Diagnostic Imaging of Musculoskeletal Diseases (eBook)

Preface 4
Contents 6
Contributors 7
1 Bone Structure and Function 9
Introduction 9
The Skeleton 9
Bone Formation and Degradation 9
Bone Architecture 10
Gross Morphology 10
Parts of a Long Bone 10
Epiphysis 10
Physis or Epiphyseal Plate 10
Metaphysis 11
Diaphysis (Shaft) 11
Bone Marrow 11
Periosteum 12
Endosteum 12
Microscopic Features of Bone 12
Blood Supply of Bone 12
Nerve Supply of Bones 13
Bone Cells 13
Osteoprogenitor Cells 13
Osteoblasts 13
Osteocytes 14
Osteoclasts 14
Osteoclasts Are the Primary Bone Resorbing Cells 14
Mechanism of Osteoclast-Mediated Bone Resorption 14
Bone Matrix 14
Classification of Collagens 15
Enzymes 15
Alkaline Phosphatase 15
The Hydrated (Muco)Polysaccharide Gels 15
Mineralization 15
Remodeling of Bone 16
The Regulation of Bone and Cartilage 18
Endocrine 18
Paracrine/Autocrine 18
Parathyroid Hormone 18
Calcitonin 18
Vitamin D 19
Vitamin A 19
Estrogens 19
Androgens 19
Growth Hormone 19
Proteolipids 19
Growth Factors 19
Other Growth Factors 20
Mechanosensory Systems and Stretch Studies (Wolff Law) 20
References 20
2 Systematic Approach to Metabolic Diseases of Bone 22
Introduction 22
Bone Metabolism 22
Calcium Metabolism 22
Phosphorus Metabolism 23
Parathyroid Hormone 23
Vitamin D Metabolism 23
Biochemical Markers of Bone Turnover 23
Bone Density 24
Generalized Diminished Bone Density 24
Osteoporosis 26
WHO Definitions of Osteoporosis 27
Diagnostic Imaging of Osteoporosis 28
Radiographic evaluation 28
Quantitative Evaluation of Osteoporosis 31
Dual-Energy X-ray Absorptiometry (DXA) 31
Quantitative Computerized Tomography (QCT) 32
Microcomputerized Tomography 33
Quantitative Ultrasonography 33
Magnetic Resonance Imaging (MRI) 33
Osteoporosis Is a Major Public Health Problem 34
Prevention and Treatment of Osteoporosis 35
Prevention 36
Treatment 36
Vertebroplasty and Kyphoplasty 38
Scurvy 38
Prognosis 40
Copper Deficiency 40
Endocrine Osteoporosis 41
Stress Deficiency Osteoporosis (Disuse Atrophy) 41
Reflex Sympathetic Dystrophy 41
Osteogenesis Imperfecta 41
Idiopathic Juvenile Osteoporosis 41
Homocystinuria 42
Idiopathic Regional Migratory Osteoporosis 42
Inadequate Osteoid Mineralization 43
Rickets 43
Radiological Manifestations 44
Prognosis 46
Osteomalacia 47
Radiological Manifestations 48
Renal Osteodystrophy 50
Hereditary Renal Tubular Diseases 50
X-Linked Hypophosphatemic Vitamin D Refractory Rickets (Familial Vitamin D-Resistant Rickets) (MIM 307800) 51
Radiological Manifestations 51
Vitamin D-Dependent Rickets 52
Iatrogenic Osteomalacic Syndromes 52
Anticonvulsant Drug-Induced Rickets and Osteomalacia 52
Aluminum Intoxication 52
Tumor-Related Rickets and Osteomalacia 53
Hypophosphatasia 53
Atypical Axial Osteomalacia 53
Hereditary Hyperphosphatasemia (Juvenile Paget Disease) 53
Hypervitaminosis D 54
Hypervitaminosis A 54
Fluorosis 55
Further Readings 57
Bone Metabolism 57
Bone Density 57
Generalized Diminished Bone Density 57
Osteopenia 58
Osteoporosis 58
Radiographic evaluation of osteoporosis 59
Dual X-ray absorptiometry (DXA) 59
Quantitative CT absorptiometry 60
Quantitative ultrasonography for evaluation of osteoporosis 60
