Atlas of Normal Roentgen Variants That May Simulate Disease E-Book

The uncovertebral mal-alignment was detected in all 12 cases. Normally, the two components of the uncovertebral joint enjoy a concentric relationship that in the axial plane is reminiscent of the relationship of headphones with the wearer's head. We name this appearance the 'headphones' sign. Radiologists should be aware of the headphones sign as a reliable indicator of facet joint dislocation on axial imaging used in the assessment of cervical spine injuries. The aim of this study was to assess feasibility and accuracy of augmented reality-guided lumbar facet joint injections.

A spine phantom completely embedded in hardened opaque agar with 3 ring markers was built. A 3-dimensional model of the phantom was uploaded to an augmented reality headset Microsoft HoloLens. Two radiologists independently performed 20 augmented reality-guided and 20 computed tomography CT -guided facet joint injections each: The radiologists targeted the virtual facet joint and tried to place the needle tip in the holographic joint space.

Computed tomography was performed after each needle placement to document final needle tip position. Time needed from grabbing the needle to final needle placement was measured for each simulated injection. An independent radiologist rated images of all needle placements in a randomized order blinded to modality augmented reality vs CT and performer as perfect, acceptable, incorrect, or unsafe. Accuracy and time to place needles were compared between augmented reality-guided and CT-guided facet joint injections. One augmented reality-guided injection missed the facet joint space by 2 mm.

No unsafe needle placements occurred. Lumbar facet syndrome - Lumbar facet joint injection and low back pain. The authors conducted a retrospective study lo evaluate the effectiveness of injection therapy in the lumbar zygapophysial joints with anesthetics and steroids in patients with persisting low back pain and lumbar facer syndrome. Thirty-seven patients with low back pain who reported immediate relief of their pain after controlled blocks into the facet joints between the fourth and fifth lumbar vertebrae and the fifth lumbar and first sacral vertebrae were evaluated.

Outcome was evaluated using the visual analog pain scales. All outcome measures were repeated at eight days and six weeks alter controlled injection. Fifteen patients experienced a good response with pain relief of eight points or more in the VAS. To investigate the feasibility, accuracy of B ultrasound in the examination of joint space of lumbar spine facet joints compared with CT scan.

Ten healthy adult volunteers were enrolled. The joint space of lumbar facet joints was measured by ultrasound. To identify the spinal levels, the posterior parasagittal sonograms were obtained at levels L1 to S1. The lumbar facet joints were delineated with the help of transverse sonograms at each level. Meanwhile, the lumbar facet joints were evaluated by spiral CT on the same plane, reformatted to 1-mm axial slices. A total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 volunteers.

The lumbar facet joint space can be accurately demonstrated by ultrasound. Full Text Available A case of facet joint fracture following a rear-end motor vehicle accident who presented with chronic low back pain and sciatica is outlined. Diagnosis was made with 99Tc nuclear bone scan and was confirmed on computed tomographic scan after diagnosis with regular radiographs had failed.

Facetectomy relieved pain but led to symptoms related to asymmetric load on the opposite facet joint. Symptoms were substantially relieved with a facet joint deinnervation procedure. Facet joint fracture was felt to occur as a consequence of compression forces on the facet joint at the time of impact.

Unusual case of paediatric septic arthritis of the lumbar facet joints due to Kingella kingae. A month-old boy presented with febrile limping that had developed over 6days, associated with right lumbosacral inflammatory swelling. Magnetic resonance imaging MRI showed joint effusion of the right L5-S1 zygapophyseal joint , complicated by destructive osteomyelitis of the L5 articular process and paraspinal abscess. Surgery was decided to evacuate the fluid accumulation and rule out differential diagnoses.

The diagnosis of septic arthritis of the facet joint was confirmed intraoperatively; real-time quantitative PCR analysis identified Kingella kingae. This is the first substantiated paediatric case of zygapophyseal joint septic arthritis due to K. Since empiric antibiotics are effective in early stages, physicians should consider the possibility of spinal infections due to K. Association between facet joint osteoarthritis and the Oswestry Disability Index. The study involved lumbar MRIs of patients with a mean age of The MRIs of the lumbar spine were performed on a 1. After initial blinding, each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging.

In total facet joints were graded. Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI. The index is scored from 0 to and interpreted as follows: The majority of patients The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain. Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.

Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain.

The results showed significant increase of facet joint interventions and sacroiliac joint injections from to in Medicare FFS service beneficiaries. While the increases were uniform from to , there were some decreases noted for facet joint interventions in , , and , whereas for sacroiliac joint injections, the decreases were noted in and The increases were for cervical and thoracic facet neurolysis at We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection.

