Musculoskeletal Imaging, 2nd Edition

Description

In its fully revised and updated second edition, Musculoskeletal Imaging covers every aspect of musculoskeletal radiology. This medical reference book incorporates the latest diagnostic modalities and interventional techniques, as well as must-read topics such as hip, groin and cartilage imaging; newly described impingements; and new concepts in the hip including teres ligament pathology. Accessibility in print, online and across portable devices makes Musculoskeletal Imaging a fully searchable and dependable source for both reading and reference. This publication is a key title in the popular Expert Radiology Series, which delivers evidence-based expert guidance from around the globe. "This is an excellent benchbook and accompanying electronic resource which will be of value to trainee radiologists and established consultants."  Reviewed by: Dr Steve Amerasekara, Consultant Radiologist on behalf of journal RAD Magazine, July 2015 "This outstanding text is now an acclaimed primary resource and therefore belongs in the libraries and at the work stations of all general and orthopedic hospital departments of radiology and, indeed, at any and all imaging facilities involved in musculoskeletal imaging." Foreword by: Lee F. Rogers,  June 2015 Fully understand each topic with a format that delivers essential background information.Streamline the decision-making process with integrated protocols, classic signs, and ACR guidelines, as well as a design that structures every chapter consistently to include pathophysiology, imaging techniques, imaging findings, differential diagnosis, and treatment options. Write the most comprehensive reports possible with help from boxes highlighting what the referring physician needs to know, as well as suggestions for treatment and future imaging studies.Access in-depth case studies, valuable appendices, and additional chapters covering all of the most important musculoskeletal procedures performed today.Quickly locate important information with a full-color design that includes color-coded tables and bulleted lists highlighting key concepts, as well as color artwork that lets you easily find critical anatomic views of diseases and injuries.Engage with more than 40 brand-new videos, including arthroscopic videos. Easily comprehend complicated material with over 5,000 images and new animations. Explore integrated clinical perspectives on the newest modalities such as PET-CT in cancer, diffusion MR, as well as ultrasonography, fusion imaging, multi-slice CT and nuclear medicine.Learn from team of international experts provides a variety of evidence-based guidance, including the pros and cons of each modality, to help you overcome difficult challenges.Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, references, and videos from the book on a variety of devices. Front cover Inside front cover Musculoskeletal Imaging Copyright page Contributors Foreword Preface to the First Edition Preface to the Second Edition Table of Contents Video Contents 1 General Imaging Principles Conventional Radiography Musculoskeletal ULTRASONOGRAPHY Computed Tomography Magnetic Resonance Imaging Coil Selection Imaging Sequence Selection Optimizing Signal-to-Noise Ratio MR Arthrography Artifacts Heterogeneous Fat Suppression Water Suppression Motion Artifact Blur Artifact Field Cutoff/Coil Malpositioning Magic Angle Phenomenon Magnetic Susceptibility Artifact Chemical Shift Artifact Nuclear Medicine in Musculoskeletal Imaging Summary ▶ Suggested Readings References 1 Injury One Axial Skeleton 2 General Principles of Osseous Injury Purpose of the Imaging Report Bone Types Geographic Anatomy of Long and Short Bones Types of Musculoskeletal Injuries Ligamentous Injuries (Selected Examples) Skeletal Injuries Skeletal Injury Fractures Fracture Healing Musculoskeletal Injuries Commonly Associated with Nonligamentous Soft Tissue Injury Spinal Injuries with Inherent Spinal Cord Injury Cervical Spine Thoracic and Lumbar Spine Spinal Injuries with Potential Spinal Cord Injury Cervical Spine Thoracolumbar Spine Bending Fractures Musculoskeletal Injuries with Associated Clinically Significant Ligamentous Component Shoulder Elbow Wrist Hand Pelvis Avulsion Injuries Knee Ankle Foot ▶ Suggested Readings References 3 Imaging of Facial and Skull Trauma Prevalence, Epidemiology, and Definitions Anatomy and Biomechanics Clinical Presentation Nasal Fractures Orbital Fractures Internal Orbital Fractures Orbital Rim Fractures Naso-Orbito-Ethmoid Fractures Zygomaticomaxillary Complex Fractures Le Fort Fractures Frontal Sinus Fractures Temporal Bone Fractures Skull Base Fractures Cranial Vault Fractures Mandibular Fractures Manifestations of the Disease Radiography Computed Tomography Magnetic Resonance Imaging Ultrasound Considerations in the Pediatric Population Differential Diagnosis ▶ Suggested Readings References 4 Cervical Spine Injuries Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Mechanisms of Injury Flexion Extension Rotation Shearing Imaging Techniques Indications for Imaging Radiography Flexion-Extension Radiographs Computed Tomography Magnetic Resonance Imaging Obtunded Patients Recommendations Imaging Findings Imaging Evaluation Computed Tomographic Evaluation Magnetic Resonance Imaging Evaluation Specific Cervical Spine Injuries C0-C1 Upper Cervical Spine Occipitoatlantal Dissociation Occipital Condyle Fractures C1 C1-C2 C2 Lower Cervical Spine Burst Fracture Flexion Teardrop Fracture Extension Teardrop Fracture Vertical Split Fracture Facet Dislocation Hyperflexion Sprain Hyperextension Dislocation Posterior Element Fractures Spinous Process Fractures Articular Pillar/Facet/Laminar/Transverse Process Fractures Whiplash Injuries SCIWORA and SCIMRA Associated Neurologic Injuries Stability versus Instability: Imaging Criteria Normal Variants Synopsis of Treatment Options ▶ Suggested Readings 5 Injury of the Thoracic Cage and Thoracolumbar Spine Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Imaging Rib Fractures Radiography Multidetector Computed Tomography Ultrasonography Magnetic Resonance Imaging Nuclear Medicine Sternal Fractures Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Ultrasonography Fractures to the Thoracic and Lumbar Spine Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options Medical Treatment Surgical Treatment Acknowledgments ▶ Suggested Readings References Two Appendicular Skeleton Upper Extremities 6 Normal Shoulder Imaging Modalities and Technical Aspects Normal Anatomy Osseous Structures Labrum Joint Capsule Ligaments Long Head of the Bicipital Tendon Rotator Cuff Deltoid Muscle Bursae Neurovascular Bundles Most Significant Normal Variants Shape of the Undersurface of the Acromion Os Acromiale Sublabral Foramen and Sublabral Recess Variations of the Glenohumeral Ligaments Anterior Capsular Insertion Insertion of the Long Head of the Biceps Tendon Basic Biomechanics Normal Biomechanics The Overhead Throwing Mechanism Joint Stability ▶ Suggested Readings References 7 Osseous Injuries of the Shoulder Girdle Prevalence, Epidemiology, and Definitions Manifestations of the Disease Acute Osseous Injuries of the Clavicle Radiography Acute Osseous Injuries of the Acromioclavicular Joint Radiography Magnetic Resonance Imaging and CT Acute Osseous Injuries of the Sternoclavicular Joint Radiography Multidetector Computed Tomography Acute Osseous Injuries of the Glenohumeral Joint Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Acute Osseous Injuries of the Scapula Radiography Multidetector Computed Tomography Acute Osseous Injuries of the Proximal Humerus Radiography Multidetector Computed Tomography ▶ Suggested Readings References 8 Shoulder Impingement Syndromes Prevalence, Epidemiology, and Definitions Definitions Classification Pathophysiology Anatomy Biomechanics Pathology Manifestations of the Disease Subacromial Impingement and Rotator Cuff Tears Radiography Magnetic Resonance Imaging Technical Aspects Rotator Cuff Tendinosis Full-Thickness Rotator Cuff Tears Partial-Thickness Rotator Cuff Tears Cystic Lesions Muscle Atrophy Acromial Morphology Pitfalls in Magnetic Resonance Imaging of the Rotator Cuff Multidetector Computed Tomography Ultrasonography Arthroscopy Subcoracoid Impingement and Subscapularis Tendon Tears Radiography Magnetic Resonance Imaging Ultrasonography Arthroscopy Internal (Posterosuperior) Impingement Magnetic Resonance Imaging Arthroscopy Anterosuperior Internal Impingement Arthroscopy Magnetic Resonance Imaging Anterior Internal Impingement Entrapment of the Long Head of the Biceps Tendon Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 9 Glenohumeral Instability Prevalence, Epidemiology, and Definitions Anatomy Normal Variations Biomechanics Anterior Instability Posterior Instability Multidirectional Instability Microinstability and Superior Labrum Anterior to Posterior Tears Posterosuperior Labral Tears Pathology Anterior Posterior Multidirectional Microinstability SLAP Tears Posterosuperior Labral Tears Manifestations of the Disease Anterior Instability Radiography Magnetic Resonance Imaging Conventional Magnetic Resonance Imaging versus Magnetic Resonance Arthrography Magnetic Resonance Imaging Findings Multidetector Computed Tomography Arthroscopy Posterior Instability Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Arthroscopy Multidirectional Instability Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Arthroscopy Microinstability Radiography Magnetic Resonance Imaging Superior Labrum Anterior to Posterior Tears Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Arthroscopy Posterosuperior Labral Tears and Paralabral Cysts Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Arthroscopy Biceps Pulley Mechanism Anatomy and Injuries Differential Diagnosis From Clinical Data From Supportive Diagnostic Techniques Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 10 Normal Elbow Introduction Conventional Radiography Computed Tomography Computed Tomographic Arthrography Magnetic Resonance Imaging MR Arthrography Ultrasonography Normal Anatomy Bones Elbow Joint Ligaments Muscles Cubital Fossa Neurovascular Structures Normal Ultrasonographic Anatomy Basic Biomechanics Acknowledgments ▶ Suggested Readings References 11 Acute Osseous Injury of the Elbow and Forearm Anatomy (Including Gross Anatomy and Normal Variants) Fat 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 References 12 Soft Tissue Injury to the Elbow Prevalence, Epidemiology, and Definitions Musculotendinous Injury Lateral Epicondylitis Medial Epicondylitis Biceps Tendon Injuries Triceps Tendon Injuries Ligamentous Injuries and Elbow Instability Ulnar Collateral Ligament Complex Radial Collateral Ligament Complex Elbow Dislocation Entrapment Neuropathy Biomechanics Tendons Ligaments Nerves Pathology Lateral Epicondylitis Medial Epicondylitis Biceps Tendon Injuries Triceps 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 Ultrasonography Nuclear Medicine Triceps Tendon Injuries Radiography Magnetic Resonance Imaging 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 Surgical Treatment Biceps Tendon Injury Medical Treatment Surgical Treatment Triceps Tendon Injury Surgical Treatment Platelet-Rich-Plasma Injections Elbow Instability Medical Treatment Surgical Treatment ▶ Suggested Readings References 13 Normal Wrist Normal Wrist Technical Aspects Conventional Radiography Rationale and Indications Fluoroscopy Advantages Limitations Fluoroscopic Arthrography Rationale and Indications Advantages Limitations Computed Tomography Rationale and Indications Advantages Disadvantages Technical Aspects Computed Tomographic Arthrography Rationale and Indications Magnetic Resonance Imaging Rationale and Indications Advantages Limitations Technical Aspects Magnetic Resonance Arthrography (Direct) Rationale and Indications Technical Aspects Advantages Limitations Magnetic Resonance Arthrography (Indirect— with Intravenous Infusion of Gadolinium) Rationale and Indications Technical Aspects Advantages Limitations Ultrasonography Rationale and Indications Advantages Disadvantages 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 Intrinsic Ligaments Extrinsic Ligaments and Triangular Fibrocartilage Complex 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 Practical Normal Variants Development The Long Hand Bones The Distal Phalanges The Middle and Proximal Phalanges The Metacarpals The Short Hand Bones The Scaphoid The Lunate The Triquetrum The Pisiform The Trapezium The Trapezoid The Capitate The Hamate The Distal Forearm Sesamoid Bones Biomechanics Wrist Motion Carpal Bone Motion ▶ Recommended Reading References 14 Acute Osseous Injury to the Wrist Prevalence, Epidemiology, and Definitions Anatomy (Including Gross Anatomy and Normal Variants) Biomechanics Special Anatomic Considerations Scapholunate Angle and the Capitolunate Angle Variants Imaging Techniques Manifestations of the Disease Distal Radius/Ulna Carpal Fractures Dislocations Synopsis of Treatment Options Surgical Treatment ▶ Suggested Readings References 15 Internal Derangement of the Wrist Introduction Triangular Fibrocartilage Complex Central Disk or Triangular Fibrocartilage Dorsal and Volar Radioulnar Ligaments Ulnocarpal Ligaments Ulnomeniscal Homologue (Ulnar Collateral Ligament Complex) Normal Anatomy Styloid Component Collateral Component Distal Insertion Radioulnar Component Biomechanics of the Triangular Fibrocartilage Complex Pathology Manifestations of the Disease The Palmer Classification Class 1: Traumatic Lesions of the TFCC class 1a lesions class 1b lesions class 1c lesions class 1d lesions Class 2: Degenerative Lesions of the TFCC ulnar impaction syndrome class 2a lesions class 2b lesions class 2c lesions class 2d lesions class 2e lesions Scapholunate Ligament Anatomy Biomechanics Pathology Scapholunate Dissociation and Rotatory Subluxation of the Scaphoid Manifestations of the Disease Magnetic Resonance Imaging Scapholunate Ligament Lunotriquetral Ligament Anatomy