The present CAD method using texture analysis to analyze the distribution/heterogeneity of SUV and CT values for malignant and benign bone and soft-tissue lesions improved the differential diagnosis on (18)F-FDG PET/CT images.

Study DesignProspective study.PurposeWe evaluated the usefulness of diffusion tensor imaging (DTI) in diagnosing patients with cervical myelopathy by determining the accuracy of normal DTI parameter values.Overview of LiteratureDTI can visualize white matter tracts in vivo and quantify anisotropy. DTI is known to be more sensitive than conventional magnetic resonance imaging (MRI) in detecting subtle pathological changes of the spinal cord.MethodsA total of 31 normal subjects (13 men and 18 women; age, 23-87 years; mean age, 46.0 years) were included in this study. The patients had no symptoms of myelopathy or radiculopathy. A Philips Achieva 3-Tesla MRI with SE-type Single Shot EPI was used to obtain diffusion tensor images. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured as DTI parameters on axial sections of several cervical levels. Subjects were divided into two groups: >40 years (n=16) and ≤40 years (n=15). A paired t-test was used to compare significant differences between the groups. ADC and FA values were most stable on axial sections.ResultsFor all subjects, mean ADC and FA values were 1.06±0.09×10-3 mm2/sec and 0.68±0.05, respectively. ADC was significantly higher in subjects >40 years of age than in those ≤40 years. There was no significant difference in FA values between the two groups. The mean ADC value was significantly higher in normal subjects >40 years of age than in those ≤40 years.ConclusionsIt is important to consider age when evaluating cervical myelopathy by DTI.

Therapeutic study-level III.

An osteochondral lesion in the knee joint is caused by a focal traumatic osteochondral defect, osteochondritis dissecans, an isolated degenerative lesion, or diffuse degenerative disease. An osteochondral lesion with a cleft-like appearance accompanying medial meniscus injury is rare without trauma. We report the case of a 13-year-old boy who complained of right knee pain and swelling, with radiographic findings of an osteochondral defect. Arthroscopic inspection showed an osteochondral lesion in the medial condyle of the femur and tibial plateau accompanying a partial medial meniscus discoid tear. Partial meniscectomy was performed, and a microfracture procedure was carried out on the osteochondral defect. The patient was asymptomatic at 2 years' follow-up. This technique is a relatively easy, completely arthroscopic procedure that spares the bone and cartilage and has yielded a good clinical outcome in a skeletally immature patient who had an osteochondral lesion with a cleft-like appearance.A rticular cartilage is vulnerable to traumatic injury and subsequent degeneration, which appears as a focal traumatic osteochondral defect, an osteochondritis dissecans lesion, or an early isolated degenerative lesion. We present the case of a patient with an osteochondral lesion with a cleft-like appearance accompanying a partial discoid medial meniscus tear. Our surgical technique facilitated anatomic restoration of the osteochondral lesion with a cleft-like appearance in an immature patient. CaseA 13-year-old boy had complained of right knee pain and swelling 2 years previously. His clinical history was negative for previous trauma. Pain was not accompanied by locking and catching symptoms, but it had gradually increased with participation in sports activities.A physical examination showed swelling, mild effusion, and medial joint line tenderness in the right knee. The range of motion was between 0 and 140 . Findings of the Watson-Jones and McMurray tests for the medial meniscus were positive. The results of the Lachman test, anterior and posterior drawer tests, and varus and valgus stress tests were normal. The patient had no patellofemoral symptoms.A plain radiograph showed the presence of a bone defect in the femoral medial condyle (Fig 1). Magnetic resonance imaging (MRI) showed a partial discoid medial meniscus tear, an osteochondral lesion (measuring 10 mm  28 mm) in the femoral medial condyle, and a chondral lesion in the tibial medial plateau on a T2-weighted gradient-echo image (Fig 2). There was no bone bruise in the femoral medial condyle or the tibial medial plateau. Surgical TechniqueA standard arthroscopic examination was performed through a routine anterolateral portal (Video 1). Arthroscopy showed a tear in the posterior third of the partial discoid medial meniscus, an osteochondral lesion in the femoral medial condyle, and a chondral lesion in the tibial medial plateau (Fig 3). The osteochondral defect of the femoral medial condyle and the chondral defect of the tibial medial plateau were fo...

No abstract