Percutaneous transfacet fixation was then performed at L4—L5 level with a cannulated screw using CT and fluoroscopy guidance. Using the visual analog scale VAS , pain decreased from 9. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable VAS at 0 during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation could be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst. Imaging findings predicting the outcome of cervical facet joint blocks.

Hechelhammer, Lukas; Pfirrmann, Christian W. Fifty facet joints in 37 patients were included in the study. In all patients, pain relief was assessed using a visual analogue scale. All computed tomography CT examinations were blindly reviewed by two radiologists. Osteoarthritis was rated using the Kellgren classification. Factors affecting results of fluoroscopy-guided facet joint injection: Probable differences in the outcome of treatment between pure facet joint hypertrophy and concomitant diseases.

Full Text Available Study Design: Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Facet joint injection was applied to 94 patients treated at our hospital between and mean age For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertrophy were placed in group A 47 patients, 41 women and 6 men, mean age Injections were applied around the facet joint under surgical conditions utilizing fluoroscopy device guidance.

A mixture of methylprednisolone and lidocaine was used as the injection ingredient. In terms of Oswestry Disability Index ODI and visual analog scale VAS scores, no significant difference was found between preinjection and immediate postinjection values in both groups, and the scores of group A patients were significantly lower P facet hypertrophy, steroid injection around the facet joint is an effective treatment, but if there is an existing major pathology, it is not as effective.

Treatment of lumbar facet joint syndrome by CT-guided intraarticular infiltration of fact joints. In 62 patients with facet syndrome a total of joints were infiltrated, CT monitoring being used in all cases. Each facet joint was infiltrated with 0. The patients were divided into three groups. Group 1 consisted of 24 persons who had undergone lumbar disc surgery, group 2 of 23 patients with spondylarthrosis of the facet joints , and group 3 of 15 patients who had undergone lumbar disc surgery but hat additional spondylarthrosis.

Very good results were defined as pain relief for longer than 4 weeks, good results as pain relief for up to 4 weeks and poor results as brief pain relief or none at all. In 27 patients facet infiltration was performed for the purpose of diagnosis. Results were significantly in group 2 than in group 1. In group 3 results were better than in group 1, but worse than in group 2.

These differences were not statistical by significant. Seven patients in the diagnostic group had no pain relief, and facet syndrome was excluded. These relationships may help clinicians better identify impaired quadriceps activation. Experimental data have shown that quadriceps activation and strength may be directly mediated by intracapsular joint pressure created by saline injection.

An inverse relationship between quadriceps activation and the amount of saline injected has been reported. This association has not been demonstrated for traumatic effusion. We hypothesized that traumatic joint effusion due to ACL rupture and postinjury quadriceps strength would correlate well with quadriceps activation, allowing clinicians to use effusion and strength measurement as a surrogate for electrophysiological assessment of quadriceps activation. A complete clinical evaluation of the knee was performed, including ligamentous assessment and assessment of range of motion and effusion.

Quadriceps function was electrophysiologically assessed using maximal volitional isometric contraction and burst superimposition techniques to quantify both strength and activation. Therefore, it should not be used as a clinical substitute for electrophysiological assessment of quadriceps. Congenital absence of the lumbar facet joint associated with bilateral spondylolysis of the fifth lumbar vertebra.

A year-old boy presented with a rare case of congenital absence of lumbar facet joint manifesting as low back pain. Physical examination showed no neurological or hematologic abnormalities. Radiography revealed absence of a facet joint on the right side of L Computed tomography and three-dimensional computed tomography revealed absence of the facet joint on the right side of L and spondylolysis on both sides of L5. Pain subsided after conservative treatment. This is an extremely rare case of congenital absence of lumbar facet joint associated with bilateral spondylolysis. Facet joint osteoarthritis is considered a consequence of the aging process; however, there is evidence that it may be associated with degenerative changes of other structures.

The goal of this study was to investigate the correlation between lumbar multifidus muscle features and facet joint osteoarthritis. This retrospective study included patients who had acute or chronic low back pain and were diagnosed with facet joint osteoarthritis on computed tomography scan. Morphometric parameters, including cross-sectional area, muscle-fat index, and percentage of bilateral multifidus asymmetry at L3-L4, L4-L5, and L5-S1, were evaluated with T2-weighted magnetic resonance imaging.

A higher multifidus muscle-fat index was independently associated with facet joint osteoarthritis, and bilateral multifidus size asymmetry was associated with the development of facet joint osteoarthritis at L5-S1. It seems more accurate to consider facet joint osteoarthritis a failure of the whole joint structure, including the paraspinal musculature, rather than simply a failure of the facet joint cartilage. To describe the associations between effusion -synovitis and joint structural abnormalities in patients with knee osteoarthritis OA over 24 months.