Biomechanics Pathology Magnetic Resonance Imaging Extrinsic Ligaments Dorsal Extrinsic Ligaments Dorsal Radiocarpal (Dorsal Radiolunotriquetral Ligament) Dorsal Intercarpal Ligament Volar Extrinsic Ligaments Radioscaphocapitate Volar Radiolunotriquetral Ligament Short Radiolunate Ligament Pathology of Extrinsic Ligaments Carpal Instability Pathology Dorsiflexed Intercalated Segment Instability Volarflexed Intercalated Segment Instability Articular Cartilage Evaluation ▶ Suggested Readings References 16 Acute Osseous Trauma to the Hand Prevalence, Epidemiology, and Definitions Pathology Routine Imaging Additional Imaging Manifestations of the Disease Fractures 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 Fractures Radiography Metacarpal Neck Fractures (Boxer’s Fracture) Metacarpal Diaphyseal Fractures Intraarticular Basilar Fractures of Metacarpals Traumatic Injuries to the Proximal Phalanx Radiography Traumatic Injury to the Middle Phalanx Radiography Volar Base Fractures Dorsal Base Fractures Comminuted or Pilon Fractures of the Base Traumatic Injury to the Distal Phalanx Radiography Dorsal Base Fracture (Baseball or Mallet Finger) Volar 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 Surgical Treatment ▶ Suggested Readings References 17 Compressive and Entrapment Neuropathies of the Upper Extremities Upper Extremity Shoulder Suprascapular Nerve Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Quadrilateral Space Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Elbow Pronator Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Anterior Interosseous Nerve Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Cubital Tunnel Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Radial Tunnel Syndrome—Posterior Interosseous Nerve Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Wrist Carpal Tunnel Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Ulnar Tunnel Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings Differential Diagnosis Superficial Radial Nerve Syndrome Etiology Clinical Findings Magnetic Resonance Imaging Findings ▶ Suggested Readings 18 Soft Tissue Injuries of the Hand and Wrist Ulnar-Sided Impaction Syndromes Ulnar Impingement Syndrome Prevalence, Epidemiology, and Definitions Pathology Manifestations of the Disease Radiography Nuclear Medicine Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Ulnar Styloid Impaction Syndrome Prevalence, Epidemiology, and Definitions Anatomy Pathology Manifestations of the Disease Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Arthroscopy Differential Diagnosis Synopsis of Treatment Options Hamatolunate Impaction Syndrome Prevalence, Epidemiology, and Definitions Anatomy Pathology Manifestations of the Disease Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Arthroscopy Differential Diagnosis Synopsis of Treatment Options Wrist Instability Prevalence, Epidemiology, and Definitions Anatomy Pathology Classification Manifestations of the Disease Radiography Additional Views Measurement of Carpal Bone Alignment Fluoroscopy Stress Views Cineradiography or Fluoroscopy with Videotape Arthrography Multidetector Computed Tomography Magnetic Resonance Imaging Magnetic Resonance Arthrography Arthroscopy Differential Diagnosis Synopsis of Treatment Options Lesions of the Ligaments of the Fingers Metacarpophalangeal Joint of the Thumb Prevalence, Epidemiology, and Definitions Anatomy Pathology Manifestations of the Disease Radiography Ultrasonography Multidetector Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Basal Joint of the Thumb Prevalence, Epidemiology, and Definitions Anatomy Pathology Manifestations of the Disease Radiography Magnetic Resonance Imaging Synopsis of Treatment Options Proximal Interphalangeal Joint Prevalence, Epidemiology, and Definitions Anatomy Pathology Manifestations of the Disease Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options Metacarpophalangeal Joint Prevalence, Epidemiology, and Definitions Anatomy Manifestations of the Disease Radiography Magnetic Resonance Imaging Synopsis of Treatment Options Extensor Tendon Injuries Anatomy First Extensor Compartment (de Quervain 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 Pathology 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 Fourth and Fifth Extensor Compartments: Lacerations Manifestations of the Disease Ultrasonography and Magnetic Resonance Imaging Synopsis of Treatment Options Mallet Finger Prevalence, Epidemiology, and Definitions Manifestations of the Disease Radiography 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 Pathology 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 Synopsis of Treatment Options Ganglion Cyst Prevalence, Epidemiology, and Definitions Pathology Manifestations of the Disease Radiography Ultrasonography Magnetic Resonance Imaging Arthroscopy Differential Diagnosis Synopsis of Treatment Options Foreign Bodies Prevalence, Epidemiology, and Definitions Pathology Manifestations of the Disease Radiography Ultrasonography Multidetector Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References Lower Extremities 19 Normal Pelvis and Hip Technical Aspects Techniques and Relevant Aspects Conventional Radiography Rationale and Indications Advantages Limitations Measurements from an Anteroposterior View Normal Pelvic Lines Acetabular Measurements Femoral Head Proximal Head Multidetector Computed Tomography Rationale and Indications Advantages Limitations Technical Aspects Measurements Computed Tomographic Arthrography Technical Aspects Magnetic Resonance Imaging: Conventional Pelvis Imaging Rationale and Indication Advantages Limitations Technical Aspects Dedicated Hip Magnetic Resonance Imaging Rationale and Indications Advantages Limitations Technical Aspects Measurements Indirect Magnetic Resonance Arthrography Rationale and Indications Technical Aspects Advantages Limitations Direct Magnetic Resonance Arthrography Rationale and Indications Technical Aspects Advantages Limitations Ultrasonography Rationale and Indications Advantages Limitations Technical Aspects Normal Anatomy Osseous Structures Femoral Head Pelvis and Acetabulum Bone Marrow Cartilage Labrum Variations of the Labrum Joint Capsule Ligaments Muscles and Tendons Anterior Quadrant Lateral Quadrant Posterior Quadrant Bursae Neurovascular Bundles Common Variants Cystic Changes in the Femoral Neck, Herniation Pits Labral Signal Sublabral Sulcus Variations of the Labrum Trabecular Bars Iliopsoas Bursa Communication Anterior Capsule Variants Os Acetabuli Otto Pelvis, Protrusio Acetabuli Basic Biomechanics ▶ Suggested Readings References 20 Acute Osseous Injury to the Pelvis and Acetabulum Pelvic Ring Injuries Prevalence, Epidemiology, and Definitions 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 Vertical Shear Injury Complex Injury Synopsis of Treatment Options Provisional Stabilization Definitive Stabilization Anteroposterior Compression Injuries Lateral Compression Injuries Acetabular Fractures Prevalence, Epidemiology, and Definitions Anatomy Imaging Techniques Radiography Manifestations of the Disease Elementary Fractures Posterior Wall Fracture Transverse Fracture Anterior Column Posterior Column Anterior Wall Associated Fractures Transverse and Posterior Wall Fractures Fractures of Both Columns T-Shaped Fractures Anterior Wall or Anterior Column with Transverse Fracture Posterior Column and Posterior Wall Fracture Synopsis of Treatment Options Bone Stress Fractures of the Pelvis Prevalence, Epidemiology, and Definitions Biomechanics and Pathology Manifestations of the Disease Radiography Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options Avulsion Fractures Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Imaging Techniques Manifestations of the Disease Radiography Avulsion Fractures of the Ischial Tuberosity Avulsion Fractures of the Anterior-Inferior Iliac Spine Avulsion Fractures of the Anterior-Superior Iliac Spine Avulsion Fractures of the Pubic Bones Avulsion Fractures of the Iliac Crest Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Selected Readings References 21 Athletic Pubalgia Pelvic Anatomy in Relation to Pubalgia Biomechanical Basis and Pathophysiology of Pubalgia Imaging Findings in Clinical Athletic Pubalgia ▶ Suggested Readings References 22 Acute Osseous Injury to the Hip and Proximal Femur Radiologic Anatomy of the Proximal Femur General Considerations Traumatic Hip Dislocations and Femoral Head Fractures Prevalence, Epidemiology, and Definitions Anatomy (Including Gross Anatomy and Normal Variants) Biomechanics Manifestations of the Disease Radiographic Imaging Techniques Imaging Findings Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis Clinical Diagnosis Radiologic Diagnosis Treatment Options Medical Surgical Subchondral Insufficiency Fractures of the Femoral Head Prevalence, Epidemiology, and Definitions Anatomy (Including Gross Anatomy and Normal Variants) Biomechanics Pathology Manifestations of the Disease Radiographic Imaging Findings Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis From Clinical Data From Diagnostic Techniques Treatment Options Medical Surgical Traumatic Fractures of the Femoral Neck Prevalence, Epidemiology, and Definitions Anatomy (Including Gross Anatomy and Normal Variants) Biomechanics Manifestations of the Disease Radiographic Imaging Techniques Imaging Findings Magnetic Resonance Imaging Computed Tomography Nuclear Medicine Differential Diagnosis From Clinical Data From Diagnostic Techniques Treatment Options Medical Surgical Stress Fractures of the Femoral Neck Prevalence, Epidemiology, and Definitions Anatomy (Including Gross Anatomy and Normal Variants) Biomechanics Manifestations of the Disease Radiographic Imaging Findings Magnetic Resonance Imaging Differential Diagnosis From Clinical Data From Diagnostic Techniques Treatment Options Medical Surgical Intertrochanteric Fractures Prevalence, Epidemiology, and Definitions Anatomy (Including Gross Anatomy and Normal Variants) Biomechanics Manifestations of the Disease Radiographic Imaging Techniques Imaging Findings Magnetic Resonance Imaging Computed Tomography Differential Diagnosis From Clinical Data From Diagnostic Techniques Treatment Options Medical Surgical Isolated Fractures of the Greater and Lesser Trochanters Prevalence, Epidemiology, and Definitions Manifestations of the Disease Radiographic Imaging Techniques Imaging Findings Magnetic Resonance Imaging Differential Diagnosis From Clinical Data Treatment Options Medical Surgical Subtrochanteric Fractures Prevalence, Epidemiology, and Definitions Biomechanics Manifestations of the Disease Radiographic Imaging Techniques Imaging Findings Treatment Options Medical Surgical Pathologic Fractures ▶ Suggested Readings References 23 Internal Derangement of the Hip and Proximal Femur Anatomy of the Hip Joint Radiologic Methods Magnetic Resonance Arthrography of the Hip Computed Tomography Arthrography of the Hip Osteonecrosis of the Hip Prevalence, Epidemiology, and Definitions Pathology Imaging Findings by Stage Stage 0 Stage I Radiography and Computed Tomography Nuclear Medicine Magnetic Resonance Imaging Stage II Radiography and Computed Tomography Nuclear Medicine Magnetic Resonance Imaging Stages III and IV Radiography and Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options Legg-Calvé-Perthes Disease Prevalence, Epidemiology, and Definitions Pathology Imaging Findings by Catterall Classification Radiology Grade I Grade II Grade III Grade IV Magnetic Resonance Imaging Transient Osteoporosis of the Hip (Bone Marrow Edema Syndrome) Prevalence, Epidemiology, and Definitions Pathology Imaging Findings Radiography and Computed Tomography Nuclear Medicine Magnetic Resonance Imaging Synopsis of Treatment Options Bone Contusion/Microfractures Prevalence, Epidemiology, and Definitions Pathology Imaging Findings Radiography and Computed Tomography Nuclear Medicine Magnetic Resonance Imaging Stress/Insufficiency Fractures Prevalence, Epidemiology, and Definitions Imaging Findings Magnetic Resonance Imaging Lesions of the Acetabular Labrum Anatomy Pathology Imaging Findings Radiography and Computed Tomography Magnetic Resonance Imaging Synopsis of Treatment Options Femoroacetabular Impingement (FAI) Prevalence, Epidemiology, and Definitions Biomechanics Cam Impingement Pincer Impingement Imaging Findings Radiography Magnetic Resonance Imaging and Computed Tomography Synopsis of Treatment Options Synovial Osteochondromatosis Prevalence, Epidemiology, and Definitions Anatomy Imaging Findings Radiography Computed Tomography Magnetic Resonance Imaging Iliopsoas Bursitis Prevalence, Epidemiology, and Definitions Synopsis of Treatment Options Snapping (External) Hip (Coxa Saltans) Prevalence, Epidemiology, and Definitions Synopsis of Treatment Options Septic Arthritis Rapidly Destructive Hip Disease (Postel’s Disease) ▶ Suggested Readings References 24 Normal Knee Imaging Techniques Technical Aspects Controversies Normal Anatomy Biomechanics ▶ Suggested Readings References 25 Acute Osseous Injury to the Knee Prevalence, Epidemiology, and Definitions Pathophysiology Anatomy Pathology Radiographic Diagnosis of Fractures Radiographic Findings That Warrant Additional Imaging ▶ Suggested Readings References 26 Internal Derangement of the Knee: Normal Anatomy Biomechanics Meniscal Function Imaging Techniques Manifestations of the Disease Magnetic Resonance Imaging Meniscal Tears Oblique or Horizontal Tears Vertical Longitudinal Tears and Bucket Handle Tears Radial and Parrot Beak Tears Peripheral Tears Meniscal Extrusion/Meniscal Root Tears Complex Tears Symptomatic versus Asymptomatic Meniscal Tears Errors and Pitfalls of Interpretation anterior horn of the lateral meniscus meniscal flounce meniscofemoral ligament transverse meniscal ligament popliteus tendon volume 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 Postoperative Meniscus ▶ Suggested Readings References 27 Internal Derangement of the Knee: Anterior Cruciate Ligament Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Pathology 