Philippa Tyler

Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review

Magnetic resonance imaging (MRI) is the mainstay of diagnosis, staging and follow-up of much musculoskeletal pathology. Diffusion-weighted magnetic resonance imaging (DWI) is a recent addition to the MR sequences conventionally employed. DWI provides qualitative and quantitative functional information concerning the microscopic movements of water at the cellular level. A number of musculoskeletal disorders have been evaluated by DWI, including vertebral fractures, bone marrow infection, bone marrow malignancy, primary bone and soft tissue tumours; post-treatment follow-up has also been assessed. Differentiation between benign and malignant vertebral fractures by DWI and monitoring of therapy response have shown excellent results. However, in other pathologies, such as primary soft tissue tumours, DWI data have been inconclusive in some cases, contributing little additional information beyond that gained from conventional MR sequences. The aim of this article is to critically review the current literature on the contribution of DWI to musculoskeletal MRI.

The imaging of myositis ossificans.

Myositis ossificans (MO) is characterized by abnormal heterotopic bone formation involving striated muscle, tendons, ligaments, fasciae, and aponeuroses. Myocardium, the diaphragm, tongue, larynx, smooth muscle, and sphincters are all spared. Several subtypes of myositis ossificans exist: posttraumatic myositis ossificans (PTMO), nontraumatic/pseudomalignant myositis ossificans, and myositis ossificans progressiva (MOP). This article reviews the clinical features and differential diagnoses of each subtype of MO and illustrates the typical imaging features demonstrated by plain radiography, ultrasound, radionuclide bone scans, computed tomography, and magnetic resonance imaging.

Magnetic resonance imaging of anatomical variations in the knee Part 2: Miscellaneous

Magnetic resonance imaging is the modality of choice for investigation of internal derangement of the knee. The reporting radiologist must be familiar with both normal anatomy and anatomical variants within the knee, in order to avoid mis-diagnosis, over-investigation and unnecessary intervention. This article reviews the recognised anatomical variants of the non-ligamentous/musculotendinous structures of the knee, their anatomy, incidence and typical appearances on MRI.

Basic Principles of MRI

Magnetic resonance imaging (MRI) is the imaging modality of choice for the evaluation of a variety of musculoskeletal pathologies. MRI has the advantage that it does not use ionising radiation and is non-invasive. In addition, it has a high soft tissue resolution and imaging capabilities in multiple planes.

Magnetic resonance imaging of anatomical variations in the knee. Part 1: ligamentous and musculotendinous

Magnetic resonance imaging (MRI) is now the modality of choice for the investigation of internal derangement of the knee. Technological advances, including the wider availability of stronger magnets and new sequences, allows improved visualisation of smaller structures. Normal variants must be recognised as such, so that both over-investigation and mis-diagnosis are avoided. This article reviews both the well-recognised and the less common ligamentous and musculotendinous anatomical variants within the knee and illustrates their imaging characteristics on MRI.

The Management of Head Injuries: A Practical Guide for the Emergency Room

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Radiological Imaging of Primary Benign and Malignant Bone Tumours

Primary bone tumours are much less common than metastatic tumour deposits in bones and multiple myeloma/plasmacytoma. In this chapter, we shall describe the salient clinical features and radiological characteristics of primary benign and malignant bone tumours. Radiology of bone tumours relies heavily on assessment of patient’s age, bones affected and distribution of tumour in the bone. With the knowledge of only these three features, the differential diagnosis of bone tumours can be significantly narrowed down. Plain radiographs help characterise the tumours, and in most cases, a reasonably accurate diagnosis can be made on assessment of these clinico-radiological features. Although CT and MR help to characterise these features more, their main importance lies in local extent of bone involvement and distant staging of the tumour, assessment of treatment planning, to act as a guide to biopsy and for follow-up. Whole-body bone scan and lately FDG PET scans have important roles to play in staging of malignant tumours.