Orthopaedic Imaging: A Practical Approach

xv
Foreword vii
Preface to the First Edition ix
Preface xi
Acknowledgments xiii
Pa r t I
INTRODUCTION TO
ORTHOPAEDIC IMAGING 1
Chapter 1
The Role of the Orthopaedic Radiologist 3
Suggested Readings 11
Chapter 2
Imaging Techniques in Orthopaedics 13
Choice of Imaging Modality 13
Imaging Techniques 13
Conventional Radiography 13
Magnification Radiography 14
Stress Views 14
Scanogram 14
Fluoroscopy and Videotaping 14
Digital (Computed) Radiography 14
Tomography 15
Computed Tomography 16
Arthrography 21
Angiography 22
Myelography 22
Diskography 25
Ultrasound 25
Scintigraphy (Radionuclide Bone Scan) 28
Diphosphonates 31
Gallium-67 32
Indium 33
Nanocolloid 35
Immunoglobulins 35
Chemotactic Peptides 35
Iodine 36
Gadolinium 36
PET, PET/CT, and PET/MRI 37
Magnetic Resonance Imaging 37
Suggested Readings 53
Chapter 3
Histology, Formation, and
Growth of Bone and Articular Cartilage 55
Bone: Histology, Formation, and Growth 55
Articular Cartilage: Histology, Formation, and Growth 62
Suggested Readings 67
Pa r t II
TRAUMA 69
Chapter 4
Imaging Evaluation of Trauma 71
Imaging Modalities 71
Radiography and Fluoroscopy 71
Computed Tomography 71
Scintigraphy 71
Ultrasound 71
Arthrography 71
Myelography and Diskography 71
Angiography 71
Magnetic Resonance Imaging 71
Fractures and Dislocations 79
Diagnosis 79
Radiographic Evaluation of Fractures 79
Indirect Signs as Diagnostic Clues 92
Radiographic Evaluation of Dislocations 99
Monitoring the Results of Treatment 99
Fracture Healing and Complications 101
Other Complications of Fractures, Dislocations,
and Traumatic Insults to the Bones and Soft Tissues 107
Stress Fractures 123
Injury to Soft Tissues 134
C ont ents xvi Contents
Sports Injuries 136
Upper Extremity 140
Weight Lifter Pectoralis 140
Little League Shoulder 140
Golfer’s Elbow 140
Tennis Elbow 141
Little League Elbow 141
Baseball Pitcher’s Elbow 141
Goalkeeper’s Elbow 141
Oarsman’s Wrist 143
Cyclist’s Wrist 143
Gymnast’s Wrist 144
Boxer’s Fracture 144
Skier’s Thumb 144
Bowler’s Thumb 144
Lower Extremity 144
Sports Hernia 144
Runner’s Knee (Iliotibial Band Friction Syndrome) 144
Jumper’s Knee 144
Tennis Leg 144
Shin Splints 144
Footballer’s Ankle (Athlete’s Ankle) 144
Snowboarder’s Fracture 148
Turf Toe 148
Practical Points to Remember 148
Suggested Readings 149
Chapter 5
Upper Limb I: Shoulder Girdle 151
Trauma to the Shoulder Girdle 151
Anatomic–Radiologic Considerations 151
Injury to the Shoulder Girdle 167
Fractures About the Shoulder 167
Dislocations in the Glenohumeral Joint 176
Impingement Syndrome 187
Rotator Cuff Tear 191
Injury to the Cartilaginous Labrum 193
Injury to the Glenohumeral Ligaments 201
Miscellaneous Abnormalities 201
Compressive and Entrapment Neuropathies
of the Shoulder 208
Suprascapular Nerve Syndrome 208
Quadrilateral Space Syndrome 208
Parsonage-Turner Syndrome (Idiopathic Brachial
Plexopathy, Neuralgic Amyotrophy) 210
Serratus Anterior Paralysis (Scapular Winging) 210
The Postoperative Shoulder 211
Practical Points to Remember 215
Suggested Readings 215
Chapter 6
Upper Limb II: Elbow 218
Trauma to the Elbow 218
Anatomic–Radiologic Considerations 218
Injury to the Elbow 223
Fractures About the Elbow 223
Osteochondritis Dissecans of the Capitellum 240
Dislocations in the Elbow Joint 243
Injury to the Soft Tissues 245
Bursitis 254