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 The Posterior Cruciate Ligament Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Pathology Manifestations of the Disease Radiography Magnetic Resonance Imaging Computed Tomography Ultrasonography Other IntraArticular Ligaments Prevalence, Epidemiology, and Definitions Anatomy Intermeniscal Ligaments The Meniscofemoral Ligaments Miscellaneous Intraarticular Minor Ligaments Lateral Supporting Structures Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Pathology Manifestations of the Disease Magnetic Resonance Imaging Ultrasonography Medial Supporting Structures Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Pathology Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options ▶ Suggested Readings References 28 Internal Derangement of the Knee: The Extensor Apparatus Quadriceps Tendon Rupture Anatomy Prevalence Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options Patellar Tendinosis and Tear Anatomy Prevalence and Epidemiology Biomechanics Pathology Clinical Presentation Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Jumper’s Knee (Patellar Tendinitis) Prevalence Biomechanics Pathology Manifestations of the Disease Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options Osgood-Schlatter Disease, Sinding-Larsen-Johansson Syndrome, and Patellar Sleeve Avulsion Prevalence and Epidemiology Biomechanics Pathology Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Differential Diagnosis Patellar Tendon/Lateral Femoral Condyle Friction Syndrome Prevalence Biomechanics Manifestations of the Disease Magnetic Resonance Imaging Infrapatellar Fat Pad Impingement (Hoffa Disease) Anatomy Biomechanics Pathology Manifestations of the Disease Magnetic Resonance Imaging Differential Diagnosis Patellar Position and Maltracking Anatomy Prevalence Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Excessive Lateral Pressure Syndrome and the Patellofemoral Pain Syndrome Prevalence Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Patellar Dislocation Biomechanics Pathology Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Bipartite Patella and Dorsal Defect of the Patella Anatomy Prevalence Biomechanics Clinical Presentation Manifestations of the Disease Radiography Magnetic Resonance Imaging Synopsis of Treatment Options Iliotibial Band Anatomy Prevalence Biomechanics Manifestations of the Disease Magnetic Resonance Imaging Ultrasonography Popliteus and Biceps Femoris Muscles and Tendons (the Posterolateral Corner) Anatomy Prevalence Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Differential Diagnosis Synopsis of Treatment Options Hamstrings Anatomy Prevalence Biomechanics Pathology Manifestations of the Disease Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options Calf Anatomy Biomechanics Prevalence Pathology Manifestations of the Disease Magnetic Resonance Imaging Ultrasonography Differential Diagnosis Synopsis of Treatment Options Semimembranosus and Pes Anserinus Tendons (the Posteromedial Corner) Anatomy Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Bursae Anatomy Prevalence Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Ultrasonography Differential Diagnosis Synopsis of Treatment Options Plicae Anatomy Prevalence Biomechanics Manifestations of the Disease Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 29 Internal Derangement of the Knee: Prevalence, Epidemiology, and Definitions Traumatic Chondral or Osteochondral Lesions Osteochondritis Dissecans Subchondral Insufficiency Fractures Anatomy Biomechanics Reaction of Cartilage to Loading Reaction of Cartilage to Injury Manifestations of the Disease Traumatic Chondral or Osteochondral Lesions and Intraarticular Fractures Definition Grading of Cartilage Lesions Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Arthroscopy Osteochondritis Dissecans of the Knee Definition Grading of Osteochondritis Dissecans Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Arthroscopy Subchondral Insufficiency Fracture of the Knee Definition Grading of Subchondral Insufficiency Fractures Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Arthroscopy Differential Diagnosis From Clinical Data From Supportive Diagnostic Techniques Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 30 Normal Ankle and Foot Technical Aspects Conventional Radiography Indication Advantages Disadvantages Technical Aspects Computed Tomography Indications Advantages Disadvantages Magnetic Resonance Imaging Indications Advantages Disadvantages Technical Aspects Ultrasonography Indications Advantages Disadvantage Technical Aspects Normal Anatomy Talocrural Joint Medial Ankle Mortise Medial Collateral Ligament Complex Central Ankle Mortise and Joint Capsule Lateral Ankle Mortise Syndesmotic Ligament Complex Lateral Collateral Ligament Complex Talocalcaneal Joint Anterior Subtalar Joint Posterior Subtalar Joint Spring Ligament Complex Sinus Tarsi Talocalcaneonavicular Ligament Complex Calcaneocuboid Joint Chopart Joint Intertarsal Joints Tarsometatarsal Joints Lisfranc Ligament Lesser Digit Metatarsophalangeal Joints, Plantar Plates (Phalangeal Apparatus) Muscles, Tendons, and Retinacula Around the Ankle Medial Tendons Anterior Tendons Lateral Tendons Posterior Tendons Plantar Aponeurosis Muscles, Tendons, and Retinacula Around the Foot First Plantar Muscle Layer Second Plantar Muscle Layer Hallux Sesamoid Complex and Third Plantar Muscle Layer Fourth Plantar Muscle Layer Common Variant Anatomy Accessory Ossicles Posterior Intermalleolar Ligament Low-Lying Peroneus Brevis Muscle Peroneus Quartus Muscle Peroneus Calcaneus Internus Accessory Soleus Accessory Flexor Digitorum Longus Muscle Basic Biomechanics ▶ Suggested Readings 31 Acute Osseous Injury to the Ankle and Foot Overview Anatomy Ankle Hindfoot Talus Talar Neck Fractures Talar Body Fractures Lateral Process Fractures Posterior Process Fractures Comminuted Talar Body Fractures Talar Head Fractures Talar Dislocations Calcaneus Calcaneal Fracture-Dislocations Intraarticular Fractures Extra-articular Fractures Calcaneal Dislocations Midfoot Midfoot Fracture-Dislocations Navicular Fractures Cuboid Fractures Cuneiform Fractures Tarsometatarsal Fracture-Dislocations Forefoot Metatarsal Fractures Sesamoid Fractures Phalangeal Fractures Metatarsophalangeal and Interphalangeal Dislocations Biomechanics Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Differential Diagnosis From Clinical Data From Supportive Diagnostic Techniques Synopsis of Treatment Options Medical Treatment of Ankle Fractures Surgical Treatment of Ankle Fractures Treatment of Talar Fracture-Dislocations Calcaneal Fracture-Dislocations Midfoot Fracture-Dislocations Forefoot Fracture-Dislocations Complications of Fractures ▶ Suggested Readings References 32 Soft Tissue Injury to the Ankle: General Considerations Prevalence and Epidemiology Clinical Presentation Classification of Ligamentous Sprain Imaging Radiography Magnetic Resonance Imaging Ultrasonography Multidetector Computed Tomography Nuclear Medicine Differential Diagnosis Lateral Ligament Injury Prevalence and Epidemiology Anatomy Biomechanics Pathology Clinical Presentation Imaging Radiography Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options Nonsurgical Treatment Surgical Treatment Syndesmotic Sprain Prevalence and Epidemiology Anatomy Biomechanics Pathology Clinical Presentation Imaging Radiography Magnetic Resonance Imaging Ultrasonography Multidetector Computed Tomography Arthroscopy Synopsis of Treatment Options Nonsurgical Treatment Surgical Treatment Deltoid Ligament Injury Prevalence and Epidemiology Anatomy Biomechanics Pathology Clinical Presentation Classification Imaging Radiography Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options Nonsurgical Treatment Surgical Treatment Ligaments of the Sinus Tarsi Prevalence and Epidemiology Anatomy Biomechanics Pathology Clinical Presentation Imaging Radiography Magnetic Resonance Imaging The Ligaments Replacement of Normal Fat Signal in the Sinus Tarsi Associated Findings Ultrasonography Multidetector Computed Tomography Synopsis of Treatment Options Spring Ligament Prevalence and Epidemiology Anatomy Biomechanics Pathology Clinical Presentation Imaging Radiography Magnetic Resonance Imaging Ultrasound Synopsis of Treatment Options Lisfranc Ligament Complex Prevalence and Epidemiology Anatomy Biomechanics Pathology Clinical Presentation Imaging Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Synopsis of Treatment Options Nonsurgical Treatment Surgical Treatment ▶ Suggested Readings References 33 Soft Tissue Injury to the Ankle: Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Posterior Ankle Tendons (Achilles, Plantaris) Achilles Tendon Achilles Tendon Variants Plantaris Tendon Medial Ankle Tendons (Tibialis Posterior, Flexor Hallucis Longus, and Flexor Digitorum Longus) Tibialis Posterior Flexor Hallucis Longus Flexor Digitorum Longus Lateral Tendons (Peroneus Brevis and Peroneus Longus) Anatomic Variants of the Peroneal Tendons Anterior Ankle Tendons (Tibialis Anterior, Extensor Digitorum Longus, Peroneus Tertius, and Extensor Hallucis Longus) Tibialis Anterior Extensor Digitorum Longus and Peroneus Tertius Extensor Hallucis Longus Pathology Biomechanics Achilles Tendon Medial Tendons Lateral Tendons Anterior Tendons Imaging Techniques Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Tenography Manifestations of the Disease Anterior Tendons General Features Tibialis Anterior Radiography Magnetic Resonance Imaging Ultrasonography Medial Tendons General Features Tibialis Posterior Flexor Hallucis Longus Radiography Magnetic Resonance Imaging Tibialis Posterior Flexor Hallucis Longus Ultrasonography Lateral Tendons General Features Peroneal Tendons Radiography Magnetic Resonance Imaging Lateral Tendons Ultrasonography Posterior Tendons General Features Achilles Tendon Plantaris Tendon Radiography Magnetic Resonance Imaging Achilles Tendon Ultrasonography Differential Diagnosis Posterior Ankle Pain Heel Pain Lateral Ankle Pain Medial Ankle Pain Anterior Ankle Pain Synopsis of Treatment Options Medical Treatment Peroneus Brevis Tibialis Posterior Tendon Achilles Tendon Surgical Treatment Achilles Tendon Tibialis Posterior Tendon Peroneal Tendon ▶ Suggested Readings References 34 Soft Tissue Injury to the Ankle: Ankle Impingement Syndromes Anterolateral Impingement Syndrome Anatomy Pathology Clinical Presentation Imaging Radiography Ultrasonography Magnetic Resonance Imaging Computed Tomographic Arthrography and Magnetic Resonance Arthrography Differential Diagnosis Treatment Anterior Impingement Syndrome Pathology Clinical Presentation Imaging Radiography Ultrasonography Magnetic Resonance Imaging Computed Tomographic Arthrography and Magnetic Resonance Arthrography Treatment Medial Impingement Syndrome Anatomy Pathology Clinical Presentation Imaging Radiography Ultrasonography Magnetic Resonance Imaging Computed Tomographic Arthrography and Magnetic Resonance Arthrography Differential Diagnosis Treatment Posterior Impingement Syndrome Anatomy Pathology Clinical Presentation Imaging Radiography Ultrasonography Magnetic Resonance Imaging Computed Tomographic Arthrography and Magnetic Resonance Arthrography Differential Diagnosis Treatment Osteochondral Lesion of the Talus Pathology Clinical Presentation Imaging Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Computed Tomographic Arthrography and Magnetic Resonance Arthrography Treatment ▶ Suggested Readings References 35 Compressive and Entrapment Neuropathies of the Lower Extremity Lower Extremity Pelvis/Thigh Piriformis Syndrome Etiology Clinical Findings MRI Findings Ultrasound Findings Differential Diagnosis Iliacus Syndrome Etiology Clinical Findings MRI Findings Differential Diagnosis Saphenous Neuropathy Etiology Clinical Findings MRI Findings Differential Diagnosis Obturator Neuropathy Etiology Clinical Findings MRI Findings Lateral Femoral Cutaneous Neuropathy (Meralgia Paresthetica) Etiology Clinical Findings MRI Findings Ultrasound Findings Differential Diagnosis Knee Proximal Tibial Neuropathy Etiology Clinical Findings MRI Findings Differential Diagnosis Common Peroneal Neuropathy Etiology Clinical Findings MRI Findings Ultrasound Findings Differential Diagnosis Ankle/Foot Deep Peroneal Neuropathy Etiology of Anterior Tarsal Tunnel Syndrome Clinical Findings MRI Findings Differential Diagnosis Superficial Peroneal Neuropathy Etiology Clinical Findings MRI Findings Tarsal Tunnel Syndrome Etiology Clinical Findings MRI Findings Ultrasound Findings Differential Diagnosis Baxter’s Neuritis Etiology Clinical Findings MRI Findings Differential Diagnosis Jogger’s Foot Etiology Clinical Findings MRI Findings Sural Neuropathy Etiology Clinical Findings MRI Findings Forefoot Morton Neuroma Etiology Clinical Findings MRI Findings Ultrasound Findings Joplin’s Neuroma Etiology Clinical Findings MRI Findings ▶ Suggested Readings 36 Imaging of the Forefoot Imaging Techniques Painful Conditions of the First Metatarsophalangeal Joint Anatomic Considerations Disorders of the First Metatarsophalangeal Joint Hallux Valgus Hallux Rigidus Bunionette (Tailor’s Bunion) Sesamoiditis Turf Toe Painful Conditions of the Lesser Metatarsals Metatarsalgia Plantar Plate Anatomy Lesser Metatarsophalangeal Joint Instability, Plantar Plate Degeneration, and Rupture Summary ▶ Suggested Readings References Three Pediatric Injuries 37 Lower Extremity Injuries in Children Epidemiology and Background Anatomy and Biomechanics of the Developing Skeleton Physeal Fractures Acute Apophyseal Injuries Buckle and Bowing Fractures High-Energy Fractures Toddler’s Fracture Pathologic Fractures Slipped Capital Femoral Epiphysis Legg-Calve-Perthes Disease Knee Injuries Patellar Sleeve Fracture Osgood-Schlatter Disease Sinding-Larsen-Johansson Disease Patellar Tendinosis Transient Lateral Patellar Dislocation Patellofemoral Pain Syndrome Anterior Cruciate Ligament Tear in Children Osteochondral Defects and Osteochondritis Dissecans