Stephanie A. Schwartz

Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology.

ObjectiveTo correlate the amount of bone marrow edema (BME) calculated by magnetic resonance imaging(MRI) with clinical findings, histopathology, and radiographic findings, in patients with advanced hip osteoarthritis(OA).Materials and methodsThe study was approved by The Institutional Human Subject Protection Committee. Coronal MRI of hips was acquired in 19 patients who underwent hip replacement. A spin echo (SE) sequence with four echoes and separate fast spin echo (FSE) proton density (PD)-weighted SE sequences of fat (F) and water (W) were acquired with water and fat suppression, respectively. T2 and water:fat ratio calculations were made for the outlined regions of interest. The calculated MRI values were correlated with the clinical, radiographic, and histopathologic findings.ResultsAnalyses of variance were done on the MRI data for W/(W + F) and for T2 values (total and focal values) for the symptomatic and contralateral hips. The values were significantly higher in the study group. Statistically significant correlations were found between pain and total W/(W + F), pain and focal T2 values, and the number of microfractures and calculated BME for the focal W/(W + F) in the proximal femora. Statistically significant correlations were found between the radiographic findings and MRI values for total W/(W + F), focal W/(W + F) and focal T2 and among the radiographic findings, pain, and hip movement. On histopathology, only a small amount of BME was seen in eight proximal femora.ConclusionThe amount of BME in the OA hip, as measured by MRI, correlates with the severity of pain, radiographic findings, and number of microfractures.

CT Findings of Rupture, Impending Rupture, and Contained Rupture of Abdominal Aortic Aneurysms

OBJECTIVE With the increasing use of cross-sectional imaging for a variety of medical and surgical conditions affecting the abdomen and pelvis, familiarity with the imaging features of aneurysm rupture--and the findings suspicious for impending or contained aneurysm rupture--is crucial for all radiologists. This pictorial essay will review the imaging findings of rupture of abdominal aortic aneurysms and of complicated aneurysms. CONCLUSION Prompt detection of abdominal aortic aneurysm rupture or impending rupture is critical because emergent surgery may be required and patient survival may be at stake.

Bradyarrhythmias During Use of the AngioJet System

The AngioJet system is an effective thrombectomy device, but it may cause chest discomfort and provoke bradyarrhythmias that range from mild bradycardia to asystole. The cause of AngioJet-induced bradyarrhythmia is unknown, although several hypotheses have attempted to explain the phenomenon. Herein several cases will be described, followed by a review of the relevant literature. The literature review suggests that the cause may be related to the effects of the hydrodynamic jets on stretch-activated receptors present on the vascular endothelium, and that pretreatment with gadolinium or streptomycin might prevent activation of these receptors.

Imaging Characteristics of Diffuse Idiopathic Skeletal Hyperostosis With an Emphasis on Acute Spinal Fractures: Review

OBJECTIVE The educational objectives of this self-assessment module are for the participant to exercise, self-assess, and improve his or her understanding of the imaging of diffuse idiopathic skeletal hyperostosis (DISH), with emphasis on acute spinal fractures. CONCLUSION Understanding the pathomechanics of the fractures in the ankylosed spine is important in the differentiation of the acute spinal fractures in DISH and ankylosing spondylitis. This article emphasizes the imaging features of spinal DISH and acute spinal fractures in DISH, distinguishing them specifically from those in ankylosing spondylitis.

Intravascular Papillary Endothelial Hyperplasia Sonographic Appearance With Histopathologic Correlation

Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular proliferative process characterized by papillary proliferation of endothelial cells located within a vascular lumen. The lesions occur most commonly in the extremities and in the head and neck region. 1,2 Reports of the imaging findings of these masses are scarce. We report a rare case of IPEH occurring in a dorsal wrist vein with demonstration of the sonographic appearance and pathologic correlation.

Bilateral asymmetric hip dislocation: case report and literature review

Simultaneous anterior and posterior hip dislocation is an unusual injury. A unique case is presented, consisting of bilateral asymmetric hip dislocation with associated femoral head, femoral shaft, and acetabular fractures resulting from a motorcycle collision. The mechanisms of injury, management, role of imaging, and complications of this injury complex are discussed, with a review of the relevant literature.

Imaging Characteristics of Diffuse Idiopathic Skeletal Hyperostosis With an Emphasis on Acute Spinal Fractures: Self-Assessment Module

The educational objectives for this self-assessment module are for the participant to exercise, self-assess, and improve his or her understanding of the imaging of diffuse idiopathic skeletal hyperostosis (DISH).

Pancreatitis-associated splenic vein thrombosis with intrasplenic venous thrombosis: a case report

Splenic vein thrombosis most often results from pancreatic disease and can result in gastrointestinal bleeding due to gastric varices. The diagnosis is becoming more frequent with the increasing utilization of imaging. This case report will review the imaging findings of splenic vein thrombosis with an illustration of the involvement of intrasplenic segmental venous branches.