Compressive and Entrapment Neuropathies of the Elbow 254
Pronator Teres Muscle Syndrome 254
Supinator Muscle Syndrome 255
Cubital Tunnel Syndrome 255
Practical Points to Remember 255
Suggested Readings 257
Chapter 7
Upper Limb III: Distal Forearm, Wrist,
Hand, and Fingers 258
Distal Forearm 258
Anatomic–Radiologic Considerations 258
Injury to the Distal Forearm 258
Fractures of the Distal Radius 258
Injury to the Soft Tissue at the Distal Radioulnar Articulation 273
Wrist and Hand 277
Anatomic–Radiologic Considerations 277
Injury to the Wrist 280
Fractures of the Carpal Bones 280
Kienböck Disease 297
Hamatolunate Impaction Syndrome 302
Dislocations of the Carpal Bones 302
Carpal Instability 316
Injury to the Bones of the Hand 316
Bennett and Rolando Fractures 316
Boxer’s Fracture 318
Injury to the Soft Tissue of the Hand 318
Carpal Tunnel Syndrome 318
Guyon Canal Syndrome 320
Anterior Interosseous Nerve Syndrome 320
Fingers 322
Normal Anatomy of the Fingers 322
Injury to the Bones and Soft Tissues of the Fingers 326
Gamekeeper’s Thumb 326
Avulsion Fractures of the Fingers 326
Flexor Pulley System Rupture (Climber’s Finger) 327
de Quervain Syndrome 327
Tendon and Ligament Tears 329
Practical Points to Remember 333
Suggested Readings 333
Chapter 8
Lower Limb I: Pelvic Girdle, Sacrum, and
Proximal Femur 335
Trauma to the Pelvic Girdle 335
Anatomic–Radiologic Considerations 335
Injury to the Pelvis and Acetabulum 336
Classification of Pelvic Fractures 336
Fractures of the Pelvis 342
Fractures of the Acetabulum 345
Injuries of the Acetabular Labrum 347
Femoroacetabular Impingement Syndrome 347
Injury to the Sacrum 347 Contents xvii
Trauma to the Proximal Femur 355
Fractures of the Proximal Femur 355
Intracapsular Fractures 355
Extracapsular Fractures 359
Dislocations in the Hip Joint 364
Tendon and Muscle Lesions 370
Compressive and Entrapment Neuropathies 370
Piriformis Syndrome 372
Iliacus Syndrome 372
Obturator Neuropathy 373
Lateral Femoral Cutaneous Neuropathy (Meralgia Paresthetica) 373
Morel-Lavallée Lesion (Closed Degloving Injury) 374
Sports Hernia 374
Stress and Insufficiency Fractures 374
Practical Points to Remember 375
Suggested Readings 375
Chapter 9
Lower Limb II: Knee 377
Trauma to the Knee 377
Anatomic–Radiologic Considerations 377
Injury to the Knee 385
Fractures About the Knee 385
Sinding-Larsen-Johansson Disease 397
Osgood-Schlatter Disease 400
Injuries to the Cartilage of the Knee 403
Injury to the Soft Tissues About the Knee 417
The Postoperative Knee 441
Surgical Management of Meniscal Tears 441
Anterior Cruciate Ligament Reconstruction 441
Cartilage Repair 441
Practical Points to Remember 456
Suggested Readings 456
Chapter 10
Lower Limb III: Ankle and Foot 458
Trauma to the Ankle and Foot 458
Anatomic–Radiologic Considerations 458
Imaging of the Ankle and Foot 458
Injury to the Ankle 467
Fractures About the Ankle Joint 467
Injury to the Soft Tissues About the Ankle Joint and Foot 483
Injury to the Foot 493
Fractures of the Foot 493
Complications 508
Dislocations in the Foot 508
Miscellaneous Painful Soft-Tissue Abnormalities
of the Ankle and Foot 520
Tarsal Tunnel Syndrome 520
Sinus Tarsi Syndrome 520
Posterior Tibialis Tendon Dysfunction 521
Chronic Tendinosis of the Posterior Tibialis Tendon 521
Tears of the Posterior Tibialis Tendon 521
Painful Accessory Navicular Bone Syndrome 521