Blount Disease and Other Osteochondroses Stress Fractures Muscle Strain and Tear Accessory Ossicles ▶ Suggested Readings References 38 Upper Extremity Injuries in Children Prevalence, Epidemiology, and Definitions Anatomy Remodeling Biomechanics Pathology Manifestations of the Disease Injuries of the Clavicle Lateral Clavicular Physis and Acromioclavicular Joint Medial Clavicular Physis and Sternoclavicular Joint Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Scapular Fractures Radiography Computed Tomography Magnetic Resonance Imaging Injuries of the Glenohumeral Joint, Rotator Cuff, and Proximal Humerus Brachial Plexus Palsy Glenohumeral Dislocation Rotator Cuff Injuries Proximal Humeral Fractures Radiography Magnetic Resonance Imaging Computed Tomography Ultrasonography Injuries of the Elbow Supracondylar Fractures Lateral Condyle Fractures Medial Epicondyle Fractures Lateral Epicondyle Fractures Distal Humerus Transphyseal Fracture Separation Fractures of the Proximal Radius Olecranon Fractures Radial Head Subluxation Elbow Dislocation Sports Injuries Around the Elbow Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Injuries of the Forearm, Wrist, and Carpus Diaphyseal Injuries of the Radius and Ulna Monteggia Fracture-Dislocations Fractures of the Distal Forearm and Wrist Carpal Fractures Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Metacarpal and Phalangeal Fractures Metacarpal and Phalangeal Injuries Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography ▶ Suggested Readings References 39 Skeletal Manifestations of Pediatric Nonaccidental Injury Prevalence, Epidemiology, and Definitions Imaging Fracture Pattern Pathology Radiographic Evaluation Dating of Fractures Radiologic Findings Fractures of the Extremities Classic Metaphyseal Lesion/Fracture Diaphyseal Fractures Epiphyseal Injuries Extremity Fractures (Hand and Foot) Thoracic Trauma Rib Fractures Fractures of the Shoulder Girdle, Sternum, and Pelvis Spinal Fractures Craniofacial Fractures Differential Diagnosis Diseases Simulating Nonaccidental Injury Accidental Trauma Obstetric Injury Rickets Osteogenesis Imperfecta Osteomyelitis Other Diseases Normal Variants ▶ Suggested Readings References Four Other Musculoskeletal Injuries 40 Stress Injury Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Pathology Imaging of Stress Fractures Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Specific Anatomic Sites for Stress Injuries Femur Tibia Calcaneus Talus Tarsal Navicular Stress Fractures in the Metatarsal and Sesamoid Bones Other Sites of Lower Extremity Sacrum Pelvis Pars Interarticularis Stress Fracture (Spondylolysis) Upper Extremity Stress Injuries of the Physis Differential Diagnosis Synopsis of Treatment Options Medical Therapy Surgical Therapy Case Studies Appendix: Case Studies Case Study 1 History Findings Differential Diagnosis Diagnosis Commentary Case Study 2 History Findings Diagnosis Commentary Case Study 3 History Findings Diagnosis Commentary Case Study 4 History Findings Diagnosis Commentary Case Study 5 History Findings Diagnosis Commentary Case Study 6 History Findings Differential Diagnosis Diagnosis Commentary Case Study 7 History Findings Differential Diagnosis Diagnosis Commentary Case Study 8 History Findings Differential Diagnosis Diagnosis Commentary Case Study 9 History Findings Differential Diagnosis Diagnosis Commentary Case Study 10 History Findings Diagnosis Commentary References for Case Studies ▶ Suggested Readings References 41 Radiation Effects in the Musculoskeletal System* History and Radiation Sources Anatomy Pathology Manifestations of the Disease Beneficial Effects Side Effects in Soft Tissue Radiography Magnetic Resonance Imaging Non-Neoplastic Side Effects in Bone Radiography Magnetic Resonance Imaging Computed Tomography Tumor Induction in Bone or Soft Tissue Radiography Magnetic Resonance Imaging ▶ Suggested Readings References 42 Complications of Osseous Trauma Prevalence, Epidemiology, and Definitions Manifestations of the Disease Delayed Union, Pseudarthroses, or Nonunion of Fractures Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Malunion, Cartilage Damage, and Early Degenerative Changes Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Growth Disturbances Due to Physeal Injuries Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Posttraumatic Osteomyelitis Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Ultrasonography Nuclear Medicine Positron Emission Tomography Avascular Necrosis Radiography Multidetector Computed Tomography Magnetic Resonance Imaging Posttraumatic Osteoporosis and Osteolysis Sudeck Atrophy Refracture Posttraumatic Cysts and Pseudotumors Differential Diagnosis ▶ Suggested Readings References 43 Muscle Injury and Sequelae Prevalence, Epidemiology, and Definitions Anatomy Biomechanics Pathology Imaging Findings Muscle Trauma Intrinsic: Muscle Strain or Tear Magnetic Resonance Imaging Ultrasound Extrinsic: Contusion Magnetic Resonance Imaging Ultrasound Myositis Ossificans Radiographs Ultrasound Magnetic Resonance Imaging Computed Tomography Delayed-Onset Muscle Soreness Magnetic Resonance Imaging Ultrasound Muscle Herniation Ultrasound Magnetic Resonance Imaging Compartment Syndrome Magnetic Resonance Imaging Ultrasound Diabetic Muscle Infarction Magnetic Resonance Imaging Ultrasound Denervation Magnetic Resonance Imaging Ultrasound ▶ Suggested Readings References 44 Complex Regional Pain Syndrome Prevalence and Epidemiology Clinical Presentation Clinical Staging Pathophysiology Imaging Techniques and Diagnostic Testing Modified IASP (Budapest) Criteria Techniques and Relevant Aspects Diagnostic Testing Radiography Scintigraphy Single-Photon Emission Computed Tomography of the Brain Doppler Ultrasonography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 2 Arthropathies and Neurologic/Muscular Disorders and Connective Tissue Disease 45 Degenerative Disorders of the Spine Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Manifestations of the Disease Intervertebral Disk Degeneration Radiography Magnetic Resonance Imaging Discography Posterior Annular Tears Magnetic Resonance Imaging and Computed Tomographic Discography Herniation of the Nucleus Pulposus Radiography Computed Tomography Magnetic Resonance Imaging Vertebral End Plate Radiography Magnetic Resonance Imaging Osteoarthritis of the Facet Joints Radiography Computed Tomography Magnetic Resonance Imaging Pain Testing Cysts of the Intervertebral Facet Joints Computed Tomography Magnetic Resonance Imaging Degenerative Spondylolisthesis Radiography Magnetic Resonance Imaging Spinal Stenosis Radiography Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Correlation between Clinical and Imaging Findings Synopsis of Treatment Options ▶ Suggested Readings References 46 Aging What is Aging? Mechanisms of Aging The Aging Musculoskeletal System Within the Joint Organ as a Whole Age-Related Changes within Bone Age-Related Changes in Hyaline Cartilage Age-Related Changes in Skeletal Muscle Age-Related Changes in Ligaments and Tendons Other Age-Related Changes in the Spine Age-Related Changes in the Whole Joint Organ ▶ Suggested Readings References 47 Degenerative Disease: Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Cartilage Composition and Structure Pathology Cartilage Biomechanics Imaging Techniques Techniques and Relevant Aspects MR Imaging Biomarkers of OA and Cartilage Injury Clinical Evaluation of Articular Cartilage Injury Grade I Lesions Grade II Lesions Grade III Lesions Grade IV Lesions Bone Marrow Lesions Associated with Cartilage Injury Magnetic Resonance Imaging Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 48 Rheumatoid Arthritis Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques General Radiographic Observations Joint Swelling Subluxations Osteopenia Loss of Joint Space Erosions Osteolysis Osteitis Subchondral Cysts Osteonecrosis Selected Joints Hands and Feet Spine Manifestations of the Disease Extra-Articular Manifestations Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 49 Psoriatic Arthritis and Psoriatic Spondyloarthropathy Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Techniques and Relevant Aspects Early Changes Late Changes Pros and Cons Manifestations of the Disease Peripheral Skeleton General Radiographic Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasound Nuclear Medicine Positron Emission Tomography/Computed Tomography Axial Skeleton General Radiographic Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Positron Emission Tomography/Computed Tomography Anterior Chest Wall Disease General Radiographic Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis From Clinical Data From Supportive Diagnostic Techniques (Including Laboratory Results) Synopsis of Treatment Options Medical Surgical ▶ Suggested Readings References 50 Reactive Arthritis Etiology Prevalence and Epidemiology Clinical Presentation Musculoskeletal Manifestations Extra-articular Manifestations Natural History and Prognosis Pathology Imaging Techniques Manifestations of the Disease Spondylitis Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Sacroiliitis Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Erosive Arthritis and Proliferative New Bone Formation Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Enthesitis Radiography Magnetic Resonance Imaging Ultrasonography Dactylitis Radiography Magnetic Resonance Imaging Ultrasonography Differential Diagnosis Synopsis of Treatment Options Medical Treatment ▶ Suggested Readings References 51 Ankylosing Spondylitis Clinical Presentation Laboratory Findings Diagnosis Anatomy Imaging in Sacroiliitis Radiography Magnetic Resonance Imaging Interpretation of Sacroiliac Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Vertebral Manifestations Radiography Magnetic Resonance Imaging Nuclear Medicine Extravertebral Skeletal Manifestations Radiography Magnetic Resonance Imaging Computed Tomography Ultrasonography Nuclear Medicine Osteoporosis Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References Case Studies Case Study 1 Ankylosing Spondylitis: Early Diagnosis History Findings Differential Diagnosis Commentary Case Study 2 MRI: Sacral Pathology, Differential Diagnosis History Findings Differential Diagnosis Commentary Case Study 3 Vertebral Involvement in Ankylosing Spondylitis History Findings Commentary Case Study 4 Differential Diagnosis of Intervertebral Osteophytes History Findings Differential Diagnosis Commentary Case Study 5 Ankylosing Spondylitis and Scheuermann Disease History Findings Differential Diagnosis Commentary Case Study 6 Coxitis History Findings Differential Diagnosis Commentary Case Study 7 Coxitis: Differential Diagnosis History Findings Differential Diagnosis Commentary Case Study 8 Peripheral Arthritis History Findings Differential Diagnosis Commentary Case Study 9 Minor Trauma in Late-Stage Ankylosing Spondylitis History Findings Differential Diagnosis Commentary Case Study 10 Osteoporosis History Findings 52 Progressive Scleroderma Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Pathology Imaging Techniques Manifestations of the Disease Radiography Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 53 Systemic Lupus Erythematosus Etiology Epidemiology Clinical Presentation Musculoskeletal Manifestations of the Disease Joint Disease Avascular Necrosis Muscle Disease Radiography Avascular Necrosis Magnetic Resonance Imaging Ultrasonography Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options Medical Treatment ▶ Suggested Readings References Appendix Case Studies Case Study 1 History Findings Differential Diagnosis Diagnosis Commentary Case Study 2 History Findings Differential Diagnosis Diagnosis Commentary Case Study 3 History Findings Differential Diagnosis Diagnosis Commentary Case Study 4 History Findings Differential Diagnosis Diagnosis Commentary Case Study 5 History Findings Differential Diagnosis Diagnosis Commentary 54 Mixed Connective Tissue Disease Etiology, Epidemiology, and Prevalence Clinical Presentation and Manifestations of the Disease Classification Radiography Ultrasonography Magnetic Resonance Imaging Synopsis of Treatment Options Case Studies Case Study 1 History Findings Differential Diagnosis Diagnosis Commentary Case Study 2 History Findings Differential Diagnosis Diagnosis Commentary ▶ Suggested Readings References 55 Juvenile Idiopathic Arthritis Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Techniques and Relevant Aspects Manifestations of the Disease Appendicular Skeleton Involvement Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Manifestations of the Disease Axial Skeleton Involvement Radiography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 56 Idiopathic Inflammatory Myopathy Introduction Etiology Prevalence and Epidemiology Clinical Presentation Anatomy (Including Gross Anatomy and Normal Variants) Pathology (with Radiographic/Pathologic Correlations) Imaging Techniques Techniques and Relevant Aspects Pros and Cons Controversies Manifestations of the Disease Myositis General Magnetic Resonance Imaging Computed Tomography Ultrasound Magnetic Resonance Spectroscopy Nuclear Medicine Fasciitis General Magnetic Resonance Imaging Calcinosis General Radiography Magnetic Resonance Imaging Computed Tomography Differential Diagnosis From Clinical Data From Supportive Diagnostic Techniques (Including Laboratory Results) Synopsis of Treatment Options Medical Surgical Keywords ▶ Suggested Readings References 57 Hemochromatosis Etiology and Pathophysiology Prevalence and Epidemiology Stages of Hemochromatosis Clinical Presentation Diagnosis Musculoskeletal Manifestations of the Disease Magnetic Resonance Imaging Management of Hemochromatosis ▶ Suggested Readings References 58 Ochronosis Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Biomechanics Imaging Techniques Radiography Magnetic Resonance Imaging Arthroscopy Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 59 Diffuse Idiopathic Skeletal Hyperostosis and Ossification of the Posterior