Knee effusion -synovitis volume and score, cartilage defects, cartilage volume, and bone marrow lesions BML were assessed using magnetic resonance imaging. Joint space narrowing JSN and osteophytes were assessed using radiograph. Least significant change criterion was used to define change in effusion -synovitis volume. Total effusion -synovitis volume increased modestly from baseline 8. Baseline BML, cartilage defect, JSN, and osteophyte scores were positively associated with change in effusion -synovitis volume p effusion -synovitis score p effusion -synovitis score nor volume consistently predicted change in the above structures except cartilage volume.

In the mixed-effects models, knee effusion -synovitis was positively associated with BML volume: Change in effusion -synovitis volume was positively correlated with changes in knee pain and stiffness scores p effusion -synovitis, but effusion -synovitis did not predict knee structural changes. These findings suggest that synovial inflammation is likely the result of joint structural abnormalities in established OA. Facet joint injuries in acute cervical spine trauma: To evaluate injury patterns of facet joints and associated soft tissue injuries in patients with acute traumatic cervical facet joint injuries.

From among patients with cervical spine trauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzed with regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, and other associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury, intervertebral disc herniation, and spinal cord injury. Patterns of fracture were vertical, transverse, or comminuted, but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facet fractures.

Traumatic cervical facet joint injuries were manifested as various patterns and frequently associated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patterns helped formulate a therapeutic plan and determine of prognosis. Image-guided lumbar facet joint infiltration in nonradicular low back pain.

To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain LBP. Forty-four patients with chronic LBP of more than 3 months' duration were selected for facet joint infiltration. Fifteen patients had radiological evidence of facetal arthropathy, one had a facet joint synovial cyst, three were post—lumbar surgery patients, and two patients had spondylolysis.

Facet joint injections were carried out under fluoroscopic guidance in 39 patients and under CT guidance in 5 cases. Pain relief was assessed using the visual analog scale at 1 h post-procedure and, thereafter, at 1, 4, 12, and 24 weeks. A total of facet joints were infiltrated in 44 patients over a 2-year period. There was significant pain relief in No major complications were encountered. Facet nerve block was found to be a simple, minimally invasive, and safe procedure.

We conclude that this method represents an important alternative treatment for nonradicular back pain. The merits of using commercially available software packages versus in-house software and databases are frequently assessed by cost engineers in consulting, contracting and operating companies alike. There is no consensus on which approach is better as each company has individual requirements that are better provided for by one or the other alternative.

The FACET series of programs enables detailed cost estimates to be quickly developed from relatively conceptual cost data and allows project cost estimates to be compared with actual costs as the project proceeds. Inter-rater reliability of diagnostic criteria for sacroiliac joint -, disc- and facet joint pain. Several diagnostic criteria sets are described in the literature to identify low back pain subtypes, but very little is known about the inter-rater reliability of these criteria.

We conducted a study to determine the reliability of diagnostic tests that point towards SI joint -, disc- or facet joint pain. Inter-rater reliability study alongside three randomized clinical trials. Multidisciplinary pain center of general hospital. Patients aged 18 or more with medical history and physical examination suggestive of sacroiliac joint -, disc- and facet joint pain on lumbar level.

Making use of nowadays most common used diagnostic criteria, a physical examination is taken independently by three physicians two pain physicians and one orthopedic surgeon. One hundred patients were included. Three other parameters had a fair strength of agreement between two raters, all other parameters had a slight or poor strength of agreement. Inter-rater reliability, confidence intervals and significance of. The lower cervical spine facet joints of a road traffic crash fatality were examined using diagnostic imaging and histological techniques.

No injuries to the cervical spine facet joints could be identified with diagnostic imaging including conventional radiology, CT and MRI. Occult injuries to and in close proximity of the cervical spine facet joints were identified only on histological examination Facet joint orientation and tropism in lumbar degenerative disc disease and spondylolisthesis. Although degenerative disc disease DDD and degenerative spondylolisthesis DS are two common causes of back pain in elderly, the association between the lumbarfacet joint angle and tropism in these conditions are still unclear.

To evaluate the difference in facet joint angles between normal population and lumbar degenerative disc disease and spondylolisthesis patient. The angle of lumbar facet joints were retrospectively measured with magnetic resonance imaging MRI to determine whether there was a difference between degenerative diseases. There was no difference infacetjoint angle in DDD Facet tropism showed difference between degenerative groups and control group at L level. DS group showed difference in facet joints angle and tropism when compared with control population, while DDD showed difference only in facet tropism.