Peroneal Tendinopathies 525
Peroneus Brevis Split Tear 525
Peroneus Longus Tendinosis and Tear 525
Peroneal Tendon Dislocation 525
Painful Os Peroneum Syndrome 525
Baxter Neuropathy 526
Morton Neuroma 526
Plantar Fasciitis 526
Impingement Syndromes 527
Practical Points to Remember 530
Suggested Readings 530
Chapter 11
Spine 532
Introduction 532
Cervical Spine 532
Anatomic–Radiologic Considerations 532
Injury to the Cervical Spine 542
Fractures of the Occipital Condyles 546
Occipitocervical Dislocations 546
Fractures of the C1 and C2 Vertebrae 547
Fractures of the Mid and Lower Cervical Spine 555
Locked Facets 558
Thoracolumbar Spine 562
Anatomic–Radiologic Considerations 562
Injury to the Thoracolumbar Spine 568
Fractures of the Thoracolumbar Spine 568
Fracture–Dislocations 578
Spondylolysis and Spondylolisthesis 579
Transitional Lumbosacral Vertebra 584
Injury to the Diskovertebral Junction 584
Orthopaedic Management 597
Practical Points to Remember 599
Suggested Readings 600
Pa r t III
ARTHRITIDES 601
Chapter 12
Clinical, Imaging, and Pathologic Evaluation of the
Arthritides and Arthropathies 603
Radiologic Imaging Modalities 603
Conventional Radiography 603
Magnification Radiography 603
Tomography and Computed Tomography 603
Scintigraphy 603
Ultrasound 611
Magnetic Resonance Imaging 611
The Arthritides 611
Diagnosis 611
Clinical Information 611
Pathology 620
Imaging Features 622xviii Contents
Management 638
Medical Treatment 638
Radiotherapy 638
Orthopaedic Treatment 638
Complications of Surgical Treatment 647
Practical Points to Remember 671
Suggested Readings 671
Chapter 13
Degenerative Joint Disease 673
Osteoarthritis 673
Osteoarthritis of the Large Joints 673
Osteoarthritis of the Hip 673
Osteoarthritis of the Knee 691
Osteoarthritis of Other Large Joints 695
Osteoarthritis of the Small Joints 695
Primary Osteoarthritis of the Hand 695
Secondary Osteoarthritis of the Hand 695
Osteoarthritis of the Foot 704
Degenerative Diseases of the Spine 708
Clinical Features 708
Pathology 709
Osteoarthritis of the Synovial Joints 709
Degenerative Disk Disease 711
Spondylosis Deformans 711
Diffuse Idiopathic Skeletal Hyperostosis 714
Complications of Degenerative Disease of the Spine 717
Degenerative Spondylolisthesis 717
Spinal Stenosis 718
Neuropathic Arthropathy 721
Practical Points to Remember 723
Suggested Readings 724
Chapter 14
Inflammatory Arthritides 725
Erosive Osteoarthritis 725
Clinical Features 725
Pathology 725
Imaging Features 725
Differential Diagnosis 725
Treatment 729
Rheumatoid Arthritis 729
Adult Rheumatoid Arthritis 729
Rheumatoid Factors 730
Clinical Features 730
Imaging Features 730
Complications of Rheumatoid Arthritis 753
Rheumatoid Nodulosis 755
Juvenile Idiopathic Arthritis 758
Still Disease 758
Polyarticular Juvenile Idiopathic Arthritis 758
Juvenile Idiopathic Arthritis with Pauciarticular
Onset (Oligoarthritis) 758
Arthritis with Enthesitis 758
Juvenile Psoriatic Arthritis 758
Imaging Features of JIA 758
Macrophage Activation Syndrome 762
Treatment of Rheumatoid Arthritis 762
Seronegative Spondyloarthropathies 763
Ankylosing Spondylitis 763
Clinical Features 763
Pathology 763
Imaging Features 763
Treatment 768
Reactive Arthritis (Reiter Syndrome) 768
Clinical Features 768
Imaging Features 768
Treatment 768
Psoriatic Arthritis 770
Clinical Features 770
Imaging Features 775
Treatment 775
