Indian Journal of Musculoskeletal Radiology

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Published by: Scientific Scholar (10.25259)
Total articles ≅ 27
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Catrin Wigley, Guy Morris, Scott Evans,
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 114-116; https://doi.org/10.25259/ijmsr_12_2019

Abstract:
Pretibial lesion can have a plethora of differential diagnosis. We report a case of extraosseous pretibial ganglion cyst which was referred to our orthopedic oncology service and described the imaging features.
, Rajesh Botchu, Harun Gupta
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 75-78; https://doi.org/10.25259/ijmsr_42_2019

Abstract:
The United Kingdom National Health Service (NHS) can provide numerous possibilities for clinical skills and professional development in musculoskeletal radiology to Indian radiologists. These training opportunities are incredibly flexible, and one can tailor them according to one’s needs. Such posts include short-term professional enhancement opportunities requiring no General Medical Council registration (GMC) or Fellowship of Royal College of Radiologists qualification. They include clinical observerships or attachments, commonwealth medical fellowships and Bracco Fellowships. In addition to former, long-term subspecialty training opportunities are also available, where GMC registration is an essential pre-requisite. Such posts include dedicated 1-year musculoskeletal radiology fellowships, global fellowships, and other NHS clinical service grades positions such as locum consultants, trust-grade, and staff and associate specialist grade positions. In this editorial, we shall provide a brief introduction about each of them to make Indian radiologists aware of their existence and, in turn, help to pursue one according to individual choice.
, Philip Robinson, Harun Gupta
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 82-87; https://doi.org/10.25259/ijmsr_40_2019

Abstract:
Aim: There is an increasing incidence of hip fracture with associated morbidity and mortality making accurate and timely diagnosis essential. The aim of this study was to compare computed tomography (CT) and magnetic resonance imaging (MRI) to ascertain the optimum second-line investigation in cases where plain radiograph is not diagnostic. Material and Methods: Using the radiology information system, a total of 168 patients were identified with the suspected occult neck of femur fractures over 24 months who had undergone CT or MRI as second-line investigation. All relevant imaging was reviewed and diagnosis, any third-line or follow-up imaging was documented. Results: About 16% of patients undergoing CT as second-line test had proven originally occult femoral neck fractures on plain radiograph compared with 13% of those having MRI. About 13% of patients underwent MRI following CT and in 1/13 case MRI detected an occult fracture that had not been detected on CT. The remaining 11 patients were either negative or MRI proved CT suspicions of fracture when extra diagnostic certainty was requested by the surgeons. CT detected more non femoral pelvic fractures 47% versus 37%. Conclusion: CT and MRI are comparable at detecting occult femoral neck fractures. Given the increased availability, improved patient tolerance and speed of CT imaging, we advocate its use as the main second-line imaging modality. MRI remains a valuable problem-solving tool in a select few cases following review with a musculoskeletal radiologist.
Amit Shah, Kethesparan Paramesparan,
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 101-107; https://doi.org/10.25259/ijmsr_36_2019

Abstract:
In the past decade, new clinical and imaging criteria have vastly improved the diagnosis and outcome of patients with seronegative spondyloarthritis (SpA). It is estimated that up to 30% of patients with SpA may exhibit predominant (or only) peripheral manifestations of SpA. Lack of awareness can lead to a diagnostic delay of up to 8–9 years which can lead to significant patient morbidity. It is, therefore, essential to diagnose and treat SpA as early as possible. The aim of this pictorial review is to emphasize the important aspects of current peripheral SpA classification system and demonstrates the imaging findings related to peripheral SpA. Patients referred for imaging of peripheral joints can be from a wide referral source. Recognizing and reporting imaging features suggestive of peripheral SpA will allow appropriate and timely specialist referral with the aim of avoiding treatment delay.
, Samar Chatterjee, U. Rajesh, Prateek, Vivek Khandelwal
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 127-130; https://doi.org/10.25259/ijmsr_34_2019

Abstract:
The infrapatellar fat pad of Hoffa is an intracapsular structure which is a common site for inflammatory processes. However, it can also be involved by neoplastic pathologies. We report a case of synovial hemangioma in this location which presented a diagnostic challenge due to unusual clinical presentation. The patient was managed with multiple sessions of ultrasound-guided injection sclerotherapy with partial resolution of the lesion.
Ankita Aggarwal, , Devasenathipathy Kandasamy
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 124-126; https://doi.org/10.25259/ijmsr_30_2019

Abstract:
Lipoblastoma is an uncommon fat-containing tumor of childhood having predilection for infants. Although it is benign in nature; even then, it can be locally aggressive. Clinical examination generally reveals painless, progressively increasing compressible swelling. Computed tomography or magnetic resonance imaging along with specific clinical history clinches the diagnosis. Imaging is of paramount importance as it helps in differentiating it from it’s close mimickers, which include lipoma, liposarcoma, rhabdomyosarcoma and teratoma. Early diagnosis with complete surgical resection is the management of choice.
Shruti Kumar, Mansi Verma, , Mahesh Prakash, Lokesh Singh
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 121-123; https://doi.org/10.25259/ijmsr_18_2019

