Radiology plays a crucial role in initial assessment and follow-up of cardiac conduction devices (CCDs). At least 1 million patients in the United States have permanent CCDs, which comprise pacemakers and implantable cardioverter-defibrillators. Chest radiography is unique because it is the only imaging modality that allows evaluation of the physical integrity of CCD leads. As a result, a basic knowledge of the normal and abnormal radiographic appearances of these devices and their various components is important. Radiologists should have a working knowledge of CCD anatomy as well as appropriate positioning and appearance of CCD leads and generators. Acute complications of CCD implantation include dysrhythmia, pneumothorax, perforation of the heart muscle or a vein, heart valve damage, lead damage, inadequate seating of the terminal connector pin, and presence of an air pocket. Chronic complications include twiddler syndrome, lead fracture, damage to the lead insulation, and lead displacement. Radiologists play an important role in management of patients with CCDs by providing vital information about the device, starting immediately after implantation and continuing throughout its duration in the patient. To fulfill this role, radiologists must have a firm understanding of CCDs and their evolving technology.
There is no association between testicular microlithiasis and testicular germ cell tumors. We had hoped to do a meta-analysis, but only two studies had a sufficient case control group of non-testicular microlithiasis patients.
Ischiofemoral impingement has been reported in a number of cases as an association between hip pain and quadratus femoris MRI signal abnormality, with concurrent narrowing of the ischiofemoral space. While the literature has included much emphasis on the imaging characteristics useful in the diagnosis of this entity, information on treatment has been scant, with few case reports of surgical resection of the lesser trochanter and incomplete descriptions of steroid injection techniques. We report a case of ultrasound- and CT-guided steroid injection into the ischiofemoral space via the proximal hamstring tendons in a 57-year-old female who had imaging and clinical characteristics of ischiofemoral impingement. The technique is described as a safe alternative to other possible injection techniques.
Background:Diagnosis of partial anterior cruciate ligament (ACL) tears is difficult on magnetic resonance imaging (MRI), particularly the isolated tears of the posterolateral bundle.Purpose:To describe 2 MRI signs of partial ACL tear involving the posterolateral bundle on conventional knee MRI sequences, specifically, the “gap” and “footprint” signs.Study Design:Case-control study.Methods:We retrospectively reviewed the MRI appearance of the ACL in 11 patients with arthroscopically proven partial ACL tears isolated to the posterolateral bundle, as well as in 10 patients with arthroscopically proven intact ACLs, and evaluated for the presence of gap and/or footprint signs.Results:There was high degree of sensitivity and specificity associated with the MRI findings of “gap” and “footprint” signs with arthroscopically proven isolated posterolateral bundle tears.Conclusion:Gap and footprint signs are suggestive of posterolateral bundle tear of the ACL, and the presence of 1 or both of these imaging findings should alert the radiologist to the possibility of a posterolateral bundle tear.
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