Magnetic resonance Imaging (MRI) 60
Osteoporosis: A major health problem 61
Prevention and treatment of osteoporosis 61
Scurvy 62
Copper deficiency 62
Endocrine osteoporosis 62
Reflex sympathetic dystrophy 62
Osteogenesis imperfecta 62
Idiopathic juvenile osteoporosis 62
Homocystinuria 63
Idiopathic Regional Migratory Osteoporosis 63
Rickets 63
Osteomalacia 63
Hereditary renal tubular diseases 64
Renal osteodystrophy 64
Iatrogenic Osteomalacia 64
Oncogenic Osteomalacia 64
Hypophosphatasia 65
Atypical axial osteomalacia 65
Hereditary hyperphosphatasia (Juvenile Paget disease) 65
Hypervitaminosis D 65
Hypervitaminosis A 65
Fluorosis 65
Vertebroplasty and Kyphoplasty 66
3 Systematic Approach to Radiology of Endocrine Disorders Affecting the Musculoskeletal System 67
Introduction 67
Bone Changes of Pituitary Dysfunction 68
Gigantism 68
Cerebral Gigantism (Sotos Syndrome) 68
Acromegaly 68
Radiological Manifestations 69
Endocrine Causes of Short Stature 72
Bone Changes of Thyroid Dysfunction 74
Hypothyroidism 74
Radiological Manifestations 76
Hyperthyroidism 80
Bone Changes of Parathyroid Dysfunction 80
Hyperparathyroidism 81
Primary Hyperparathyroidism 81
Radiological Imaging of Parathyroid Tumors 82
Radiological Manifestations of Well-Established Hyperparathyroidism 82
Secondary Hyperparathyroidism 86
Tertiary Hyperparathyroidism 88
Miscellaneous Causes of Hyperparathyroidism 88
Primary Infantile Hyperparathyroidism 88
Renal Osteodystrophy 88
Osteomalacia in Renal Osteodystrophy 89
Osteitis Fibrosa Cystica 91
Radiological Abnormalities in Secondary Hyperparathyroidism Due to Chronic Renal Failure 91
Benefits and Complications of Treatment of End-Stage Renal Disease 94
Dialysis 94
Aluminum Toxicity 94
Amyloidosis 95
Destructive Spondyloarthropathy (DSA) 95
Renal Transplantation 96
Persistent Secondary HPT 97
Ischemic Necrosis 97
Post-transplant Osteoporosis 98
Amyloidosis 98
Tendonitis and Tendon Rupture 99
Hypoparathyroidism 99
Signs and Symptoms of Hypoparathyroidism 99
Impaired Synthesis or Secretion of PTH 100
Defects of the Calcium-Sensing Receptor 101
End-Organ Resistance to PTH (Pseudohypoparathyroidism) 101
Pseudopseudohypoparathyroidism and Progressive Osseous Heteroplasia 102
Treatment 102
References 102
4 Circulatory Diseases of Bone and Adjacent Soft Tissues 105
Introduction 105
Avascular Necrosis 106
Pathophysiology and Causes 106
AVN of the Femoral Head 107
Trauma-Induced AVN 111
SONK 113
Medullary Bone Infarcts 114
AVN Precursor Syndromes 115
Regional Osteoporosis 116
Reflex Sympathetic Dystrophy 116
Transient Osteoporosis 117
Regional Migratory Osteoporosis 117
Osteochondroses (Related to Osteonecrosis) 118
Legg--Calve--Perthes Disease 118
Kienbock Disease 119
Freiberg Infraction 120
Kohler Disease 120
Osteochondritis Dissecans 121
Miscellaneous Vascular Diseases 123
Frostbite 123
Thermal and Electrical Injuries 124
Compartment Syndrome/Myonecrosis 124
Venous Insufficiency of Soft Tissue 125
Ischemic Fasciitis 126
Further Reading 126
Avascular Necrosis 126
AVN Precursor Syndromes 127
Osteochondroses Related to AVN 127
Miscellaneous Vascular Diseases of Bone and Soft Tissue 128
Frostbite 128
Thermal and Electrical Injuries 128