Abstract:
Emphysematous osteomyelitis is defined as the presence of intraosseous gas associated with any infection which is a fatal condition if prompt diagnosis and treatment is not provided. It is commonly caused by anaerobes or the members of Enterobacteriaceae family. Here, we report two cases of emphysematous osteomyelitis with coexistent pyelonephritis.
Shamrendra Narayan, , Vikram Singh, Tushant Kumar, Mridu Singh, Vandana Tiwari, Nitin Dikshit, Arvind Singh
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 92-96; https://doi.org/10.25259/ijmsr_46_2019

Abstract:
Introduction: Inflammatory back pain (IBP) is a prominent clinical symptoms in patients with spondyloarthropathy (SpA) affecting young adults and is an important cause of morbidity in the productive age group. SpA characteristically involves sacroiliac joints (SIJs). For the diagnosis of early sacroiliitis, though magnetic resonance imaging (MRI) is the preferred method, conventional radiography has been routinely used for the evaluation of sacroiliitis. Active inflammation in SIJs cannot be assessed on radiographs and they usually appear normal in the early phase of IBP. This study aims to study the clinical and radiographic patterns of IBP in Indian scenario. Materials and Methods: Treatment naive patients with low back pain and subsequently diagnosed with IBP as per Calin criteria were identified. The clinical and laboratory parameters of these patients were recorded. SIJ radiographs of these patients were analyzed. Results: Fifty-two patients were registered with 57% of subjects being female. The mean age of onset of symptoms was 32–33 years with a mean duration of symptoms being 40.9 months. No significant difference was noted in the age of onset or duration of illness in males and females. Human leukocyte antigen-B27 (HLA-B27) positivity rate was only 8.7%. About 38.4% of cases demonstrated active inflammation at presentation. Most of the cases (94.2%) though presented for the first time had radiographic evidence of sacroiliitis. A maximum number of cases (38.4%) were seen in Grade 2, followed by Grade 3 (30.8%). Cases with symmetrical sacroiliitis were more (57.1%) as compared to asymmetrical/unilateral sacroiliitis. HLA-B27 positivity in symmetric cases was 10.9% as against 12.5% in asymmetric cases. Conclusions: There is often delay in the diagnosis of sacroiliitis. This is, in contrast, to profile in developed nations where early detection of the disease occurs ultimately leading to the usefulness of early therapy. Appropriate measures need to be taken in the health-care sector to increase awareness among people and treating physicians and sensitize them to IBP and its associated morbidities. In the present scenario, where the majority of cases are presenting in the chronic stage of the disease, radiography may be advocated in resource poor areas to decrease burden and cost related to the use of MRI.
Rishabh Jain, Shashank Raj, Gurpreet Singh Sandhu, , Mahesh Prakash
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 108-110; https://doi.org/10.25259/ijmsr_26_2019

Abstract:
Osteolipomas have been described as the presence of metaplastic bone within lipoma. They have been rarely described in spine, with the incidence of R). On imaging, she was diagnosed to have an extradural fat-containing osseous lesion in lumbar spine causing compression of traversing and exiting nerve roots resulting in clinical symptoms.
Aniket Jadhav, , Vikas Reddy, Robin Kuruvilla, Pranav Mahadeokar
Indian Journal of Musculoskeletal Radiology, Volume 1, pp 88-91; https://doi.org/10.25259/ijmsr_38_2019

Abstract:
Background: Moor et al. developed a critical shoulder angle (CSA) as a radiological parameter for the development of rotator cuff injury and degenerative changes of the glenohumeral joint. The objective of this study is to evaluate the association between CSA and the development of non-traumatic rotator cuff tears (RCTs) to further validate this study. Materials and Methods: The study was performed as an observational study dividing subjects into control and study groups, differing in the presence of non-traumatic RCT. The study group comprised 50 subjects with 40 subjects in the control group. All acceptable radiographs were evaluated, to measure the CSA in accordance with Moor et al. Results: The mean CSA of control subjects was 31.79° (± 1.89°), while that of study subjects were 37.85° (± 2.25°). The relative variability in the control group was about 6% and that in the study group was also 6%, indicating internal homogeneity of the study groups. Chi-square test applied to the distribution gave a P = 0.00001, representing an excellent association between the study groups and the CSA. Conclusion: There is a significant association between larger CSA and RCTs (P = 0.00001). Individual (quantitative) anatomical parameters may imply altered biomechanics, which are likely to induce RCTs, independent of trauma and degenerative glenohumeral joint disease.
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