Enteropathic Arthropathies 778
Undifferentiated Spondyloarthritis 778
SAPHO Syndrome 778
Practical Points to Remember 781
Suggested Readings 782
Chapter 15
Miscellaneous Arthritides and Arthropathies 784
Connective Tissue Arthropathies 784
Systemic Lupus Erythematosus 784
Clinical Features 784
Pathology 784
Imaging Features 784
Treatment 786
Scleroderma 787
Clinical Features 787
Pathology 787
Imaging Features 787
Treatment 789
Polymyositis and Dermatomyositis 789
Clinical Features 789
Pathology 790
Imaging Features 791
Treatment 795
Mixed Connective Tissue Disease 795
Vasculitis 795
Metabolic, Endocrine, and Crystal Deposition
Arthropathies and Arthritides 801
Gout 801
Clinical Features 801
Hyperuricemia 801
Examination of Synovial Fluid 802
Pathology 803
Imaging Features 803
Differential Diagnosis 803
Treatment 813 Contents xix
Calcium Pyrophosphate Dihydrate Crystal Deposition Disease 813
Clinical Features 813
Pathology 813
Imaging Features 813
Differential Diagnosis 813
Calcium Hydroxyapatite Crystal Deposition Disease 819
Clinical Features 819
Imaging Features 820
Treatment 820
Hemochromatosis 820
Clinical Features 820
Pathology 821
Imaging Features 821
Treatment 821
Wilson Disease 821
Clinical Features 821
Imaging Features 822
Treatment 824
Alkaptonuria (Ochronosis) 824
Clinical Features 824
Imaging Features 824
Treatment 826
Hyperparathyroidism 826
Clinical Features 826
Pathology 826
Imaging Features 826
Treatment 826
Acromegaly 826
Miscellaneous Conditions 827
Amyloidosis 827
Clinical Features 827
Pathology 827
Imaging Features 827
Treatment 827
Multicentric Reticulohistiocytosis 827
Clinical Features 827
Imaging Features 827
Pathology 829
Treatment 829
Sarcoidosis 829
Clinical Features 829
Pathology 830
Imaging Features 830
Treatment 830
Hemophilia 830
Imaging Features 830
Jaccoud Arthritis 833
Arthritis Associated with AIDS 833
Infectious Arthritis 834
Practical Points to Remember 836
Suggested Readings 836
Pa r t IV
TUMORS AND TUMOR-LIKE LESIONS 839
Chapter 16
Imaging Evaluation of Tumors and
Tumor-like Lesions 841
Classification of Tumors and Tumor-like Lesions 841
Imaging Modalities 841
Conventional Radiography 841
Computed Tomography 841
PET and PET/CT 843
Arteriography 844
Myelography 844
Magnetic Resonance Imaging 851
Skeletal Scintigraphy (Radionuclide Bone Scan) 853
Interventional Procedures 856
Tumors and Tumor-like Lesions of Bone 856
Diagnosis 856
Clinical Information 856
Choice of Imaging Modality 856
Radiographic Features of Bone Lesions 857
Pathology 871
Stains 871
Immunohistochemistry 871
Electron Microscopy 874
Genetics of Bone Tumors 874
Management 874
Monitoring the Results of Treatment 874
Complications 880
Soft-Tissue Tumors 880
Practical Points to Remember 893
Suggested Readings 893
Chapter 17
Benign Tumors and Tumor-like Lesions I:
Bone-Forming Lesions 895
Benign Bone-Forming (Osteoblastic, Osteogenic) Lesions 895
Osteoma 895
Clinical and Imaging Features 895
Pathology 895
Differential Diagnosis 895
Osteoid Osteoma 895
Clinical and Imaging Features 895
Pathology 897
Differential Diagnosis 897
Complications 901
Treatment 901
Osteoblastoma 901
Clinical and Imaging Features 901
Pathology 916
Differential Diagnosis 923
Treatment 923
Practical Points to Remember 925
Suggested Readings 925xx Contents
Polyostotic Fibrous Dysplasia 989
Clinical and Imaging Features 989