In addition, longitudinal studies are needed to understand the clinical significant between facet joint angle and tropism in spinal degenerative diseases. Subdural empyema following lumbar facet joint injection: An exceeding rare complication. Facet joint injection is a routine intervention in the armamentarium for both the diagnostic and therapeutic management of chronic low back pain. In fact, a study by Carrino et al. Although generally considered safe, the procedure is not entirely without risk.

Complications including bleeding, infection, exacerbation of pain, dural puncture headache, and pneumothorax have been described. This case is unique, as to the best of our knowledge no other case of subdural empyema following facet joint injection has been reported in the literature. Furthermore this case serves to highlight the potential serious adverse sequelae of a routine and apparently innocuous intervention.

The need for medical practitioners to be alert to and respond rapidly to the infective complications of facet joint injection cannot be understated. A descriptive in vitro study on isolation and differentiation of human mesenchymal stem cells MSCs derived from the facet joints and interspinous ligaments.

To isolate cells from the facet joints and interspinous ligaments and investigate their surface marker profile and differentiation potentials. Lumbar spinal canal stenosis and ossification of the posterior longitudinal ligament are progressive conditions characterized by the hypertrophy and ossification of ligaments and joints within the spinal canal. MSCs are believed to play a role in the advancement of these diseases and the existence of MSCs has been demonstrated within the ligamentum flavum and posterior longitudinal ligament.

The aim of this study was to investigate whether these cells could also be found within facet joints and interspinous ligaments. Samples were harvested from 10 patients undergoing spinal surgery.

The MSCs from facet joints and interspinous ligaments were isolated using direct tissue explant technique. Cell surface antigen profilings were performed via flow cytometry. Their lineage differentiation potentials were analyzed. The facet joints and interspinous ligaments-derived MSCs have the tri-lineage potential to be differentiated into osteogenic, adipogenic, and chondrogenic cells under appropriate inductions.

Flow cytometry analysis revealed both cell lines expressed MSCs markers. Both facet joints and interspinous ligaments-derived MSCs expressed marker genes for osteoblasts, adipocytes, and chondrocytes. The facet joints and interspinous ligaments may provide alternative sources of MSCs for tissue engineering applications. The facet joints and interspinous ligaments-derived MSCs are part of the microenvironment of the human ligaments of the spinal column and might play a crucial role in the development and progression of degenerative spine conditions.

To compare hip joint effusion -synovitis prevalence in professional ballet dancers with nondancing athletes and to evaluate the relationship between effusion -synovitis and clinical measures and cartilage defects. Elite ballet and sport. Forty-nine professional ballet dancers and 49 age-matched and sex-matched athletes. Larger sized joint effusion -synovitis was exclusively found in dancers. Desmoid type fibromatosis in the facet joint of lumbar spine: Case report and review of literature. Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis.

It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L spine with bone involvement.

We retrospectively analyzed CT scans of individuals, who presented to our traumatology department between and Facet joint FJ arthritis was present in Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intra-articular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. Twenty patients with refractory lumbar facet joint pain were recruited, and each patient was treated via intra-articular pulsed radiofrequency.

The treatment effects were measured with a numerical rating scale, and the technical accuracy of intra-articular pulsed radiofrequency treatment was evaluated independently by 2 radiologists. Any adverse events or complications also were checked. We performed intra-articular pulsed radiofrequency treatment at 48 levels of the lumbar facet joints in 20 patients 5 men and 15 women; mean age, Pain scores were significantly reduced at 1 month, 3 months, and 6 months after treatment P radiofrequency results in all 20 patients, without any serious adverse effects.

Treatment using intra-articular pulsed radiofrequency is an alternative to other techniques in patients with refractory lumbar facet joint pain. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture. A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography CT is often used as secondary imaging.

To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. All fracture signs cortical and trabecular fractures, bone bruise, joint effusion , and lipohemarthrosis were recorded in hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers.

There were no fracture signs in patients. Twelve of these had a joint effusion. In patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in patients. Bone bruise was found in patients, joint effusion in 35, and lipohemarthrosis in 20 patients.

• Join Kobo & start eReading today?
• Atlas of Normal Roentgen Variants That May Simulate Disease!
• Atlas of Normal Roentgen Variants That May Simulate Disease by Theodore E. Keats.
• Lesson Plans Tears of the Giraffe.
• Registered user.
• Lange dAyala (French Edition).

Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign. Radiologic analysis using computed tomography. To analyze the degenerative changes of the facet joints in patients with spondylolysis in comparison with control subjects. Defects of the pars interarticularis are thought to result in a reduction of biomechanical stress on adjacent facet joints. Therefore, degenerative changes of the facet joints in patients with spondylolysis are expected to be less than those in patients without spondylolysis.