Longitudinal Ligament Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 60 Gout Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Manifestations of the Disease Temporal Progression of Findings Periarticular Erosions and Tophi Radiography Foot and Ankle Knee Hip Hand and Wrist Elbow Shoulder Spine and Sacroiliac Joints Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Arthroscopy Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Acknowledgments ▶ Suggested Readings References 61 Crystal-Related Arthritis Calcium Pyrophosphate Dihydrate Deposition Etiology Prevalence and Epidemiology Clinical Presentation Pathology Manifestations of the Disease Radiography Articular and Periarticular Calcification—Chondrocalcinosis Structural Changes in Joints—Pyrophosphate Arthropathy Other Radiologic Findings Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Synopsis of Treatment Options Hydroxyapatite and Basic Calcium Phosphate Etiology Prevalence and Epidemiology Clinical Presentation Pathology Manifestations of the Disease Radiography Calcification in Ligaments and Tendons Episodes of Acute Transient Synovitis Calcification due to Hydroxyapatite in Soft Tissues Other Than Joints Rapidly Progressive Osteoarthritis Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Differential Diagnosis Cholesterol Corticosteroids Calcium Oxalate (Oxalosis) Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 62 Neuropathic Osteoarthropathy Etiology Prevalence and Epidemiology Clinical Presentation Diabetic Pedal Neuropathy Pathophysiology Anatomy Pathology Biomechanics Imaging Techniques Techniques and Relevant Aspects Controversies Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 3 Infection 63 Noninflammatory Intraarticular Pathology Pigmented Villonodular Synovitis Introduction Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Manifestations of the Disease Joint Effusion Radiographic MRI Bone Erosions Radiographic Synopsis of Treatment Options Medical Surgical Synovial Osteochondromatosis Introduction Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Manifestations of the Disease Loose Bodies Radiographic Computed Tomography MRI Synopsis of Treatment Options Surgical ▶ Suggested Reading References 64 Soft Tissue Infection: Etiology Prevalence and Epidemiology Clinical Presentation Pathology Manifestations of the Disease Soft Tissue Swelling with Erythema Unexplained Pain with or without Fever Cellulitis Abscess Impetigo Acute Septic Arthritis Chronic Septic Arthritis Pyomyositis Necrotizing Fasciitis Tuberculosis Fungal Infections Imaging Techniques Ultrasonography Magnetic Resonance Imaging Image-Guided Biopsy Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings 65 Appendicular Infection Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Biomechanics Imaging Techniques Techniques and Relevant Aspects Pro and Cons (Table 65-1) Controversies Manifestations of the Disease Radiography Magnetic Resonance Imaging Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography Specific Infections SAPHO Lyme Arthritis Tuberculosis Chronic Recurrent Multifocal Osteomyelitis Differential Diagnosis (Table 65-2) ▶ Suggested Readings References 66 Spinal Infection SPINAL INFECTION Etiology Prevalence and Epidemiology Polymicrobial Spondylodiskitis Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Techniques and Relevant Aspects Radiography Computed Tomography Ultrasound Nuclear Medicine and Positron Emission Tomography–Computed Tomography Magnetic Resonance Imaging Diffusion-Weighted Imaging Pros and Cons Controversies Manifestations of the Disease Mycobacterium Tuberculosis General Radiographic Magnetic Resonance Imaging Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography–Computed Tomography Pyogenic Infection General Staphylococcus aureus Pseudomonas aeruginosa Salmonella Proteus Brucellosis Actinomyces Nocardiosis Syphilis Radiographic Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography–Computed Tomography Parasitic and Fungal Infection General Hydatid Disease Fungal Infections Aspergillus Blastomycosis Candida Coccidioidomycosis Cryptococcus radiographic magnetic resonance imaging multidetector computed tomography ultrasonography nuclear medicine positron emission tomography–computed tomography Differential Diagnosis From Clinical Data Imaging Collapsed Vertebral Body Single Vertebral Body Edema Disk and End-Plate Changes Destructive Soft Tissue Mass Synopsis of Treatment Options Medical Surgical ▶ Suggested Readings References 67 Diabetic Pedal Infection Introduction Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Vascular Disease Neuropathy Anatomy Imaging Manifestations Pros and Cons of Each Modality Controversies Radiography Magnetic Resonance Imaging Devitalization Evaluation of Extent of Involvement Computed Tomography Ultrasonography Nuclear Medicine Three-Phase Bone Scintigraphy Labeled White Blood Cell Scan Gallium Scanning Positron Emission Tomography and Cross-Sectional Imaging Differential Diagnosis Neuropathic Osteoarthropathy Gout and Other Inflammatory Arthropathies Synopsis of Treatment Options Medical Therapy Surgical Treatment ▶ Suggested Readings References 68 Pediatric Infections Introduction Manifestations of Disease Cellulitis Pyomyositis Necrotizing Fasciitis Osteomyelitis Acute Osteomyelitis Subacute and Chronic Osteomyelitis Chronic Recurrent Multifocal Osteomyelitis Orthopedic Complications of Meningococcal Septicemia Septic Arthritis Vertebral Osteomyelitis and Diskitis Congenital Infection ▶ Suggested Readings References 69 HIV Infection and AIDS Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Techniques and Relevant Aspects Radiography Cross-Sectional Imaging Nuclear Scintigraphy Positron Emission Tomography Ultrasonography Pros and Cons Controversies Manifestations of the Disease Musculoskeletal Infection Abscesses, Bursitis, Tenosynovitis Necrotizing Fasciitis Pyomyositis Septic Arthritis Osteomyelitis (Nontuberculous) Tuberculous Osteomyelitis, Spondylitis, Spondylodiskitis Related Inflammatory Conditions: Arthritides, Polymyopathies Psoriatic Arthritis Reactive Arthritis Acute Symmetric Polyarthritis Nonspecific Arthralgias Inflammatory Conditions of Muscle Related Musculoskeletal Neoplasms Musculoskeletal Complications of Antiretroviral Therapy Miscellaneous Musculoskeletal Manifestations Avascular Necrosis (Osteonecrosis) Osteopenia and Osteoporosis Hypertrophic Osteoarthropathy Myositis Ossificans Circumscripta Synopsis of Treatment Options Acknowledgment ▶ Suggested Readings References 70 Atypical Mycobacterial Infection Mycobacterial Infection Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Brucellosis Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Reading Cat-Scratch Disease Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Fungal and Higher Bacterial Infections Etiology, Pathophysiology, Prevalence and Epidemiology, Clinical Presentation, Pathology, and Differential Diagnosis Coccidioidomycosis North American Blastomycosis South American Blastomycosis Cryptococcosis Sporotrichosis Histoplasmosis Aspergillosis Candidiasis Mucormycosis Maduromycosis Actinomycosis Nocardiosis Manifestations of the Disease Radiography Coccidioidomycosis North American Blastomycosis Cryptococcosis Sporotrichosis Histoplasmosis Aspergillosis Candidiasis Mucormycosis Maduromycosis Actinomycosis Nocardiosis Magnetic Resonance Imaging Coccidioidomycosis North American Blastomycosis Cryptococcosis Sporotrichosis Histoplasmosis Aspergillosis Candidiasis Mucormycosis Maduromycosis Actinomycosis Nocardiosis Multidetector Computed Tomography Coccidioidomycosis North American Blastomycosis Cryptococcosis Sporotrichosis Histoplasmosis Aspergillosis Candidiasis Mucormycosis Maduromycosis Actinomycosis Nocardiosis Ultrasonography Nuclear Medicine Coccidioidomycosis North American Blastomycosis Cryptococcosis Sporotrichosis Histoplasmosis Aspergillosis Candidiasis Mucormycosis Maduromycosis Actinomycosis Nocardiosis Positron Emission Tomography/Computed Tomography Synopsis of Treatment Options Medical Treatment Coccidioidomycosis Blastomycosis Cryptococcosis Sporotrichosis Histoplasmosis Aspergillosis Candidiasis Mucormycosis Maduromycosis Actinomycosis Nocardiosis ▶ Suggested Reading Hydatid Disease (Echinococcosis) Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Leprosy Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Reading Lyme Disease Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Melioidosis Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Pathology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Surgical ▶ Suggested Reading Syphilis Etiology Prevalence and Epidemiology Pathophysiology Congenital Syphilis Acquired Syphilis Manifestations of the Disease Radiography Early Congenital Syphilis osteochondritis. osteitis (diaphyseal osteomyelitis). periostitis. miscellaneous findings. late congenital syphilis. clutton joints. Secondary Syphilis Tertiary Syphilis Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Reading Tuberculosis Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Manifestations of the Disease Imaging Techniques Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References Mycobacterial Infection Brucellosis Cat Scratch Disease Fungal and Higher Bacterial Infections Hyatid Disease Leprosy Lyme Disease Melioidosis Syphilis Tuberculosis 4 Hematologic and Vascular Diseases 71 General Principles of MRI of the Bone Marrow ABSTRACT Anatomy and Physiology of Normal Bone Marrow Magnetic Resonance Imaging Techniques T1-Weighted Spin-Echo Sequence Intermediate-Weighted Spin-Echo Sequence T2-Weighted Fast Spin-Echo Sequence Fat-Saturated Spin-Echo Sequences Gradient-Echo Sequences Gadolinium-Enhanced Sequences Whole-Body Diffusion-Weighted Imaging F-18 FDG-PET (PET and PET/CT) Other Sequences Normal Anatomy Magnetic Resonance Appearance of the Normal Marrow Magnetic Resonance Imaging Patterns of Marrow Lesions Marrow Depletion Marrow Infiltration Marrow Replacement What the Radiologist Needs to Know How Can the Sensitivity of Bone Marrow Magnetic Resonance Imaging Be Increased? How Can the Specificity of Bone Marrow Magnetic Resonance Imaging Be Increased? How Can Better Fat Suppression Be Achieved? Is This a Normal Variant? Vertebral Marrow Heterogeneities in Elderly Patients Islands of Fatty Marrow Vertebral Hemangioma Enostosis Islands of Red Marrow Hematopoietic Marrow Hyperplasia ▶ Suggested Readings References 72 Ischemic Bone Lesions ABSTRACT Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Histopathology Diagnosis of Osteonecrosis Imaging Features/Manifestations of the Disease Systemic Osteonecrosis Radiographs Magnetic Resonance Imaging Posttraumatic Osteonecrosis Radiographs MR Imaging Spontaneous Osteonecrosis Radiographs MR Imaging Staging of Osteonecrosis Differential Diagnosis Systemic Osteonecrosis Spontaneous Osteonecrosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Summary of Imaging Findings of Ischemic Bone Lesions References 73 Hemophilia and Related Disorders Abstract Acute Hemarthrosis Recurrent Hemarthrosis Hyperemia Synovial Hypertrophy Hemosiderin Deposition Articular Surface Damage Acute Soft Tissue Hemorrhage Chronic Mass Lesion/Pseudotumor Etiology Prevalence and Epidemiology Clinical Presentation Acute Hemarthrosis Recurrent Hemarthrosis Chronic Joint Pain and Dysfunction Acute Soft Tissue Hemorrhage Recurrent Soft Tissue Hemorrhage Chronic Mass Lesion/Pseudotumor Life-Threatening Blood Loss Fracture Pathophysiology Manifestations of the Disease Acute Hemarthrosis Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Chronic Joint Changes Radiography Hyperemia Synovial Hypertrophy Hemosiderin Deposition Articular Surface Damage Intraosseous Cyst Formation Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Acute Soft Tissue Changes Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Chronic Soft Tissue Changes Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Recurrent Hemorrhage Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Pseudotumor Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 74 Sickle Cell Anemia Abstract Etiology Prevalence and Epidemiology Clinical Presentation Imaging Techniques Manifestations of the Disease Bone Marrow Changes (Marrow Hyperplasia) Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Vascular Occlusion Sickle Cell Dactylitis (Hand-Foot Syndrome, Aseptic Dactylitis) Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Manifestations of the Disease Miscellaneous Findings Infarction Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Infection (Osteomyelitis and Septic Arthritis) Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Reading References 75 Thalassemia Abstract Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology and Imaging Bone Disease in Untreated or Undertreated Thalassemia Major Patients Skull Thorax Spine Tubular Bones Bone and Joint Disease after Optimal Transfusion and Iron Chelation Osteoporosis: Bone Mineral Densitometry Bone Marrow and Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 76 Myelofibrosis Abstract Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Treatment Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Techniques and Relevant Aspects Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Dual-Energy X-Ray Absorptiometry Differential Diagnosis Synopsis of Prognosis and Treatment Options Prognosis Medical Treatment Surgical Treatment ▶ Suggested Readings References 5 Metabolic, Hormonal, and Systemic Disease 77 Osteoporosis Etiology Bone Turnover Generalized Osteoporosis Primary Osteoporosis Osteogenesis Imperfecta Secondary Osteoporosis Regional Osteopenia Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Regional Osteoporosis Generalized Osteoporosis Imaging Techniques Radiographic Morphometry Bone Densitometry Dual-Energy X-ray Absorptiometry Quantitative Computed Tomography Radiation Dose in Bone Densitometry Other Research Methods Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Useful Websites with Useful Educational and Guideline Material: References 