Pathology 996
Complications 996
Fibrocartilaginous Dysplasia 996
Clinical, Pathologic, and Imaging Features 996
Associated Disorders 996
McCune-Albright Syndrome 996
Mazabraud Syndrome 997
Osteofibrous Dysplasia 1002
Clinical, Imaging, and Histopathologic Features 1002
Complications and Treatment 1006
Desmoplastic Fibroma 1006
Clinical and Imaging Features 1006
Pathology 1010
Treatment 1010
Practical Points to Remember 1014
Suggested Readings 1014
Chapter 20
Benign Tumors and Tumor-like Lesions IV:
Miscellaneous Lesions 1016
Simple Bone Cyst 1016
Clinical and Imaging Features 1016
Pathology 1016
Complications and Differential Diagnosis 1016
Treatment 1016
Aneurysmal Bone Cyst 1016
Clinical and Imaging Features 1016
Pathology 1024
Complications and Differential Diagnosis 1024
Treatment 1030
Solid Variant of Aneurysmal Bone Cyst 1035
Clinical and Imaging Features 1035
Pathology 1035
Treatment 1035
Giant Cell Tumor 1035
Clinical and Imaging Features 1035
Pathology 1036
Differential Diagnosis 1046
Complications and Treatment 1046
Fibrocartilaginous Mesenchymoma 1051
Clinical and Imaging Features 1051
Pathology 1051
Hemangioma 1051
Clinical and Imaging Features 1051
Pathology 1060
Differential Diagnosis 1060
Treatment 1060
Intraosseous Lipoma 1060
Clinical and Imaging Features 1060
Pathology 1060
Nonneoplastic Lesions Simulating Tumors 1062
Intraosseous Ganglion 1062
Brown Tumor of Hyperparathyroidism 1067
Chapter 18
Benign Tumors and Tumor-like Lesions II:
Lesions of Cartilaginous Origin 927
Benign Chondroblastic Lesions 927
Enchondroma (Chondroma) 927
Clinical and Imaging Features 927
Pathology 930
Differential Diagnosis 936
Complications 936
Treatment 937
Enchondromatosis, Ollier Disease, and Maffucci Syndrome 937
Clinical and Imaging Features 937
Pathology 939
Complications 939
Osteochondroma 939
Clinical and Imaging Features 939
Pathology 942
Complications 943
Treatment 943
Multiple Osteocartilaginous Exostoses 947
Clinical and Imaging Features 947
Complications 949
Treatment 949
Bizarre Parosteal Osteochondromatous Proliferation 956
Clinical and Imaging Features 956
Pathology 961
Treatment 961
Chondroblastoma 961
Clinical and Imaging Features 961
Pathology 963
Treatment and Complications 963
Chondromyxoid Fibroma 968
Clinical and Imaging Features 968
Pathology 968
Differential Diagnosis 971
Treatment 971
Practical Points to Remember 971
Suggested Readings 973
Chapter 19
Benign Tumors and Tumor-like Lesions III: Fibrous,
Fibroosseous, and Fibrohistiocytic Lesions 975
Fibrous Cortical Defect and Nonossifying Fibroma 975
Clinical and Imaging Features 975
Pathology 975
Complications and Treatment 975
Benign Fibrous Histiocytoma 975
Clinical and Imaging Features 975
Periosteal Desmoid 981
Clinical and Imaging Features 981
Pathology 981
Differential Diagnosis 981
Fibrous Dysplasia 983
Monostotic Fibrous Dysplasia 983
Clinical and Imaging Features 983
Pathology 983 Contents xxi
Malignant Lymphoma 1149
Clinical Features 1149
Imaging Features 1149
Pathology 1149
Differential Diagnosis 1158
Treatment and Prognosis 1158
Myeloma 1158
Clinical Features 1158
Imaging Features 1158
Pathology 1162
Differential Diagnosis 1162
Complications, Treatment, and Prognosis 1167
Adamantinoma of Long Bones 1167
Clinical and Imaging Features 1167
Pathology 1168
Treatment and Prognosis 1168
Chordoma 1169
Clinical Features 1169
Imaging Features 1169
Pathology 1170
Complications, Treatment, and Prognosis 1170
Primary Leiomyosarcoma of Bone 1170
Clinical Features 1170
Imaging Features 1170
Pathology 1171
Differential Diagnosis 1171
Hemangioendothelioma and Angiosarcoma 1171
Clinical Features 1171
Imaging Features 1174
Pathology 1174
Benign Conditions with Malignant Potential 1176
Medullary Bone Infarct 1176
Chronic Draining Sinus Tract of Osteomyelitis 1176
Plexiform Neurofibromatosis 1178
Paget Disease 1178
Radiation-Induced Sarcoma 1178
Skeletal Metastases 1178
Clinical Features 1178
Imaging Features 1180
Pathology 1181
Complications 1181
Practical Points to Remember 1190
Suggested Readings 1191
Chapter 23
Tumors and Tumor-like Lesions of the Joints 1193
Benign Lesions 1193
Synovial (Osteo)Chondromatosis 1193
Clinical Features 1193
Imaging Features 1193
Pathology 1193
Differential Diagnosis 1193
Treatment and Prognosis 1196
Pigmented Villonodular Synovitis 1196
Clinical Features 1196
Imaging Features 1200
Langerhans Cell Histiocytosis (Eosinophilic Granuloma) 1067
Clinical and Imaging Features 1067
Pathology 1071
Treatment and Prognosis 1074
Infantile Myofibromatosis 1074
Erdheim-Chester Disease (Lipogranulomatosis) 1074
Medullary Bone Infarct 1076
Myositis Ossificans 1076
Practical Points to Remember 1079
Suggested Readings 1079
Chapter 21
Malignant Bone Tumors I: Osteosarcomas and
Chondrosarcomas 1082
Osteosarcomas 1082
Primary Osteosarcomas 1082
Conventional Osteosarcoma 1082
Low-Grade Central Osteosarcoma 1089
Telangiectatic Osteosarcoma 1089
Giant Cell–Rich Osteosarcoma 1090
Small Cell Osteosarcoma 1090
Fibrohistiocytic Osteosarcoma 1094
Intracortical Osteosarcoma 1095
Gnathic Osteosarcoma 1096
Multicentric (Multifocal) Osteosarcoma 1096
Surface (Juxtacortical) Osteosarcomas 1096
Soft-Tissue (Extraskeletal) Osteosarcoma 1104
Osteosarcomas with Unusual Clinical Presentation 1108
Secondary Osteosarcomas 1109
Chondrosarcomas 1113
Primary Chondrosarcomas 1113
Conventional Chondrosarcoma 1113
Clear Cell Chondrosarcoma 1114
Mesenchymal Chondrosarcoma 1114
Myxoid Chondrosarcoma 1117
Dedifferentiated Chondrosarcoma 1117
Periosteal (Juxtacortical) Chondrosarcoma 1117
Secondary Chondrosarcomas 1120
Soft-Tissue (Extraskeletal) Chondrosarcomas 1120
Practical Points to Remember 1135
Suggested Readings 1136
Chapter 22
Malignant Bone Tumors II:
Miscellaneous Tumors 1138
Fibrosarcoma and Malignant Fibrous Histiocytoma 1138
Clinical Features 1138
Imaging Features 1138
Pathology 1138
Differential Diagnosis 1138
Complications and Treatment 1140
Ewing Sarcoma 1140
Clinical Features 1140
Imaging Features 1141
Pathology 1142
Differential Diagnosis 1142
Treatment and Prognosis 1149xxii Contents
Chapter 25
Osteomyelitis, Infectious Arthritis, and
Soft-Tissue Infections 1235
Osteomyelitis 1235
Pyogenic Bone Infections 1235
Acute and Chronic Osteomyelitis 1235
Subacute Osteomyelitis 1240
Nonpyogenic Bone Infections 1240
Tuberculous Infections 1240
Fungal Infections 1242
Syphilitic Infection 1245
Differential Diagnosis of Osteomyelitis 1245
Chronic Recurrent Multifocal Osteomyelitis 1246
Infectious Arthritides 1247
Pyogenic Joint Infections 1247
Complications 1250
Nonpyogenic Joint Infections 1250
Tuberculous Arthritis 1250
Other Infectious Arthritides 1252
Infections of the Spine 1254
Pyogenic Infections 1254
Clinical and Imaging Features 1254