Compartment Syndrome/Myonecrosis 128
Venous Insufficiency 128
Ischemic Fasciitis 129
5 Imaging Approach to Musculoskeletal Trauma 130
Introduction 130
Osseous Trauma 130
Bones: Fracture 131
Osseous Anatomy and Physiology 131
Wolff's Law 131
Cortical and Trabecular Bone 132
Osseous Elasticity, Mineralization, Aging Phenomena, and Physeal Growth Plates 135
Force and Environment External to the Skeleton 143
Ring Rule 146
Ligaments: Anatomy and Strength 148
Fracture Features and Terminology 155
Evaluation of Fracture Healing 156
Osseous Blood Supply 156
Granulation and Periosteal New Bone 158
Fracture Fixation and Stability 160
Dislocations 160
Joint Morphology and Ligaments 160
Soft Tissue Trauma and Internal Derangement of Joints 161
Muscle Strain 161
Tendon Strain and Traumatic Tendonitis 163
Ligament Sprain 172
Hyaline Cartilage 175
Fibrocartilage 178
Conclusion 199
Further Readings 199
Osseous Trauma and Bone Biomechanics 199
Dislocations 202
Muscle and Tendon Strain, Ligament Sprain and Traumatic Tendonitis 203
Hyaline Cartilage 205
Fibrocartilage 205
6 Imaging and Understanding Fracture Fixation 207
Introduction 207
History of Osteosynthesis 207
Biology of Bone Healing: The Traditional Concept of Callus Healing 208
Robert Danis and the Concept of Callus-Free Bone Healing 208
Maurice Müller and Development of the AO Group 210
Biology of Bone Healing in Various Mechanical Environments: The Concepts of Direct and Indirect Bone Healing 210
Bone Screws 212
Techniques of Absolute Stability 216
Lag Screw Fixation 217
Compression Plates 218
Dynamic Compression Plate (DCP) 218
Limited-Contact Compression Plate (LC-DCP) 219
Tubular Plates 220
Plate Contouring and Reconstruction Plates 220
Tension Band Fixation 222
Angled Plates 223
Compression Plates with Sliding Screws: Dynamic Hip Screw (DHS) and Dynamic Condylar Screw (DCS) 223
Locking Plates 228
Techniques of Relative Stability 228
Intramedullary Nailing 229
Splintage 230
Bridging 230
Dynamization 230
Nail--Screw Systems 230
Bridge Plating 231
External Fixator 232
Types of Fixators 233
Pin External Fixator 233
Ring External Fixator (Ilizarov Device) 234
Hybrid External Fixator 234
Complications 235
Internal Fixator: LISS and LCP 235
LISS -- Less Invasive Stabilization System 242
LCP -- Locking Compression Plate 242
Conclusion 242
References 242
7 Systematic Approach to Tumors and Focal Lesions of Bone 244
Introduction 244
Bone Tumors 244
Classification of Bone Tumors 244
Bone Tumor Statistics 245
Genetics of Bone Tumors 245
Differential Diagnosis of Solitary Bone Lesions 245
Classic Analyses 245
Margin Analysis 245
Matrix Analysis 246
Periosteal Reaction 246
CT Analysis of Bone Tumors 248
MR Imaging of Bone Tumors 248
Approach to Specific Locations 249
Vertebral column 249
Chest wall 249
Pelvis 250
Skull 251
Staging of Bone Tumors 251
Musculoskeletal Tumor Society (Enneking) System 251
TNM System 251
Imaging Evaluation of Tumor Response After Chemotherapy and RT 252
Cartilaginous Tumors 252
Benign Chondroma 252
Osteochondroma 255
Chondroblastoma 257
Chondromyxoid Fibroma 259
Chondrosarcoma 259
Central Chondrosarcoma 260
Peripheral Chondrosarcoma 261
Periosteal Chondrosarcoma 261