78 Hyperparathyroidism, Renal Osteodystrophy, Osteomalacia, and Rickets Abstract Hyperparathyroidism Renal Osteodystrophy Rickets and Osteomalacia Hyperparathyroidism Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Radiography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Renal Osteodystrophy Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Manifestations of the Disease Soft Tissue Calcification In Children Osteoarticular Manifestations and Chronic Dialysis Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment Rickets and Osteomalacia Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 79 Amyloidosis Abstract Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 80 Pituitary and Thyroid Disorders Abstract Acromegaly and Pituitary Gigantism Hypopituitarism Hyperthyroidism Hypothyroidism Acromegaly and Pituitary Gigantism Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Techniques and Relevant Aspects Pros and Cons Manifestations of the Disease Radiography Soft Tissue Skull Hand Foot Spine Peripheral Joints Bony Excrescences Bone Mineral Density Differential Diagnosis Acromegaly Pituitary Gigantism Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Hypopituitarism Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Techniques and Relevant Aspects Pros and Cons Manifestations of the Disease Radiography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Hyperthyroidism Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Manifestations of the Disease Radiography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings Hypothyroidism Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References for Acromegaly and Pituitary Gigantism References for Hypopituitarism References for Hyperthyroidism References for Hypothyroidism 81 Gaucher Disease* Abstract Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Nonskeletal Skeletal Features Pathology Imaging Techniques Techniques and Relevant Aspects Pros and Cons Manifestations of the Disease Radiography Bone Densitometry Magnetic Resonance Imaging Computed Tomography Ultrasonography Nuclear Medicine Synopsis of Treatment Options Medical Treatment Enzyme Replacement Therapy Enzyme Replacement Therapy in Children Monitoring the Effects of Treatment Costs Substrate Reduction Therapy Surgical Treatment ▶ Suggested Readings References 82 Storage Diseases Abstract Etiology Mucopolysaccharidoses Glycogenoses Prevalence and Epidemiology Clinical Presentation Mucopolysaccharidoses Hurler Syndrome (MPS I H) Scheie Syndrome (MPS I S) Hurler-Scheie Syndrome (MPS I H/S) Hunter Syndrome (MPS II) Sanfilippo Syndrome (MPS III) Morquio Syndrome (MPS IV) Maroteaux-Lamy Syndrome (MPS VI) Sly Syndrome (MPS VII) Natowicz Syndrome (MPS IX) Glycogenoses von Gierke Disease (GSD I) Pompe Disease (GSD II) Forbes-Cori Disease (GSD III) Andersen Disease (GSD IV) McArdle Disease (GSD V) Hers Disease (GSD VI) Tarui Disease (GSD VII) GSD IX Pathophysiology Manifestations of the Disease: Mucopolysaccharidoses Radiography Hurler Syndrome (MPS I H) Skull Chest Spine Pelvis Hand Long Bones The Other Mucopolysaccharidoses (Except Morquio Syndrome) Morquio Syndrome (MPS IV) Magnetic Resonance Imaging Multidetector Computed Tomography Manifestatons of the Disease: Glycogenoses Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 83 Osteogenesis Imperfecta Abstract Etiology Prevalence and Epidemiology Clinical Presentation Manifestations of the Disease Type I Imaging Findings Type II Imaging Findings Type III Imaging Findings Type IV Imaging Findings Other Forms of Osteogenesis Imperfecta Imaging Techniques Radiography Computed Tomography Magnetic Resonance Imaging Ultrasonography Bone Mineral Density Supportive Diagnostic Techniques DNA Testing Collagen Analysis Differential Diagnosis Differentiation from Nonaccidental Injury Synopsis of Treatment Options Medical Therapy Surgery ▶ Suggested Readings References 84 Marfan Syndrome Abstract Chest deformity Spine Pelvis Peripheral skeleton Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Manifestations of the Disease Chest Deformity Spine Radiography Magnetic Resonance Imaging and Multidetector Computed Tomography Pelvis Radiography Bone Mineral Density Elongation of the Extremities and Arachnodactyly Radiography Feet Radiography Skull Radiography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 85 Paget Disease Abstract Epidemiology Etiology Pathophysiology Clinical Presentation Manifestations of the Disease Laboratory Investigations Radiography Skeletal Scintigraphy Positron Emission Tomography/Computed Tomography Fusion Imaging Computed Tomography Magnetic Resonance Imaging Complications Benign Bone Softening Fracture Associated Arthritis Nerve Entrapment Neoplastic Metastasis Soft Tissue Masses ▶ Suggested Readings References 86 Hypertrophic Osteoarthropathy Abstract Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Manifestations of the Disease Radiography Nuclear Medicine Positron Emission Tomography Computed Tomography Differential Diagnosis Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 87 Sarcoidosis Abstract Etiology Prevalence and Epidemiology Clinical Presentation Manifestations of the Disease Radiography Magnetic Resonance Imaging Nuclear Medicine Positron Emission Tomography/Computed Tomography Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 88 Tuberous Sclerosis Abstract Etiology Prevalence and Epidemiology Clinical Presentation Imaging Techniques Manifestations of the Disease Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Differential Diagnosis ▶ Suggested Readings References 89 Drug-Related Bone and Soft Tissue Disorders Abstract Corticosteroids Osteoporosis and Pathologic Fractures Osteonecrosis Neuropathy-Like Articular Destruction Osteomyelitis and Septic Arthritis Other Disorders Other Drugs Associated with Osteoporosis Phenytoin and Phenobarbital Aluminum Deferoxamine Bisphosphonates Ifosfamide Other Drugs Associated with Rickets and Osteomalacia Vitamin A Retinoids Vitamin D Fluorosis Prostaglandin E Vasoconstrictors, Calcium Gluconate, and Milk-Alkali Syndrome Polyvinyl Chloride Bismuth Poisoning Methotrexate Teratogens Vitamin A and Retinoids Alcohol Thalidomide Cocaine Warfarin Disorders Associated with Nutritional Deficiencies Hypovitaminosis C (Scurvy) Infantile Scurvy Adult Scurvy Deficiencies of Zinc and Other Elements ▶ Suggested Readings References 6 Musculoskeletal Tumors and Tumor-Like Lesions 90 The Patient with a Tumor or a Tumor-Like Lesion of Bone Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Techniques and Relevant Aspects Manifestations of the Disease Radiography Magnetic Resonance Imaging Computed Tomography Nuclear Medicine Differential Diagnosis Synopsis of Treatment Options ▶ Suggested Readings References 91 The Patient with a Soft Tissue Lump Imaging Techniques Recognition Ultrasonography Magnetic Resonance Imaging Computed Tomography Manifestations of the Disease Defining the Shape and Structure of a Lesion Vascularity Calcification Muscle Injury Old Injury Acute Injury: Hematomas Nerve-Related Lesions Lesions According to Site Locating Spread The Decision to Biopsy Summary ▶ Suggested Readings References 92 Primary Bone Tumors Manifestations of Disease Osteoid-Producing Tumors Osteoma Osteoid Osteoma and Osteoblastoma Osteosarcoma Conventional (High-Grade Intramedullary) Osteosarcoma Multicentric Osteosarcoma Telangiectatic Osteosarcoma Low-Grade Central Osteosarcoma Surface Osteosarcoma Parosteal Osteosarcoma Periosteal Osteosarcoma High-Grade Surface Osteosarcoma Secondary Osteosarcoma Cartilage-Producing Tumors Osteochondroma Chondroma Chondroblastoma Chondromyxoid Fibroma Chondrosarcoma Central Chondrosarcoma Secondary Peripheral Chondrosarcoma and Periosteal Chondrosarcoma Dedifferentiated Chondrosarcoma Clear Cell Chondrosarcoma Mesenchymal Chondrosarcoma Fibrogenic and Fibrohistiocytic Tumors Benign Fibrous Histiocytoma of Bone Desmoplastic Fibroma Fibrosarcoma Hematopoietic (Myeloproliferative) Tumors Lymphoma Osteoclastic Giant Cell Rich Tumors Notochordal Tumors Vascular Tumors Hemangioma Glomus Tumor, Cystic Angiomatosis, Lymphangiomatosis, and Gorham Disease Glomus Tumor Cystic Angiomatosis, Lymphangiomatosis, and Gorham Disease Epithelioid Hemangioma Angiosarcoma and Epithelioid Hemangioendothelioma Myogenic Tumors Lipogenic Tumors Miscellaneous Tumors Tumors of Undefined Neoplastic Nature ▶ Suggested Readings References 93 Myeloma Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Techniques and Relevant Aspects Pros and Cons Radiography Versus Magnetic Resonance Computed Tomography Versus Radiography Computed Tomography Versus Magnetic Resonance Whole-Body Versus Spinal MR-Imaging Whole-Body Magnetic Resonance Versus Positron Emission Tomography–Computed Tomography Controversies Manifestations of the Disease Radiography Magnetic Resonance Imaging Prognosis Computed Tomography Nuclear Medicine Studies Positron Emission Tomography– Computed Tomography Differential Diagnosis Monoclonal Gammopathy of Unknown Significance, Smoldering Myeloma Solitary Plasmacytoma Vertebral Fractures Synopsis of Treatment Options Medical Treatment Surgical Treatment Evaluation of Relapse/Response to Therapy ▶ Suggested Readings References 94 Tumor-Like Lesions of Bone Manifestations of Disease Cystic Lesions Simple Bone Cyst Aneurysmal Bone Cyst Epidermal Inclusion Cyst Intraosseous Ganglion Fibrous Lesions Fibrous Cortical Defect/Nonossifying Fibroma Fibrous Dysplasia Osteofibrous Dysplasia Liposclerosing Myxofibrous Tumor Langerhans Cell Histiocytosis Metabolic Disorders Normal Variants Posttraumatic Disorders Stress Fractures Avulsion Injuries Subperiosteal Hemorrhage and Hyperplastic Callus Posttraumatic Bone Cysts Infection ▶ Suggested Readings References 95 Soft Tissue Tumors Prevalence and Epidemiology Clinical Presentation Imaging Techniques Manifestations of the Disease Fibroblastic/Myofibroblastic Tumors Nodular Fasciitis Elastofibroma Dorsi Fibromatoses Palmar Fibromatosis Plantar Fibromatosis Desmoid-Type Fibromatosis (Aggressive Fibromatosis) Abdominal Fibromatosis Dermatofibrosarcoma Protuberans Solitary Fibrous Tumor Adult Fibrosarcoma Myxofibrosarcoma Fibrohistiocytic Tumors Giant Cell Tumor of Tendon Sheath Pigmented Villonodular Synovitis (Diffuse-Type Giant Cell Tumor) Xanthoma Undifferentiated Pleomorphic Sarcoma with Prominent Osteoclastic Giant Cells Lipomatous Tumors Lipoma Chondroid Lipoma Lipoblastoma Lipoma of Tendon Sheath Lipoma Arborescens Lipomatosis of Nerve (Fibrolipomatous Hamartoma) Diffuse Lipomatosis Hibernoma Malignant Lipomatous Tumors Atypical Lipomatous Tumor, Well-Differentiated Liposarcoma, or Lipoma-like Liposarcoma Myxoid Liposarcoma Pleomorphic and Round Cell Liposarcoma Dedifferentiated Liposarcoma Tumors of Vascular Origin Benign Vascular Soft Tissue Lesions Vascular Tumors of Intermediate Malignancy Grade Tumors of Lymphatic Origin Tumors of Muscular Origin Synovial Tumors Tumors of Peripheral Nerves Extraskeletal Cartilaginous and Osseous Tumors Synovial Osteochondromatosis Extraskeletal Chondrosarcoma Extraskeletal Osteosarcoma Primitive Neuroectodermal Tumors Tumors of Uncertain Differentiation Soft Tissue Metastases Pediatric Soft Tissue Tumors Differential Diagnosis Cytogenetics and Molecular Genetics of Soft Tissue Tumors Synopsis of Treatment Options ▶ Suggested Readings References 96 Tumor-like Soft Tissue Lesions Normal Anatomic Variations and Muscular Anomalies Inflammatory and Infectious Lesions Necrotizing Fasciitis Abscess Pyomyositis Hydatid Cystic Disease Focal Myositis Diabetic Muscle Infarction Bursitis Sarcoidosis Cat-Scratch Disease Actinomycosis Traumatic Lesions Hematoma and Contusion Foreign Body Reactions Calcific Myonecrosis Hypothenar Hammer Syndrome Muscle Herniations Myositis Ossificans Injection Granulomas Skin Lesions Pilomatricoma Granuloma Annulare Epidermal Inclusion Cyst Crystal Depositions Gout and Pseudogout Calcific Tendinosis Other Vascular Lesions Miscellaneous Tumoral Calcinosis Amyloid Tumor of Soft Tissue ▶ Suggested Readings References 97 Metastatic Disease Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology Imaging Techniques Technical Aspects Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Nuclear Medicine Positron Emission Tomography/Computed Tomography Positron Emission Tomography/Magnetic Resonance Pros and Cons Controversies Which Whole-Body Imaging Technique Is Best for Initial Staging and Subsequent Monitoring? Does Magnetic Field Strength Matter? Are Intravenous Contrast Agents Needed? Manifestations of the Disease Spinal Involvement Radiography Magnetic Resonance Imaging Multidetector Computed Tomography Nuclear Medicine Ivory Vertebrae Hypertrophic Osteoarthropathy Radiography Nuclear Medicine Focal Periosteal Reaction Cortical Metastases Soft Tissue Mass Magnetic Resonance Imaging Multidetector Computed Tomography Ultrasonography Synovial Involvement Pathologic Fracture Radiography Magnetic Resonance Imaging Differential Diagnosis Synopsis of Treatment Options Medical Treatment Radiation Therapy Surgical Treatment Treatment Response ▶ Suggested Readings References 98 Treatment Strategies for Musculoskeletal Tumors and Tumor-Like Lesions Functionality Diagnosis Patient History Physical Examination Laboratory Tests Imaging Biopsy Principles of Treatment Staging and Compartments Systemic Control Local Control Surgery (Neo)adjuvant Therapies Antiblastic Chemotherapy Isolating Limb Perfusion Radiation Therapy Arterial Embolization Radiofrequency Ablation Surgical Treatment Benign Bone and Soft Tissue Tumors Malignant Bone and Soft Tissue Tumor Bone Metastases Surgical Techniques Amputation Limb Salvage Prosthetic Device Bone Allograft Allograft Prosthetic Composite Bone Transplant Choosing a Type of Reconstruction The Patient’s Choice Acknowledgment ▶ Suggested Readings References 99 Staging Bone and Soft Tissue Tumors Imaging Techniques Magnetic Resonance Computed Tomography Bone Scintigraphy Positron Emission Tomography/Computed Tomography Controversies Manifestations of the