Join Kobo & start eReading today

Abdominal and pelvic multidetector computed tomography scans of subjects, performed for conditions unrelated to low back pain, were reviewed. Sex-matched and age-matched controls without spondylolysis were chosen randomly [spondylolysis - group]. Subjects in the spondylolysis group were subdivided into either bilateral spondylolysis or unilateral spondylolysis groups for comparison with the control group.

Four radiologic findings narrowing, sclerosis, osteophyte, and bone cyst indicative of degenerative change of the facet joints adjacent to the L5 pars defects were evaluated and the degree of degenerative change was graded by summing the number of degenerative changes score range, Degenerative changes of the facet joints in patients with lumbar spondylolysis were more severe than those without spondylolysis.

Evaluation of the relationship between age, gender, and body mass index, and lumbar facet joint pain. Full Text Available Introduction: In this descriptive study 76 patients who were diagnosed, after a diagnostic block, as having lumbar facet joint pain were evaluated by their age, sex, and body mass index BMI. Data were collected according to a checklist and entered to SPSS version The mean age of the participants was Lumbar facet joint pain was more frequent in the age range of years.

Based on our findings, the chances of developing lumbar facet joint pain is more in women who are between 40 years and 55 years of age and whose BMI is We compared signal change on magnetic resonance imaging MRI with fat suppression and bone scan activity of lumbar facet joints to determine if these two imaging findings are correlated. Pedicle marrow signal intensity changes in the lumbar spine: Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI.

The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment.

Contribution of facet joints , axial compression, and composition to human lumbar disc torsion mechanics. Stresses applied to the spinal column are distributed between the intervertebral disc and facet joints. Structural and compositional changes alter stress distributions within the disc and between the disc and facet joints. These changes influence the mechanical properties of the disc joint , including its stiffness, range of motion, and energy absorption under quasi-static and dynamic loads.

There have been few studies evaluating the role of facet joints in torsion. Furthermore, the relationship between biochemical composition and torsion mechanics is not well understood. Therefore, the first objective of this study was to investigate the role of facet joints in torsion mechanics of healthy and degenerated human lumbar discs under a wide range of compressive preloads.

The second objective was to develop a quantitative structure-function relationship between tissue composition and torsion mechanics. The findings from this study demonstrate that annulus fibrosus GAG content plays an important role in disc torsion mechanics. A decrease in GAG content with degeneration reduced torsion mechanics by more than an order of magnitude, while collagen content did not significantly influence disc torsion mechanics.

The biochemical-mechanical and compression-torsion relationships reported in this study allow for better comparison between studies that use discs of varying levels of degeneration or testing protocols and provide important design criteria for biological repair strategies. Published by Wiley Periodicals, Inc. Quantify histological changes in the lower cervical spine facet joints with regard to age and gender using systematic random sampling of entire joints. Neck pain is a common debilitating musculoskeletal condition The cause of neck pain is multifactorial and osteoarthritis is one potential cause.

The cervical spine facet joints have been implicated in the aetiology of chronic neck pain. Hence, a detailed description of their anatomy and age The lower four cervical spine segments C4-C7 included were obtained from 72 subjects during autopsy; 29 females median age 53 years [] and 43 males median age 38 years [].

A total of articular facets were embedded in toto in hard plastic The prevalence of lumbar facet joint edema in patients with low back pain. The objective was to assess the prevalence of lumbar facet joint edema in patients with low back pain. Lumbar spine MR examinations 1. In 9 patients follow-up MR examinations were performed and results were compared with pain. The agreement between the change in intensity of facet joint edema and the change in intensity of pain was assessed using kappa statistics and Kendall's tau coefficient. Kendall's tau coefficient was 0.

This fact may be useful for planning treatment including facet joint injections. Delayed onset of a spinal epidural hematoma after facet joint injection. Full Text Available The treatment of chronic back pain is a challenging problem. Facet joint infiltration is an established treatment for chronic low back pain caused by arthrosis of the lumbar facet joints. Due to the increasing number of patients with chronic low back pain, this therapy has become more frequent. Our case shows that even a delayed onset of spinal epidural hematoma is possible and should be kept in mind as a possible cause of acute myelopathy after spinal intervention.

Qualitative and quantitative assessment of degeneration of cervical intervertebral discs and facet joints. Degeneration of intervertebral discs and facet joints is one of the most frequently encountered spinal disorders. In order to describe and quantify degeneration and evaluate a possible relationship between degeneration and biomechanical parameters, e. However, few scoring systems for the assessment of degeneration of the cervical spine exist.