Clear Cell Chondrosarcoma 261
Mesenchymal Chondrosarcoma 263
Dedifferentiated Chondrosarcoma 263
Osseous Tumors 264
Osteoma and Bone Island (Enostosis) 264
Osteoid Osteoma 265
Osteoblastoma 266
Osteosarcoma 268
Conventional Osteosarcoma 268
Small Cell Osteosarcoma 270
Parosteal Osteosarcoma 271
Periosteal Osteosarcoma 271
Telangiectatic Osteosarcoma 272
Giant-Cell-Rich Osteosarcoma 274
Low-Grade Central Osteosarcoma (Intraosseous Well-Differentiated Osteosarcoma) 275
High-Grade Surface Osteosarcoma 275
Osteosarcoma of the Mandible and Maxilla 275
Multicentric Osteosarcomata 275
Osteosarcoma Associated with Other Conditions 276
Fibrous and Fibrohistiocytic Tumors 276
Non-ossifying Fibroma and Fibrous Cortical Defects (Fibroxanthoma, Metaphyseal Fibrous Defect) 276
Fibrous Dysplasia 277
Desmoplastic Fibroma 279
Fibrosarcoma 280
Malignant Fibrous Histiocytoma (Pleomorphic Sarcoma) 281
Vascular Tumors 281
Hemangioma 282
Angiosarcoma (Including Hemangioendothelioma) 283
Other Mesenchymal Tumors 285
Cysts (Simple Bone Cyst, Aneurysmal Bone Cyst) 285
Simple Bone Cyst (Unicameral Bone Cyst, UBC) 285
Aneurysmal Bone Cyst 286
Intraosseous Ganglion 288
Intraosseous Lipoma 289
Giant Cell Tumor 290
Giant Cell Reparative Granuloma 292
Brown Tumor of Hyperparathyroidism 292
Chordoma 293
Osteofibrous Dysplasia and Adamantinoma 294
Hematopoietic Tumors 296
Langerhans Cell Histiocytosis 296
Malignant Lymphoma 297
Mastocytosis 300
Leukemia 300
Multiple Myeloma 301
Ewing Sarcoma and Primitive Neuroectodermal Tumor (PNET) Group 302
Metastases 305
Statistics 305
Mechanism of Metastases 305
Types of Metastases 306
Osteolytic Metastases 306
Sclerotic Metastasis 306
Acrometastasis 306
Cortical Metastasis 306
Intertrabecular Metastasis 306
Congenital/Hereditary Syndromes 307
Enchondromatosis 307
McCune--Albright Syndrome 307
Multiple Osteochondromas 307
Retinoblastoma Syndrome 308
Li Fraumeni Syndrome 308
Rothmund--Thomson Syndrome 308
Werner Syndrome 309
Paraneoplastic Syndromes 309
Hypertrophic Osteoarhropathy 309
PTHrP Bone Resorption 309
Oncogenic Osteomalacia 311
Summary 311
Further Readings 311
8 Systematic Approach to Tumors and Tumor-Like Conditionsof Soft Tissue 315
Introduction 315
Adipocytic Tumors 318
Benign 318
Lipoma 318
Lipomatosis 320
Lipoblastoma 321
Hibernoma 321
Malignant 321
Liposarcoma 321
Fibrous Lesions 325
Benign 325
Nodular Fasciitis 325
Elastofibroma 327
Myositis Ossificans 327
Intermediate (Locally Aggressive) 328
Fibromatoses 328
Malignant 330
Fibrosarcoma 330
Fibrohistiocytic Lesions 331
Benign 331
Giant Cell Tumor of Tendon Sheath 331
Malignant 332
Malignant Fibrous Histiocytoma (Undifferentiated Pleomorphic Sarcoma) 332
Dermatofibrosarcoma Protuberans 333
Perivascular Tumors 333
Benign 333
Glomus Tumor 333
Skeletal Muscle Tumors 334
Malignant 334
Rhabdomyosarcoma 334
Vascular Tumors 335
Benign 335
Hemangiomas and Arteriovenous Malformations 335
Intermediate 336
Kaposi Sarcoma 338
Malignant 339
Angiosarcoma 339
Peripheral Nerve Sheath Tumors 339
Benign 339
Malignant 341
Tumors of Uncertain Differentiation 341
Benign 341
Intramuscular Myxoma 341
Malignant 343
Synovial Sarcoma 343
Miscellaneous Lesions 344