Disease Bone Marrow Involvement Cortex Periosteum Muscular Compartments Neurovascular Bundle Joints ▶ Suggested Readings References 100 Monitoring Therapy in Bone and Soft Tissue Tumors Pathophysiology Imaging Techniques Dynamic Contrast-Enhanced Magnetic Resonance Imaging Diffusion-Weighted Magnetic Resonance Imaging Ultrasonography Monitoring Therapy Conventional Radiography Unenhanced Magnetic Resonance Imaging Contrast-Enhanced Magnetic Resonance Imaging Diffusion-Weighted Magnetic Resonance Imaging Ultrasonography Positron Emission Tomography Imaging Post-Therapeutic Changes and Recurrences Benign Bone Tumors Sarcomas Positron Emission Tomography in Detection of Recurrence Imaging as Surveillance Strategy ▶ Suggested Readings References 7 Clinically Relevant Development Dysplasias 101 Focal Growth Disturbances Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Imaging Techniques Techniques and Relevant Aspects Manifestations of the Disease Absent or Hypoplastic Bones (Deficiency) Glenoid Hypoplasia Radiographic Findings MRI Arthrography Radial or Ulnar Ray Deficiency Amputations of Limbs Proximal Femoral Focal Deficiency Radiographic Findings Ultrasonography and MRI Tibial and Fibular Deficiency Hand and Foot Anomalies Extra Bones Fusion Anomalies and Segmentation Deformities Congenital Pseudarthrosis Synostosis Syndactyly and Symphalangism Bowing Deformities Hypertrophy of Bones Synopsis of Treatment Options Medical Treatment Surgical Treatment Acknowledgment ▶ Suggested Readings References 102 Developmental Dysplasia of the Hip Etiology and Prevalence Manifestations of the Disease Radiography Computed Tomography Magnetic Resonance Imaging Ultrasonography Synopsis of Treatment Options Clinical Examination Ultrasound Techniques Anatomic (Morphology) Measurement Dynamic Stability Testing Combined Clinical and Ultrasound Examination Late Presentation Screening Strategies Follow-Up True Dislocation Postoperative Imaging Effectiveness Summary ▶ Suggested Readings References 103 Coalitions Etiology Prevalence and Epidemiology Clinical Presentation Tarsal Coalition Carpal Coalition Manifestations of the Disease Tarsal Coalition Calcaneonavicular Coalition Radiography Talocalcaneal Coalition Radiography Computed Tomography Magnetic Resonance Imaging Talonavicular Coalition Radiography Other Coalitions Carpal Coalitions Lunotriquetral Coalition Capitate-Hamate Fusion Radiography Pisiform-Hamate Fusion Carpal Boss Synopsis of Treatment Options Medical Treatment Surgical Treatment ▶ Suggested Readings References 104 Dysplasias Achondroplasia Hypochondroplasia Thanatophoric Dysplasia Kniest Dysplasia Spondyloepiphyseal Dysplasia Congenita Stickler Syndrome Asphyxiating Thoracic Dystrophy Ellis-Van Creveld Syndrome Multiple Epiphyseal Dysplasia Pseudoachondroplasia Metaphyseal Dysplasia Schmid Type X-Linked Spondyloepiphyseal Dysplasia Tarda Dyschondrosteosis Campomelic Dysplasia Chondrodysplasia Punctata Infantile Cortical Hyperostosis Osteopetrosis Pyknodysostosis Diaphyseal Dysplasia Osteogenesis Imperfecta Mucopolysaccharidoses Multiple Cartilaginous Exostoses Enchondromatosis (Ollier) Fibrous Dysplasia Cleidocranial Dysplasia Apert Syndrome Mandibulofacial Dysostosis (Treacher Collins Syndrome) Trisomy 21 (Down Syndrome) Turner Syndrome ▶ Suggested Readings References 105 Spinal Deformity Classification and Definitions Curve Characteristics Etiology, Clinical Presentation, and Imaging Techniques Idiopathic Scoliosis Early-Onset Idiopathic Scoliosis Late-Onset Idiopathic Scoliosis—Adolescent Scoliosis Congenital Spinal Deformities Spinal Dysraphism Neuromuscular Scoliosis Scoliosis Associated with Neurofibromatosis Kyphosis Scheuermann Disease Congenital Kyphosis ▶ Suggested Readings References 8 Postsurgical Imaging and Complications 106 Principles and Complications of Orthopedic Hardware Plates and Screws Cortical Plates Locked Plates Screws Intramedullary Devices Pediatric Fixation Fractures External Fixators Osteotomies and Epiphysiodesis Arthroplasty and Arthrodesis Spine Hardware Biologic Implants Bone Graft Substitutes Bioabsorbable Hardware Postoperative Imaging and Complications Postoperative Imaging Infection Loosening Catastrophic Failure Complications of Joint Replacements Implant-Related Sarcoma ▶ Suggested Readings 107 Postoperative Shoulder Imaging Techniques Subacromial Decompression Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Rotator Cuff Repair or Débridement Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Repairs for Glenohumeral Instability Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Shoulder Replacement Potential Complications and Radiologic Appearance ▶ Suggested Readings References 108 Postoperative Elbow, Wrist, and Hand Ulnar Collateral Ligament of the Elbow Reconstruction Description, Indications, Contraindications, Purpose, Underlying Mechanics Figure-of-Eight Repair Muscle-Splitting Modification American Sports Medicine Institute (ASMI) Modification Suture Anchor Method Docking Technique Interference Technique Expected Appearance on Imaging Potential Complications and Radiologic Appearance Lateral Collateral Ligament of the Elbow Reconstruction Description, Indications, Contraindications, Purpose, and Underlying Mechanics Presentation and Indications for Operative Treatment Primary Ligament Repair Lateral Collateral Ligament Complex Reconstruction Expected Appearance on Imaging Potential Complications and Radiologic Appearance Ulnar Nerve Decompression Description, Indications, Contraindications, Purpose, and Underlying Mechanics Indications for Operative Ulnar Nerve Treatment Surgical Therapy for Ulnar Nerve Decompression Simple Decompression of the Ulnar Nerve Ulnar Nerve Transposition Expected Appearance on Imaging Potential Complications and Radiologic Appearance Epicondylitis Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Biceps Tendon Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Triceps Tendon Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Olecranon Bursitis Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Common Elbow Fractures Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Elbow Arthroplasty Capitellar Resurfacing Arthroplasty Expected Appearance on Imaging Potential Complications and Radiographic Appearance Distal Forearm Fractures at the Wrist Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Carpal Tunnel Syndrome Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Scaphoid Fractures Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance Postoperative Evaluation of Carpometacarpal, Metacarpal, and Phalangeal Trauma, Including the Surrounding Soft Tissue Structures Description, Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Imaging Potential Complications and Radiologic Appearance ▶ Suggested Readings Ulnar Collateral Ligament of the Elbow Reconstruction Lateral Collateral Ligament of the Elbow Reconstruction Ulnar Nerve Decompression Epicondylitis Biceps Tendon Triceps Tendon Olecranon Bursitis Common Elbow Fractures Elbow Arthroplasty Distal Forearm Fractures at the Wrist Carpal Tunnel Syndrome Scaphoid Fractures Postoperative Evaluation of Carpometacarpal, Metacarpal, and Phalangeal Trauma Including the Surrounding Soft Tissue Structures References 109 Postoperative Hip Postoperative Imaging in Arthroscopic Hip Surgery Postoperative Imaging of the Labrum Femoroacetabular Impingement Imaging Post-Capsular, Chondral, and Ligamentum Teres Repair Cartilage Injury Capsular Injury Ligamentum Teres Injury Postoperative Imaging in Arthroplastic Hip Surgery Indications, Contraindications, Purpose, and Underlying Biomechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Loosening Dislocation Infection Acetabular Liner Wear Particle Disease Metallosis and Related Conditions Periprosthetic Fracture Heterotopic Bone Formation Pseudobursae Iliopsoas Impingement ▶ Suggested Readings Postoperative Imaging in Arthroscopic Hip Surgery Postoperative Imaging in Arthroplastic Hip Surgery References 110 Postoperative Knee Arthroscopy Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Arthrotomy Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Anterior Cruciate Ligament Reconstruction Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Position Signal Harvest Site Potential Complications and Radiologic Appearance Posterior Cruciate Ligament Reconstruction Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Medial Collateral Ligament Reconstruction Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Posterolateral Corner Reconstruction Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Multiple Ligament Reconstruction Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Meniscectomy Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Meniscal Repair Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Meniscal Transplant Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Chondral Stimulation Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Mosaicplasty/Osteochondral Autograft Transfer System Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Autologous Chondrocyte Implantation Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Osteochondral Allograft Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Osteochondritis Dissecans Repair Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Arthroplasty Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Quadriceps Repair Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Proximal Patellar Realignment Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Distal Patellar Realignment Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Tibial Plateau Fracture Fixation Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Patellar Fracture Treatment Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Tumor Resection Without Instrumentation Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Soft Tissue Tumors Bone Tumors Potential Complications and Radiologic Appearance Soft Tissue Bone Tumor Resection with Instrumentation/Allograft Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Tibial Osteotomy Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance ▶ Suggested Readings References 111 Postoperative Ankle and Foot Osteosynthesis Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Ankle Replacement Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Subtalar Arthroereisis Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Instability Operations Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Tendon Procedures Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance Expected Appearance on Relevant Modalities Plantar Fascia Surgery Description Indications, Contraindications, Purpose, and Underlying Mechanics Potential Complications and Radiologic Appearance Nerve Decompression Description Indications, Contraindications, Purpose, and Underlying Mechanics Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance ▶ Suggested Readings References 112 Imaging of the Residual Limb after Amputation Amputation Surgery Description Indications, Contraindications, Purpose, and Underlying Mechanics Indications Contraindications Expected Appearance on Relevant Modalities Potential Complications and Radiologic Appearance ▶ Suggested Readings References 113 Postoperative Infections Etiology Prevalence and Epidemiology Clinical Presentation Imaging Techniques Manifestations of the Disease in the Hip Infection Requiring Hardware Removal or Revision Arthroplasty Excision Arthroplasty Manifestations of the Disease in the Knee Infection Resulting in Tendon Graft Failure Infection and Myocutaneous Flaps Infection after Knee Arthroplasty Infectious Complications Requiring Amputation Synopsis of Treatment Options ▶ Suggested Readings References 9 Miscellaneous 114 Temporomandibular Joint Abstract Etiology Prevalence and Epidemiology Clinical Presentation Pathophysiology Anatomy Pathology (with Radiologic/Pathologic Correlation) Imaging Techniques Techniques and Relevant Aspects Plain Radiography Arthrography Computed Tomography Magnetic Resonance Imaging Manifestations of the Disease Complications of Internal Derangement Synopsis of Treatment Options Medical Management Surgical Management References 115 Dental Imaging Abstract Diagnosis of Mandibular and Maxillary Lesions Site or Location Periphery and Shape Internal Structure Effects on Surrounding Structures Inflammatory Diseases Periapical Inflammatory Disease Pathophysiology Imaging Techniques Radiography and Computed Tomography Differential Diagnosis Periodontal Disease Pathophysiology Imaging Techniques Radiography and Computed Tomography Nuclear Medicine Differential Diagnosis Osteomyelitis Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis Osteoradionecrosis and Bisphosphonate Osteonecrosis Pathophysiology Imaging Techniques Radiography and Computed Tomography Differential Diagnosis Cysts and Cyst-Like Lesions of the Jaws Radicular Cyst Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Dentigerous Cyst (Follicular Cyst) Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Odontogenic Keratocyst Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Buccal Bifurcation Cyst Pathophysiology Imaging Techniques Radiography and Computed Tomography Differential Diagnosis Nasopalatine Duct Cyst Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Nasolabial Cyst (Nasoalveolar Cyst) Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Simple Bone Cyst Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Benign Tumors of the Maxilla and Mandible Ameloblastoma Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Odontogenic Myxoma (Myxofibroma and Fibromyxoma) Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Odontoma Pathophysiology Imaging Techniques Radiography and Computed Tomography Differential Diagnosis Central Giant Cell Granuloma Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Cemento-Ossifying Fibroma Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Desmoplastic Fibroma of Bone Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Osteoma Pathophysiology Imaging