Therefore, two separate objective scoring systems to qualitatively and quantitatively assess the degree of cervical intervertebral disc and facet joint degeneration were developed and validated. The scoring system for cervical disc degeneration consists of three variables which are individually scored on neutral lateral radiographs: The scoring system for facet joint degeneration consists of four variables which are individually scored on neutral computed tomography scans: Each variable contributes with varying importance to the overall degeneration score max 9 points for the scoring system of cervical disc degeneration and max 5 points for facet joint degeneration.

Degeneration of 20 discs and facet joints of 20 patients was blindly assessed by four raters: Measurement errors and inter- and intra-rater agreement were determined. The measurement error of the scoring system for cervical disc degeneration was MR imaging and CT in osteoarthritis of the lumbar facet joints. To test the agreement between MR imaging and CT in the assessment of osteoarthritis of the lumbar facet joints , and thus to provide data about the need for an additional CT scan in the presence of an MR examination.

Using a four-point scale, two musculoskeletal radiologists independently graded the severity of osteoarthritis of lumbar facet joints on axial T2-weighted and on sagittal T1- and T2-weighted turbo-spin-echo images and separately on the corresponding axial CT scans. Kappa statistics and percentage agreement were calculated. The weighted kappa coefficients for MR imaging versus CT were 0.

The weighted kappa coefficients for interobserver agreement were 0. With regard to osteoarthritis of the lumbar facet joints there is moderate to good agreement between MR imaging and CT. When differences of one grade are disregarded agreement is even excellent. Therefore, in the presence of an MR examination CT is not required for the assessment of facet joint degeneration.

Several approaches to surgical intervention are available for patients with middle facet coalitions, ranging from resection to hindfoot arthrodesis. With a mean follow-up period of The use of a particulate juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal middle facet coalition resection combined with adjunct procedures to address concomitant pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients. Published by Elsevier Inc. Quantitative in vivo MRI evaluation of lumbar facet joints and intervertebral discs using axial T2 mapping.

To assess the feasibility of T2 mapping of lumbar facet joints and intervertebral discs in a single imaging slab and to compare the findings with morphological grading. Sixty lumbar spine segments from 10 low back pain patients and 5 healthy volunteers were examined by axial T2 mapping and morphological MRI at 3. Regions of interest were drawn on a single slice for the facet joints and the intervertebral discs nucleus pulposus, anterior and posterior annulus fibrosus. The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading "normal" vs.

The preliminary results show similar facet joint T2 values in segments with normal and abnormal Pfirrmann scores.

• Horror Factory - Ammonit (German Edition)!
• Mélusine – tome 7 - HOCUS POCUS (French Edition).
• .
• Recent Trends in Dynamical Systems: Proceedings of a Conference in Honor of Jürgen Scheurle: 35 (Springer Proceedings in Mathematics & Statistics).

There was no difference in mean T2 values between facet joints in different Weishaupt grading groups. The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading ''normal'' vs. To describe the cross-sectional and longitudinal associations between knee regional effusion synovitis and knee pain in older adults.

Kundrecensioner

Baseline knee joint effusion synovitis was graded using T2-weighted magnetic resonance imaging MRI in the suprapatellar pouch, central portion, posterior femoral recess, and subpopliteal recess. Other knee structural including cartilage, bone marrow, and menisci lesions were assessed by MRI at baseline.

Multivariable analyses were performed after adjustment for age, sex, body mass index, and other structural lesions. Effusion synovitis in posterior femoral recess and central portion were independently associated with increases in nonweight-bearing pain RR 1. Knee joint effusion synovitis has independent associations with knee pain in older adults.

Suprapatellar pouch effusion synovitis is associated with nonweight-bearing and weight-bearing knee pain, while posterior femoral recess and central portion effusion synovitis are only associated with nonweight-bearing pain. Lumbar facet joint fat pads: Their normal anatomy and their appearance when enlarged. The polar recesses, superior and inferior to lumbar facet joints , are filled by fat pads from which fat-filled synovial folds project between the articular surfaces for a distance of two to four millimetres.

The intracapsular superior recess lies between the ligamentum flavum and the lamina above. The extracapsular inferior recess lies on the back of the lamina below and communicates with the joint through a hole in the inferior capsule. The intracapsular folds move freely in and out of the joint during movements.

These features are demonstrated in anatomic studies using transverse sections and radiologic studies using computed tomography. The fat pads can be identified in CT scans by their radiolucency and distinguished from vacuum phenomenon by measuring their attenuation values. The cause of the intra-articular enlargement of the fat pads is unknown, but it is suggested that their extension into the middle third of the joint may be secondary to degenerative change in the motion segment with capsular laxity in the affected joint.