Benign 344
Ganglion Cyst 344
Hematoma 346
Morton Neuroma 346
Malignant 347
Soft Tissue Metastases 347
Conclusion 347
Suggested Readings 347
General Imaging of Tumors 347
Adipocytic Tumors 348
Fibroblastic Tumors 349
Fibrohistiocytic Tumors 350
Pericytic Tumors 350
Vascular Tumors 350
Peripheral Nerve Sheath Tumors 350
Tumors of Uncertain Differentiation 351
Miscellaneous Lesions 351
9 Imaging Approach to Hemoglobinopathies 352
Introduction 352
Sickle Cell Disease (SCD) 352
Nuclear Imaging 355
Magnetic Resonance Imaging 356
Thalassemia 357
Mixed Hemoglobinopathies 359
Iron Deficiency Anemia 359
Fanconi Aplastic Anemia 359
Hereditary Spherocytosis 359
Copper Deficiency 360
Myelofibrosis 360
Further Readings 361
10 Imaging Approach to Musculoskeletal Infections 363
Introduction 363
Acute Pyogenic Osteomyelitis 363
Infectious Agent 364
Clinical Aspects of Diagnosis 364
Radiological Pathophysiology 366
Pediatric Osteomyelitis 366
Adult Osteomyelitis 367
Radiological Diagnosis of Acute Osteomyelitis 368
Surgical Pathology of Chronic Osteomyelitis 370
Discitis 370
Brodie Abscess 370
Garre Disease 373
Imaging Utility 373
Spirochetal Osteomyelitis 378
Early Congenital Syphilis (Parrot's Pseudoparalysis) 379
Late Congenital Syphilis 380
Adult Syphilitic Osteomyelitis 380
Chronic Granulomatous Osteomyelitis 380
Tuberculous Osteomyelitis 380
Sarcoidosis 381
Viral Osteomyelitis 382
Paget Disease 384
Infection of Muscle, Fascia, and Nerves 387
Myositis and Abscess 387
Madura Foot 389
Fasciitis 390
Infection of Peripheral Nerves 397
Leprosy 397
Poliomyelitis 397
Parsonage--Turner Syndrome 398
Further Readings 398
Osteomyelitis, Pyogenic 399
Brodie Abscess 402
Chronic Granulomatous Osteomyelitis 403
Sarcoidosis 403
Paget's Disease 404
Myositis and Fasciitis 404
Leprosy 405
Parsonage--Turner Syndrome 405
11 Systematic Approach to Arthropathies 406
Introduction 406
Image Analysis 407
Soft Tissue 408
Alignment 410
Bones 410
Cartilage Spaces 412
Distribution 417
Extraordinary Findings 418
Productive Arthropathies 419
Osteoarthritis 419
Secondary Osteoarthritis 421
Neuropathic Arthritis 421
Calcium Pyrophosphate Dihydrate Deposition Arthropathy (CPPD) 425
Hemophilia 428
Hemochromatosis 430
Ochronosis 430
Destructive (Inflammatory) Arthropathies 431
Rheumatoid Arthritis 431
Juvenile Chronic Arthritis (JCA) 445
Septic Arthritis 447
Gout 451
Psoriatic Arthritis 453
Reactive Arthritis 458
Ankylosing Spondylitis 460
Spondyloarthropathy of Inflammatory Bowel Disease (IBD) 463
SAPHO Syndrome 463
Multicentric Reticulohistiocytosis (MRH) 464
Amyloid Arthritis 466
Pigmented Villonodular Synovitis (PVNS) 467
Productive and Destructive Arthropathies 473
Erosive Osteoarthritis 473
Nondestructive and Nonproductive Arthropathies 473
Systemic Lupus Erythematosus (SLE) 474
Jaccoud's Arthropathy 474
Miscellaneous Joint-Related Conditions 475
Diffuse Idiopathic Skeletal Hyperostosis (DISH) 476
Haglund's Disease 479
Scleroderma 480
Osteochondromatosis 484
Chondromalacia Patella 485
Further Readings 485
Primary Osteoarthritis 486
Secondary Osteoarthritis 487
Rheumatoid Arthritis 489
Juvenile Chronic Arthritis 490
Septic Arthritis 491
Pott's Disease 492
Gout 492