Techniques Radiography and Computed Tomography Differential Diagnosis Central Hemangioma Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Neurilemoma (Schwannoma) Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Differential Diagnosis Neurofibromatosis (von Recklinghausen Disease) Pathophysiology Imaging Techniques Radiography and Computed Tomography Diseases of Bone Periapical Cemental Dysplasia Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis Fibrous Dysplasia Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis Cherubism Pathophysiology Imaging Techniques Radiography and Computed Tomography Differential Diagnosis Langerhans Cell Histiocytosis Pathophysiology Imaging Techniques Radiography and Computed Tomography Magnetic Resonance Imaging Nuclear Medicine Differential Diagnosis ▶ Suggested Reading References 116 Normal Variants Abstract Etiology Prevalence and Epidemiology References 10 Musculoskeletal Procedures 117 Biopsy: Abstract Indications Open Biopsy versus Percutaneous Needle Biopsy Contraindications Equipment (Optimal and Including Contrast) Guidance Modality Needles Technique Approaches Technical Aspects Computed Tomography Techniques Ultrasound Techniques Medications Biopsy Controversies Who Should Perform Biopsies of Suspected Soft Tissue Sarcomas? Should Blind or Image-Guided Needle Biopsies for Soft Tissue Sarcomas Be Used? Complications Post-Procedure and Follow-Up Care ▶ Suggested Readings References 118 Percutaneous Biopsy of the Appendicular Skeleton Abstract Indications Contraindications Equipment and Technical Aspects Preoperative Assessment Technique Complications Results Indications Bone Metastases Primary Bone Tumors Skeletal Infections Other Indications Contraindications Equipment and Technical Aspects Radiologic Guidance Biopsy Needles Specimen Handling Preoperative Assessment Technique Long Bones Peripheral and Flat Bones Sclerotic Lesions Joints Complications Results Suspected Diagnosis Location of the Lesion Radiologic Features References 119 Percutaneous Biopsy of the Spine Abstract Indications Contraindications Technique Equipment and Material Complications Results Indications Bone Metastases Primary Bone Tumors Spinal Infections Other Indications Contraindications Equipment and Material Radiologic Guidance Biopsy Needles Specimen Handling Preoperative Assessment Technique Lumbar Spine Posterolateral Approach Transpedicular Approach Thoracic Spine Posterolateral Approach Transpedicular Approach Intercostal-Transverse Process and Intercostal-Vertebral Approaches Cervical Spine Sacral Spine Posterior Arch Complications Results Conclusion References 120 Tumor Ablation Abstract Techniques Chemical Ablation with Sclerosing Agents Radiofrequency Ablation Cryoablation Magnetic Resonance–Guided Focused Ultrasound Ablation Patient Selection and Procedure Chemical Ablation with Sclerosing Agents Radiofrequency Ablation Cryoablation Magnetic Resonance–Guided Focused Ultrasound Ablation References 121 Spinal Injections Abstract Indications Contraindications Equipment Technique Approaches Technical Aspects Interlaminar Technique Transforaminal or Nerve Block Technique Caudal Technique Facet Joint Techniques Controversies Outcomes Complications Post-Procedural and Follow-Up Care ▶ Suggested Readings References 122 Discography Abstract Indications Contraindications Equipment (Optimal and Including Contrast Media) Technique Approaches Lumbar Discography in the Prone Position Lumbar Discography in the Lateral Decubitus Position Cervical Discography Thoracic Discography Technical Aspects Controversies Outcomes Complications Postprocedural and Follow-Up Care ▶ Suggested Readings References 123 Vertebroplasty and Kyphoplasty Abstract Indications Contraindications Patient Selection Identification of Fractures Fracture Activity Multiple Fractures Mechanical Pain Other Investigations Equipment Injection Systems Needles Injection Devices Cements Technique Sedation and Premedication Marking Up Approach Transpedicular Parapedicular Oblique Cement Injection Cortoss Fracture Decompression Kyphoplasty Skybone Inflation Device Controversies Vertebra Plana Osteomyelitis Acute Trauma Deformity Correction Sacroplasty Cementoplasty Myeloma Outcomes Complications Unrelated to the Nature of the Procedure Allergy Infection Increased Risk of Fracture Extravasation of Cement Vascular Injection Postprocedural and Follow-Up Care References 124 Percutaneous Intradiskal Therapies Abstract Disk Anatomy and Disease Treatment of Low Back Pain Treatment of Sciatica Chemonucleolysis Indications Contraindications Equipment Technique Approaches Technical Aspects Controversies Outcomes Complications Postprocedure and Follow-Up Care Automated Percutaneous Lumbar Diskectomy Indications Contraindications Equipment Technique Approaches Technical Aspects Controversies Outcomes Complications Postprocedure and Follow-Up Care Percutaneous Laser Disk Decompression Indications Contraindications Equipment Technique Approaches Technical Aspects Controversies Outcomes Complications Postprocedure and Follow-Up Care Nucleoplasty Indications Contraindications Equipment Technique Approaches Technical Aspects Controversies Outcomes Complications Postprocedure and Follow-Up Care Intradiskal Electrothermal Therapy Indications Contraindications Equipment Technique Approaches Technical Aspects Controversies Outcomes Complications Postprocedure and Follow-Up Care Conclusion ▶ Suggested Readings References 125 Ultrasound Procedures Abstract Indications Injections Arthrography Aspiration and Drainage Biopsies Foreign Body Localization Ablation Contraindications Equipment Fusion Imaging Technique Approaches Technical Aspects Controversies Outcomes Complications Postprocedural and Follow-Up Care ▶ Suggested Readings Appendices Appendix 1 Measurements Most Frequently Used in Orthopedic Imaging Abstract Measurement Variability Spine Measurements: Imaging of Scoliosis Cobb Angle Sagittal and Coronal Balance Vertebral Rotation Rib-Vertebral Angle Difference Measurements in the Upper Extremity Axial Angle of the Shoulder Acromioclavicular Distance Glenohumeral Joint Space Glenoid Version Measurement on Shoulder Bony Stock Measurements in Hill-Sachs Lesions Shoulder Greater Tuberosity Displacement in Isolated Fracture Bony Bankart Measurement Carrying Angle of the Elbow Ulnar Variance Carpal Height Radial Inclination Palmar Tilt Radial Length Radial Shift Ulnar Translocation of the Carpus Scapholunate Distance Scapholunate and Capitolunate Angles Carpal Angle Hip Measurements Acetabular Angle Sonographic Assessment of Congenital Hip Dysplasia Wiberg’s Center-Edge Angle HTE (Horizontal Toit Externe) Angle Acetabular Index Femoral Head Coverage Hip Joint Width Distance from Acetabulum to Ilioischiatic Line Acetabular Sector Angles Femoral Angle (Neck-Shaft Angle) Angle of Anteversion of the Femoral Head Lower Extremity Measurements Axial Angles of the Knee Metaphyseal-Diaphyseal Angle of the Tibia Tibial Torsion Angle of the Tibial Plateau Patellar Height Patellar Congruence Angle Patellar Tilt Angle Tibial Tubercle–Femoral Sulcus Distance Boehler Angle Axial Angles of the Ankle Dorsoplantar Talocalcaneal Angle (Kite Angle) Lateral Talocalcaneal Angle Calcaneal Pitch Hallux Valgus Angles ▶ Suggested Readings References Appendix 2 Orthopedic Devices Abstract Plates and Screws Blade Plate and Screws Reconstruction Plate Buttress Plate and Screws Screws Cortical Screws Cancellous Screws Cannulated Screws Acutrak Screw Herbert Screw Interference Screws Bioabsorbable Screws MBA (Maxwell-Brancheau) Screw Dynamic Hip Screw (DHS) Intramedullary Devices Intramedullary Nail Elastic Stable Intramedullary Nail (ESIN) Cephalomedullary Nail Wires and Pins Kirschner Wires Cerclage Wires Tension Band Wiring Miscellaneous Staples Endobutton Suture Anchors Arthoplasty Shoulder Arthroplasty Reverse Total-Shoulder Arthroplasty Arthrosurface HemiCAP Radial Head Hemiarthroplasty Bipolar Hip Hemiarthroplasty Total-Hip Arthroplasty Hip Resurfacing Arthroplasty Unicompartmental (Partial) Knee Arthroplasty Total-Knee Arthroplasty Total-Ankle Arthroplasty MTP Joint Arthroplasty Antibiotic-Impregnated Cement Spacer Spine Instrumentation Corpectomy and Anterior Fusion Lumbar Diskectomy and Fusion Anterior Cervical Diskectomy and Fusion Lateral Mass Plate and Screws Disk Replacement Interspinous Process Devices Appendix 3 Fractures with Names Abstract Fractures with an Eponym Fractures Having a Special Name Salter-Harris Classification of Fractures Through the Growth Plate Physis References Appendix 4 Diseases with Names Baastrup Disease De Quervain Disease A Aarskog Syndrome Achondrogenesis Ahlback Disease Albers-Schönberg Disease Albright Hereditary Osteodystrophy (Pseudohypoparathyroidism) Allison-Ghormley Nodule Andersson Lesion Antley-Bixler Syndrome Askin Tumor B Baastrup Disease Baker Cyst Baller-Gerold Syndrome Bankart Lesion Bannayan Syndrome Becker Muscular Dystrophy Behçet Syndrome Bekhterev-Strümpell-Marie Disease Bennett Lesion Blount Disease Bouchard Nodes Brodie Abscess Buchanan Disease Buford Complex Bureau-Barriere Syndrome Burnett Syndrome Burns Disease Buschke-Ollendorff Syndrome C Caffey Disease (Infantile Cortical Hyperostosis) Calvé Syndrome Camurati-Engelmann Disease (Diaphyseal Dysplasia) Carpenter Syndrome (Acrocephalopolysyndactyly) Chandler Disease Charcot Joint (Neuropathic Arthropathy) Charcot-Marie-Tooth Disease Chotzen Syndrome Clutton Joint Conradi-Hünermann Disease (Chondrodysplasia Calcificans Congenita) Cope Syndrome Crohn Disease Crouzon Syndrome D De Quervain Disease Dejerine-Sottas Neuropathy Down Syndrome Duchenne Muscular Dystrophy Dupuytren Contracture Dyggve-Melchior-Clausen Syndrome E Eagle Syndrome Ehlers-Danlos Syndrome Ellis-Van Creveld Syndrome (Chondroectodermal Dysplasia) Erb Dystrophy (Dystrophia Musculorum Progressiva) Erdheim-Chester Disease (Lipid Granulomatosis) Ewing Sarcoma F Fabry Disease Fairbank-Ribbing Disease (Multiple Epiphyseal Dysplasia) Fanconi-Albertini-Zellweger Syndrome Farber Disease Felty Syndrome Fong Syndrome (Osteo-Onychodysplasia) Forestier Disease Freiberg Disease G Gardner Syndrome Garré Osteomyelitis (Sclerosing Nonsuppurative Osteomyelitis) Gaucher Disease (Glycosylceramide Lipidosis) Goldenhar Syndrome (Oculoauriculovertebral Dysplasia) Goltz Syndrome (Focal Dermal Hypoplasia) Gorham Disease (Massive Osteolysis, Vanishing Bone Disease) Gorlin Cyst (Calcifying Odontogenic Cyst) Greig Syndrome (Orbital Hypertelorism) Grisel Syndrome Guyon Canal Syndrome (Ulnar Tunnel Syndrome) H Haglund Syndrome (Tendons and Ligaments) Hajdu-Cheney Syndrome Hand-Schüller-Christian Disease Hardcastle Syndrome Hass Disease Heberden Nodes Hallermann-Streiff-François (Oculomandibulodyscephaly) Hill-Sachs Deformity Hodgkin Disease Hoffa Disease Hoffmann Syndrome Holt-Oram Syndrome Hunter Syndrome Hurler Syndrome I Isaacs Syndrome Iselin Disease J Jaccoud Arthropathy Jackson-Weiss Syndrome Jaffe-Campanacci Syndrome Jansen-Type Metaphyseal Dysplasia Jeune Syndrome (Asphyxiating Thoracic Dystrophy) Joseph, Acro-osteolysis of K Kahler Disease Kasabach-Merritt Syndrome Kashin-Beck Disease Kenny-Caffey Syndrome Kienböck Disease Kiloh-Nevin Syndrome Kirner Deformity Klinefelter Syndrome Klippel-Feil Syndrome Klippel-Trénaunay-Weber Syndrome (Parkes-Weber Syndrome) Kniest Dysplasia Köhler Disease Kümmell Disease L Langerhans Cell Histiocytosis Larsen Syndrome Launois Deformity Legg-Calvé-Perthes Disease Lenz-Majewski Dysplasia Leri-Weill Syndrome Lesch-Nyhan (Kelley-Seegmiller) Syndrome Letterer-Siwe Disease Lisch Nodule Lisfranc Joint Looser Zones M Madelung Deformity Maffucci Syndrome (Kast Syndrome) Majewski Syndrome Marfan Syndrome Marie-Strümpell Disease Maroteaux-Lamy Syndrome Mauclaire Disease Mazabraud Syndrome McCune-Albright Syndrome Melnick-Needles Syndrome Menkes Syndrome Meyer Dysplasia Morel-Lavellee Effusion Morquio Syndrome Morton Neuroma Mueller-Weiss Syndrome Munchmeyer Disease (Fibrodysplasia Ossificans Progressiva, Myositis Ossificans Progressiva) N Nager Acrofacial Dysostosis Naumoff Syndrome Niemann-Pick Disease Nievergelt Syndrome Nora Lesion (Bizarre Parosteal Osteochondromatous Proliferation) O O’Donoghue Triad Ollier Disease (Enchondromatosis) Osgood-Schlatter Disease P Paget Disease of Bone Panner Disease Parsonage-Turner Syndrome Pellegrini-Stieda Disease Perthes Lesion Pfeiffer Syndrome Pierson Disease Poland Syndrome Poncet Disease (Tuberculous Arthritis) Pott Disease Preiser Disease Pseudo-Hurler Polydystrophy (Mucolipidosis III) Pyle Syndrome R Recklinghausen Disease of Bone (Osteitis Fibrosa Cystica) Reiter Syndrome Riley-Day Familial Dysautonomia Rothmund-Thomson Syndrome S Saethre-Chotzen Syndrome Sakati Syndrome Saldino-Mainzer Syndrome Scheie Syndrome Scheuermann Disease Schmorl Node Schwartz-Jampel-Aberfeld Syndrome (Chondrodystrophic Myotonia) Sever Disease Shwachman-Diamond Syndrome Sinding-Larsen-Johansson Disease Sly Syndrome Smith-McCort Dysplasia Sprengel Deformity Stafne Developmental Cyst Stickler Syndrome Sturge-Weber-Dimitri Syndrome Sudeck Atrophy T Terry Thomas Sign Thiemann Disease (Familial Osteoarthropathy of Fingers) Tietze Syndrome Touraine-Solente-Gole-Syndrome (Pachydermoperiostosis) Trauner-Rieger Syndrome Treacher-Collins Syndrome (Mandibulofacial Dysostosis) Trevor Disease (Dysplasia Epiphysealis Hemimelica) Turner Syndrome V Van Buchem Syndrome Van Neck Disease Voorhoeve Disease (Osteopathia Striata) Vrolik Syndrome (Thick Bone Osteogenesis Imperfecta) W Waldenström Macroglobulinemia Wartenberg Syndrome Weismann-Netter-Stuhl Syndrome Werdnig-Hoffman Disease Werner Syndrome Wiedemann-Beckwith Syndrome (Exomphalos-Macroglossia-Gigantism Syndrome) Wilson Disease (Hepatolenticular Degeneration) Wohlfart-Kugelberg-Welander Syndrome (Atrophia Musculorum Pseudomyopathica) Wolcott-Rallison Dysplasia Wolf-Hirschhorn Syndrome Worth Syndrome Z Zellweger Syndrome Appendix 5 Classic Signs and Findings in Musculoskeletal Radiology Index A B C D E F G H I J K L M N O P Q R S T U V W X Z Inside back cover