Optimized cervical spine bone SPET for detection of facet joint injury after whiplash injury. Mount Medical Centre, Isotope Imaging. The most frequent origin for chronic cervical pain in patients with a remote history of whiplash injury is the cervical facet joints. Exact localization of facet joint injury is difficult and currently advocated methods include multiple invasive diagnostic injections.

Imaging was performed on a dual-headed gamma camera system using an elliptical orbit over deg. The patient's neck was flexed to eliminate the cervical lordosis. CSPET studies were independently scored by two observers blinded to the clinical and other imaging information and correlated with clinical localization and response to radiofrequency ablation. Early patient follow-up data will be presented. CSPET was felt to be clinically useful by pain therapists in targeting treatment. Full Text Available Aim: To reveal the prevalence of lumbar facet joint arthrosis in normal and stenotic lumbar spines with magnetic resonance imaging.

Osseous associated cervical spondylomyelopathy at the C2-C3 articular facet joint in 11 dogs. In dogs, vertebral canal stenosis at C2-C3 due to articular facet joint degeneration is only sporadically identified. The authors' aims were to review the clinical presentation, MRI characteristics, treatment and outcome of dogs presenting with this condition.

Eleven cases were eligible for inclusion. Surgery was performed in six cases and medical management elected in five. Long-term follow-up information was available for 11 animals. Four of the surgical cases are alive and have no neurological deficits, one was euthanased for an unrelated condition and one lost to follow-up. Of the cases managed medically, three are alive showing no neurological deficits, one is alive still displaying neurological deficits and one euthanased for an unrelated condition whilst still ataxic.

This study shows that both medical and surgical management can result in good outcomes in dogs with vertebral canal stenosis resulting from articular facet joint degeneration at the level of C2-C3. No exacerbation of knee joint pain and effusion following preoperative progressive resistance training in patients scheduled for total knee arthroplasty. Preoperative progressive resistance training PRT is controversial in patients scheduled for total knee arthroplasty TKA , because of the concern that it may exacerbate knee joint pain and effusion.

Secondary analyses from a randomized controlled trial. University Hospital and a Regional Hospital.

facet joint effusion: Topics by www.newyorkethnicfood.com

Before and after each training session, knee joint pain rated on an point scale, effusion assessed by measuring the knee joint circumference, and training load were recorded. The first and last training session were initiated by 1RM testing of unilateral leg press, knee extension Lumbar facet joint septic arthritis presenting atypically as acute abdomen — A case report and review of the literature. The atypical presentation of facet joint septic arthritis is one of the reasons why early diagnosis is elusive.

Definitive diagnoses with MRI and bacterial culture as well as prolonged antibiotic therapy are recommended in this condition.

Fler böcker av författarna

A new technique to treat facet joint pain with pulsed radiofrequency. While conservative treatments are often unsuccessful, the scientific evidence on minimally invasive therapies such as intra-articular steroid infiltration and continuous and pulsed radiofrequency PRF of the medial branches is contradictory.

Since PRF has recently been reported to successfully treat joint pain, a new application of this method is proposed for facetogenic lumbar pain via an intra-articular subcapsular approach. Here we reported two cases with successful treatment. A year-old patient presented because of persisting pain in the left gluteal region radiating to the lateral thigh and calf when standing.

Anti-inflammatory drugs produced only short-lasting insufficient relief. A year-old employee was admitted in June because of axial lower lumbar pain with intermittent diffuse radiation to the right lower extremity that worsened during walking and lying down despite receiving analgesics and physiotherapy. A new approach to treat lumbar facet joint pain with PRF is simple to perform and without serious complications. In view of the good long-lasting results obtained with the two reported cases, randomized control trials are necessary to validate this new approach.

Negative magnetic resonance imaging in femoral neck stress fracture with joint effusion: Femoral neck stress fracture FNSF is well documented in the orthopedic literature and is generally associated with strenuous activities such as long-distance running and military training. We encountered a year-old male long-distance runner with FNSF in whom the left femoral neck showed no signal changes on MRI although an effusion was detected in the left hip joint.

One month later, roentgenograms revealed periosteal callus and oblique consolidation of the left femoral neck, confirming the diagnosis of compression FNSF. Septic arthritis of a lumbar facet joint: We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan.

In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements. Pseudomeningocele in communication with the facet joint: Pseudomeningocele is an uncommon but well-known complication of lumbar spine operations.