Pathology 1254
Nonpyogenic Infections 1254
Tuberculosis of the Spine 1254
Coccidioidomycosis of the Spine 1254
Soft-Tissue Infections 1264
Practical Points to Remember 1268
Suggested Readings 1268
Pa r t VI
METABOLIC, ENDOCRINE, AND
MISCELLANEOUS DISORDERS 1271
Chapter 26
Imaging Evaluation of Metabolic, Endocrine, and
Miscellaneous Disorders 1273
Composition and Production of Bone 1273
Evaluation of Metabolic and Endocrine Disorders 1273
Radiologic Imaging Modalities 1273
Conventional Radiography 1273
Computed Tomography 1278
Scintigraphy 1278
Magnetic Resonance Imaging 1278
Imaging Techniques for Measurement of Bone Mineral Density 1278
Radionuclide and X-ray Techniques 1278
Quantitative Ultrasound Technique 1279
Practical Points to Remember 1281
Suggested Readings 1282
Pathology 1204
Differential Diagnosis 1205
Treatment and Prognosis 1205
Synovial Hemangioma 1205
Clinical Features 1205
Imaging Features 1205
Pathology 1206
Differential Diagnosis 1206
Treatment and Prognosis 1206
Lipoma Arborescens 1206
Clinical Features 1206
Imaging Features 1209
Pathology 1209
Differential Diagnosis and Treatment 1209
Malignant Tumors 1209
Synovial Sarcoma 1209
Clinical Features 1209
Imaging Features 1209
Pathology 1209
Differential Diagnosis 1209
Treatment and Prognosis 1209
Synovial Chondrosarcoma 1209
Clinical Features 1209
Imaging Features 1212
Pathology 1212
Differential Diagnosis 1212
Malignant Pigmented Villonodular Synovitis 1212
Intraarticular Liposarcoma 1212
Practical Points to Remember 1218
Suggested Readings 1218
Pa r t V
INFECTIONS 1221
Chapter 24
Imaging Evaluation of Musculoskeletal
Infections 1223
Musculoskeletal Infections 1223
Osteomyelitis 1223
Infectious Arthritis 1223
Cellulitis 1223
Infections of the Spine 1223
Imaging Evaluation of Infections 1223
Conventional Radiography, Computed
Tomography, and Arthrography 1225
Radionuclide Imaging 1225
Arteriography, Myelography, Fistulography, and Ultrasound 1228
Magnetic Resonance Imaging 1228
Invasive Procedures 1231
Monitoring the Treatment and
Complications of Infections 1231
Practical Points to Remember 1233
Suggested Readings 1233 Contents xxiii
Tumoral Calcinosis 1334
Pathophysiology and Clinical Features 1334
Imaging Features 1337
Treatment 1337
Hypothyroidism 1337
Pathophysiology and Clinical Features 1337
Imaging Features 1338
Complications 1340
Scurvy 1340
Pathophysiology and Clinical Features 1340
Imaging Features 1340
Differential Diagnosis 1340
Practical Points to Remember 1342
Suggested Readings 1342
Pa r t VII
CONGENITAL AND DEVELOPMENTAL
ANOMALIES 1343
Chapter 31
Imaging Evaluation of Skeletal Anomalies 1345
Classification 1345
Imaging Modalities 1345
Practical Points to Remember 1359
Suggested Readings 1359
Chapter 32
Anomalies of the Upper and Lower Limbs 1360
Anomalies of the Shoulder Girdle and Upper Limbs 1360
Congenital Elevation of the Scapula 1360
Dentate Scapula 1360
Madelung Deformity 1360
Anomalies of the Pelvic Girdle and Hip 1360
Congenital Hip Dislocation (Developmental Dysplasia of
the Hip) 1360
Radiographic Features 1366
Measurements 1366
Arthrography and Computed Tomography 1367
Ultrasound 1370
Magnetic Resonance Imaging 1370
Classification 1370
Treatment 1370
Complications 1375
Proximal Femoral Focal Deficiency 1375
Classification and Imaging Features 1375
Treatment 1375
Legg-Calvé-Perthes Disease 1376
Imaging Features 1376
Classification 1378
Differential Diagnosis 1380
Treatment 1380
Slipped Capital Femoral Epiphysis 1380
Imaging Features 1380
Treatment and Complications 1380
Chapter 27
Osteoporosis, Rickets, and Osteomalacia 1283
Osteoporosis 1283
Generalized Osteoporosis 1283
Localized Osteoporosis 1289
Rickets and Osteomalacia 1289
Rickets 1289
Infantile Rickets 1289
Vitamin D–Resistant Rickets 1290
Osteomalacia 1291
Renal Osteodystrophy 1293
Practical Points to Remember 1296
Suggested Readings 1296
Chapter 28
Hyperparathyroidism 1297
Pathophysiology 1297
Physiology of Calcium Metabolism 1297
Clinical Features 1298
Imaging Features 1298
Pathology 1301
Complications 1304
Practical Points to Remember 1304
Suggested Readings 1304
Chapter 29
Paget Disease 1305
Pathophysiology and Clinical Features 1305
Imaging Features 1305
Pathology 1309
Differential Diagnosis 1309
Complications 1309
Pathologic Fractures 1309
Degenerative Joint Disease 1309
Neurologic Complications 1309
Neoplastic Complications 1313
Orthopaedic and Medical Management 1313
Practical Points to Remember 1327
Suggested Readings 1327
Chapter 30
Miscellaneous Metabolic and
Endocrine Disorders 1329
Familial Idiopathic Hyperphosphatasia 1329
Clinical Features 1329
Imaging Features 1329
Differential Diagnosis 1329
Acromegaly 1329
Clinical Features 1329
Imaging Features 1329
Gaucher Disease 1333
Classification and Clinical Features 1333
Imaging Features 1333
Complications 1334
Treatment 1334xxiv Contents
Achondroplasia 1418
Clinical Features 1418
Imaging Features 1418
Complications 1423
Differential Diagnosis 1423
Mucopolysaccharidoses 1423
Fibrodysplasia Ossificans Progressiva (Myositis Ossificans
Progressiva) 1423
Clinical Features 1423
Imaging Features 1423
Pathology 1424
Sclerosing Dysplasias of Bone 1424
Osteopetrosis 1426
Pyknodysostosis (Pycnodysostosis) 1433
Enostosis, Osteopoikilosis, and Osteopathia Striata 1436
Progressive Diaphyseal Dysplasia (Camurati-Engelmann Disease) 1439
Hereditary Multiple Diaphyseal Sclerosis (Ribbing Disease) 1440
Endosteal Hyperostosis (Hyperostosis Corticalis Generalisata) 1444
Dysosteosclerosis 1445
Pyle Disease 1446
Craniometaphyseal Dysplasia 1446
Melorheostosis 1446
Craniodiaphyseal Dysplasia 1451
Hyperostosis Generalisata with Striations of Bones 1451
Other Mixed Sclerosing Dysplasias 1451
Practical Points to Remember 1453
Suggested Readings 1454
Index 1456
Anomalies of the Lower Limbs 1385
Congenital Tibia Vara 1385
Imaging Features and Differential Diagnosis 1386
Classification 1387
Treatment 1387
Dysplasia Epiphysealis Hemimelica 1389
Imaging Features and Treatment 1389
Talipes Equinovarus 1389
Measurements and Radiographic Features 1389
Treatment 1393
Congenital Vertical Talus 1393
Imaging Features 1393
Treatment 1394
Tarsal Coalition 1395
Calcaneonavicular Coalition 1395
Talonavicular Coalition 1395
Talocalcaneal Coalition 1397
Practical Points to Remember 1401
Suggested Readings 1402
Chapter 33
Scoliosis and Anomalies with General Affliction of
the Skeleton 1404
Scoliosis 1404
Idiopathic Scoliosis 1404
Congenital Scoliosis 1404
Miscellaneous Scolioses 1404
Imaging Evaluation 1404
Measurements 1404
Treatment 1409
Anomalies with General Affliction of the Skeleton 1412
Neurofibromatosis 1412
Osteogenesis Imperfecta 1415
Classification 1416
Imaging Features 1418
Differential Diagnosis 1418
Treatment 1418