a mild decrease in circumference of both thigh and calf of the left leg. A 1-cm leg length discrepancy was noted, the left leg being shorter. All joints of the lower extremities had full and symmetric range of motion, and there was no evidence of pain or tenderness. A magnetic resonance (MR) examination of the proximal femora (Fig. 2) had recently been performed on a 1.5-T system, and a b o n e scan (Fig.
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