Although it is mostly asymptomatic and managed conservatively in most cases, it is claimed as a causative factor of failed back surgery syndrome and requires surgery in some cases. Usually, its diagnosis is confidently done with imaging modalities such as magnetic resonance imaging, computed tomography and myelography. In this report, we describe a case of pseudomeningocele that communicated with a facet joint. The diagnostic approach for this unusual lesion and its probable causes are discussed.

Chronic suppurative joint effusion due to burkholderia pseudomallei: Full Text Available Burkholderia pseudomallei, a Gram-negative bacillus is the causative agent of Melioidosis, a glanders-like disease, primarily a disease of animals. Melioidosis has been only a rare and sporadic disease in humans outside its endemic region. Currently, diagnosis of B. We report a case of chronic left hip joint effusion in a known case of diabetes mellitus. Gram stain of computed tomography CT-guided aspirate from the joint revealed Gram-negative bacilli along with pus cells. Unfortunately, patient could not be started on appropriate antibiotics due to delay in detection and patient succumbed to severe septicemia.

This case is reported to highlight importance of automated identification and sensitivity especially in nonendemic areas and unusual antibiogram of this organism for which disc diffusion method is not standardized. The possibility of the radiological and ultrasonographic examination of the facet joints of the equine thoracic and lumbar spine. The facet joints of the equine thoracic and lumbar spine were examined by radiology and ultrasonography in 31 and 20 standing horses, respectively.

The employed methods were evaluated. The independent evaluation of the ensuing films by four experienced veterinary surgeons yielded a significantly better assessment of the tested parameters in the 20 o ventral oblique technique. It was possible to depict the facet joints of the right and left sides between the caudal margin of the scapula and the diaphragm with the pulmonary field as background rich in contrast. In 20 horses, the facet joints were examined from Th10 to L6 in longitudinal and sagittal planes.

A linear-array ultrasound probe with a frequency of 7,5 MHz and a convex ultrasound probe with a frequency of 3,5 MHz were used. Depending on the nutritional state, the soft tissue structures could be evaluated. The evaluation of the facet joints themselves was very limited. Magnetic resonance imaging-determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis: To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging MRI and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis RA and osteoarthritis OA.

Synovial inflammation and 9 separate tissue characteristics were graded histologically. Synovial membrane and joint effusion volumes were Management of low back pain with facet joint injections and nerve root blocks under computed tomography guidance. The aim of this work was to assess the performance of facet joint and nerve root infiltrations under computed tomography guidance for the management of low back pain and to investigate the complications and patient tolerance. The study was board-certified and informed consent was obtained from all patients.

In 1 year, 86 consecutive patients 47 male, 39 female, age range years, mean age 63 with low back pain for more than 2 years were included. All patients were clinically examined and had cross-sectional imaging performed before the procedure. Fifty-five facet joint infiltrations and 31 nerve blocks were performed under computed tomography guidance. All patients completed two valid pain questionnaires before and 3 months after the procedures. At the same time, they were clinically examined by the referring Orthopaedic Surgeon.

The pain response was assessed by comparing the scores of the questionnaires.

The improvement in clinical examination findings was assessed as well. No complications were observed. All procedures were very well tolerated by patients. Facet joint and nerve infiltrations under computed tomography guidance constitute an accurate and safe method that could be used to relieve low back pain and minimize the risk of disability. Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints.

Patient history and physical examination are frequently used procedures to diagnose chronic low back pain CLBP originating from the facet joints , although the diagnostic accuracy is controversial. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. Twelve studies were included, in which combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias.

Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0. Patient history and physical examination cannot be used to limit the need of a diagnostic block. Make the correct diagnosis with hundreds of MR and CT correlations.

Recognize the entire spectrum of normal variants with over 6, images , the largest collection available on this topic. Prepare for the pitfalls of the oral exam with an easily accessible text that's designed to help you avoid false positives. Find the most essential content more quickly with a much more compact print volume that covers only the most important skeletal presentations. Access the complete contents of the book online at www. Read more Read less. Applicable only on ATM card, debit card or credit card orders.

Cashback will be credited as Amazon Pay balance within 10 days. Valid only on your first 2 online payments. Cashback will be credited as Amazon Pay balance within 10 days from purchase. Here's how terms and conditions apply. Customers who viewed this item also viewed. Page 1 of 1 Start over Page 1 of 1. Clark's Positioning In Radiography.

Customers who bought this item also bought. The Requisites Requisites in Radiology. Review "This is an outstanding atlas that is probably the top reference of its kind in the field. To get the free app, enter mobile phone number. See all free Kindle reading apps. Don't have a Kindle? Saunders; 9 edition 26 June Language: Be the first to review this item Amazon Bestsellers Rank: