scholarly journals Outcomes of Magnetic Resonance Imaging Detected Occult Neck of Femur Fractures: Do They Represent a Less Severe Injury with Improved Outcomes?

Hip & Pelvis ◽  
2019 ◽  
Vol 31 (1) ◽  
pp. 18 ◽  
Author(s):  
Pradyumna Raval ◽  
Alistair I.W. Mayne ◽  
Phey Ming Yeap ◽  
Thomas Barry Oliver ◽  
Arpit Jariwala ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Severe Injury ◽  
Resonance Imaging ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Improved Outcomes

scholarly journals Does the Use of Magnetic Resonance Imaging Scan in Occult and Suspected Metastatic Pathological Neck of Femur Fractures Affect the Choice of Surgical Intervention?

2019 ◽  
Vol 10 ◽  
pp. 117956031984328
Author(s):  
Basil Budair ◽  
Mohammad Al-Tibi ◽  
Tarek Boutefnouchet
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Resonance Imaging ◽  
Occult Fracture ◽  
Mri Scan ◽  
Pathological Fractures ◽  
Neck Of Femur ◽  
Femur Fractures

Background: Magnetic resonance imaging (MRI) is often employed as the diagnostic modality of choice in occult and suspected pathological femoral neck fractures. We evaluated the clinical utility of MRI scan in this patient population. Method: Retrospective observational analysis of cases with a radiologically occult or suspected metastatic pathological neck of femur fracture. Results: From a total of 894 femoral neck fractures treated in our institution, 100 patients had and MRI scan pre-operatively for either occult fracture or suspected fracture secondary metastatic disease. Magnetic resonance imaging confirmed the presence of 13 simple fractures. A total of 14 patients had pathological features suggestive of metastasis, of which 12 were clearly visible on plain radiographs. Surgical plan did not change after MRI for any of these pathological fractures. Conclusion: Results of this study demonstrate that an MRI scan had an impact on treatment selection only when a simple but radiographically occult fracture is suspected and but not in the context of suspected metastatic pathological fractures.

The Spectrum of Brain Stem Lesions in Children

2020 ◽  
Author(s):  
Hanuman Prasad Prajapati ◽  
Raj Kumar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brain Stem ◽  
Pediatric Patients ◽  
Neurophysiological Monitoring ◽  
Resonance Imaging ◽  
Improved Outcomes ◽  
Brain Stem Lesions ◽  
Stem Lesions ◽  
Brain Stem Gliomas

AbstractThe objective of this study was to describe the clinicodemographic profiles, management, and outcomes of brain stem lesions in 53 pediatric patients with brain stem lesions. Most of the patients were male, 6 to 10 years of age (8.66 ± 4.69). Out of 53 patients, there were 77.36% brain stem gliomas, 11.32% tuberculomas, 5.66% abscesses, 3.77% cavernomas, and 1.89% schwannomas. With advancement in neuroimaging (e.g., tractography), intraoperative technology (e.g., ultrasound, neurophysiological monitoring, and magnetic resonance imaging), and safe and precise incision for particular lesions, majority of brain stem lesions had improved outcomes (67.92%) with significant reduction in morbidity and mortality (11.32%).

Evaluation of Occult Femoral Neck Fractures – Computed Tomography or Magnetic Resonance Imaging?

2019 ◽  
Vol 1 ◽  
pp. 82-87
Author(s):  
Moomal Haris ◽  
Philip Robinson ◽  
Harun Gupta
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Femoral Neck ◽  
Plain Radiograph ◽  
Femoral Neck Fractures ◽  
Second Line ◽  
Resonance Imaging ◽  
Femur Fractures ◽  
Diagnostic Certainty

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

Does Severity of Brain Injury on Magnetic Resonance Imaging Predict Short-Term Outcome in Neonates Who Received Therapeutic Hypothermia?

2021 ◽  
Author(s):  
Indira Bhagat ◽  
Prashant Agarwal ◽  
Avishek Sarkar ◽  
Ronald Dechert ◽  
Deniz Altinok ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Injury ◽  
Magnetic Resonance ◽  
Therapeutic Hypothermia ◽  
Severe Injury ◽  
Multivariate Linear Regression Analysis ◽  
Resonance Imaging ◽  
Short Term ◽  
Cerebral Lesions ◽  
Feeding Difficulty

Objective The National Institute of Child Health and Human Development (NICHD) magnetic resonance imaging (MRI) pattern of brain injury is a known biomarker of childhood outcome following therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy (HIE). However, usefulness of this classification has not been evaluated to predict short-term outcomes. The study aimed to test the hypothesis that infants with NICHD MRI pattern of severe hypoxic-ischemic brain injury will be sicker with more severe asphyxia-induced multiorgan dysfunction resulting in prolonged length of stay (LOS) following therapeutic hypothermia. We also evaluated the role of other risk factors which may prolong LOS. Study Design We retrospectively reviewed the medical records of 71 consecutively cooled neonates to examine the ability of MRI patterns of brain injury to predict the LOS. A neuroradiologist masked to outcomes classified the patterns of brain injury on MRI as per NICHD. Pattern 2A (basal ganglia thalamic, internal capsule, or watershed infarction), 2B (2A with cerebral lesions), and 3 (hemispheric devastation) of brain injury was deemed “severe injury.” Results Out of 71 infants, 59 surviving infants had both MRI and LOS data. LOS was higher for infants who had Apgar's score of ≤5 at 10 minutes, severe HIE, seizures, coagulopathy, or needed vasopressors or inhaled nitric oxide, or had persistent feeding difficulty, or remained intubated following cooling. However, median LOS did not differ between the infants with and without MRI pattern of severe injury (15 days, interquartile range [IQR]: 9–28 vs. 12 days, IQR: 10–20; p = 0.4294). On multivariate linear regression analysis, only persistent feeding difficulty (β coefficient = 11, p = 0.001; or LOS = 11 days longer if had feeding difficulty) and ventilator days (β coefficient 1.7, p < 0.001; or LOS increased 1.7 times for each day of ventilator support) but not the severity of brain injury predicted LOS. Conclusion Unlike neurodevelopmental outcome, LOS is not related to severity of brain injury as defined by the NICHD. Key Points

THE UNIFYING ARTICULAR (SYNOVIAL) ORIGIN OF INTRANEURAL GANGLIA

Neurosurgery ◽  
2009 ◽  
Vol 65 (suppl_4) ◽  
pp. A115-A124 ◽  
Author(s):  
Robert J. Spinner ◽  
Bernd W. Scheithauer ◽  
Kimberly K. Amrami
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Critical Analysis ◽  
Surgical Approaches ◽  
Resonance Imaging ◽  
Cyst Size ◽  
Nerve Branch ◽  
Ongoing Process ◽  
Improved Outcomes ◽  
Operative Strategies

Abstract THE PATHOGENESIS OF intraneural ganglia has been an issue of curiosity, controversy, and contention for 200 years. Three major theories have been proposed to explain their existence, namely, 1) degenerative, 2) synovial (articular), and 3) tumoral theories, each of which only partially explains the observations made by a number of investigators. As a result, differing operative strategies have been described; these generally meet with incomplete neurological recoveries and high rates of recurrence. Recent advances in magnetic resonance imaging and critical analysis of the literature have clarified the mechanisms underlying the formation and propagation of these cysts, thereby confirming the unifying articular (synovial) theory. By identifying the shared features of the typical cases and explaining atypical examples or clinical outliers, several fundamental principles have been described. These include: 1) a joint origin; 2) dissection of fluid from that joint along an articular nerve branch, extension occurring via a path of least resistance; and 3) cyst size, extent, and directionality being influenced by pressures and pressure fluxes. We believe that understanding the pathogenesis of these cysts will be reflected in optimal surgical approaches, improved outcomes, and decreased frequency, if not elimination, of recurrences. This article describes the ongoing process of critically analyzing and challenging previous observations and evidence in an effort to prove a concept and a theory.

Sign in / Sign up

Export Citation Format

Share Document