Psoriatic Arthritis 493
Reactive Arthritis 493
Multicentric Reticulohistocytosis 494
Amyloid Arthropathy 494
Pigmented Villonodular Synovitis (PVNS) 494
Erosive Osteoarthritis 494
Systemic Lupus Erythematosus and Jaccoud's Arthropathy 495
Diffuse Idiopathic Skeletal Hyperostosis 495
Haglund's Disease 495
Scleroderma 495
Osteochondromatosis 495
Chondromalacia Patella 495
12 Imaging of Prostheses 496
Introduction 496
Historical Perspective 496
Terminology 497
Types of Arthroplasties 499
Materials 500
Prosthetic Designs 501
Individual Designs 502
Hip Prostheses 502
Knee Prostheses 503
Ankle Prostheses 504
Shoulder Prostheses 505
Elbow Arthroplasty 505
Wrist and Hand Joint Prostheses 506
Indications and Contraindications to Arthroplasty 507
Patient Considerations 507
Preoperative Imaging 508
Postoperative Imaging 508
Hips 508
Normal Postoperative Changes 509
Knees 509
Shoulders 509
Complications 510
General Complications 511
Complications Specific to Arthroplasties 511
Prosthetic Complications 512
Early Prosthetic Complications 513
Fractures 513
Dislocation or Subluxation 514
Retained Surgical Material 514
Delayed Prosthetic Complications 515
Fractures and Dislocations 515
Component Loosening 516
Infection and Infective Loosening 517
Particle Disease 520
Pseudobursae 521
Heterotopic Bone Formation 522
Suggested Reading 523
13 Systematic Approach to Skeletal Dysplasias with Emphasis on Non-lethal Disorders 526
Introduction 526
Helpful Hints for Learning and Remembering Bone Dysplasias 533
Bone Development and Growth 535
Achondroplasia (MIM 100800) Group 1 535
Achondrogenesis (MIM 200600, 600972, and 200610) Group 12 539
Asphyxiating Thoracic Dystrophy (Jeune Syndrome) (MIM 208500) Group 7 539
Chondrodysplasia punctata (IMM 302960, 302950, 308050, 215100, 222765, 600121118651) Group 20 540
Chondroectodermal Dysplasia (Ellis-van Creveld Disease) (MIM 225500) Group 7 542
Cleidocranial Dysplasia (MIM 119600) Group 29 542
Craniostenosis Syndromes and Other Cranial Ossification Disorders 544
Apert Syndrome (Acrocephalosyndactylism MIM 101200) Group 30 544
Progressive Diaphyseal Dysplasia (CamuratiEngelmann Disease) (MIM 131300) Group 23 545
Diastrophic Dysplasia (MIM 222600) Group 4 546
Dysplasia Epiphysealis Hemimelica (Trevor disease) MIM 127800, Group 28 547
Enchondromatosis (Ollier Disease), MIM 166000, Group 28 548
Endosteal Hyperostosis, Hyperostosis Corticalis Generalisata (MIM 239100, Van Buchem Type) (MIM 144750, Worth type) (MIM 269500, Sclerosteosis) Group 23 550
Fibrodysplasia Ossificans Progressiva (Myositis Ossificans Progressiva MIM 135100) Group 28 550
Fibrous Dysplasis (Polyostotic Form MIM 174800) Group 28 550
Gaucher Disease (MIM 230800, 230900 and 231000) 553
Hyperphosphatasemia (Juvenile Paget Disease), (MIM 239000) Group 23 554
Hypophosphatasemia (MIM 241500, Infantile type) [ 1 ], (241510 childhood type) [ 7 ], (146300 Adult type) [ 1 ] and 171760 [ 3 ], Group 25 556
Hypophosphatemic Rickets (Vitamin D Resistant Rickets, X-linked Hypophosphatemic Rickets) (MIM 307800, 193100) Group 25 559
Infantile Cortical Hyperostosis (Caffey Disease) (MIM 114000) Group 21 (Neonatal Osteosclerotic Dysplasia) 559
Marfan Syndrome (MIM 154700) 560
Melorheostosis (MIM 155950) Group 22 561
Metaphyseal Dysplasia (Pyle Disease MIM 265900) (BraunTinschert 605946) Group 23 561
Craniometaphyseal Dysplasia (MIM 123000 Autosomal Dominant) (MIM 218400 Autosomal Recessive) Group 23 562
Metaphyseal Chondrodysplasia (Metaphyseal Dysostosis) (MIM 156500,250250, 156400, 309645, 250400) Group 9 562
Metatropic Dysplasia (MIM 156530, 250600) Group 11 565
Mucopolysaccharidoses (Dysostosis Multiplex) Group 26 566
Mucopolysaccharidosis I H (MIM 252800 Hurler Disease) Group 26 566
Mucopolysaccharidosis IS (MIM 607014 Scheie Disease) Group 26 568
Mucopolysaccharidosis IH/S (MIM 607014), Group 26 568
Mucopolysaccharidosis II (MIM 309900 Hunter Disease), Group 26 568
Mucopolysaccharidosis III (MIM 252900, 252920, 252930, 252940 Sanfilippo Disease), Group 26 568
Mucopolysaccharidosis IV (Morquio Disease, Universal Vertebra Plana) (MIM 253000, 253010) Group 26 568
Mucopolysaccharidosis VI, Maroteaux and Lamy Disease (MIM 253200 ) Group 26 569
Mucopolysaccharidosis VII, Sly Disease, (MIM 253220) Group 26 570
Mucolipidosis Type II, (I-Cell Disease), MIM 252500, Group 26 570
Mucolipidosis III, Pseudo-Hurler polydystrophy, (MIM 252600), 252605, Group 26 570
Multiple Epiphyseal Dysplasia (Fairbank [ 7 ] or Ribbing [ 7 ]) (MIM 132400) Other Forms [ 1 ] (600204, 600969,607078,120210, Group 8 and MIM 226900), Group 4 570
Blount Disease (MIM 259200 and 188700) 572
Multiple Hereditary Cartilaginous Exostoses (MIM 133700, 133701, 600209) Group 28 572
Neurofibromatosis (MIM 162200, 101000, 162260, 162270, 601321,162220, 114030, 162210, 193520) [ 7 ] 574
Pseudarthrosis 576
Osteogenesis Imperfecta (MIM 166200,166240, 166210, 259420,203760, 259440, 166220) Group 24 577
Osteolysis, Torg Syndrome (MIM 277950 and 259600) Group 27 581
Osteopathia Striata with Cranial Sclerosis (Voorhoeve Disease) (MIM 166500) Group 22 581
Osteopetrosis (MIM 259 700, 259710, 259 730, 166600, 300301, 600329, 122900) Group 22 581
Osteopoikilosis (MIM 155950) [ 1 ] (MIM 166700) [ 3 , 7 ] Group 22 584
Pseudoachondroplasia (MIM 177170) Group 8 585
Pyknodysostosis (MIM 256800) Group 22 585
Saddan: (MIM 134934) (Severe Achondroplasia, Developmental Delay, and Acanthosis Nigricans) Group 1 588
Spondyloepiphyseal Dysplasia 588
Spondyloepiphyseal Dysplasia Congenita (MIM 1839002) Group 2 (Collagen Group) 588
Spondyloepiphyseal Dysplasia Tarda, X-Linked (MIM 313400) (Spondyloepimetaphyseal Group) Group 11 588
Thanatophoric Dysplasia (MIM 187600 and 187601) Group 1 588
Tuberous Sclerosis Complex (MIM 191100) 592
References 596
14 Interventional Procedures in Musculoskeletal Radiology 597
Introduction 597
Interventional Spinal Procedures 597
Procedures Targeting the Intervertebral Disc 598
Anatomy of the Intervertebral Disc 598
Imaging of the Intervertebral Disc 598
Pathophysiology of the Intervertebral Disc 598
Discography 599
Percutaneous Laser Disc Decompression 602
Intradiscal Electrothermal Therapy (IDET ® ) or Annuloplasty 605
Procedures Targeting the Vertebra 606
Percutaneous Vertebroplasty 606
Facet Joint Injection 610
Sacroiliac (SI) Joint Injection 610
Procedures Targeting Neural Structures 612
Epidural Block 612
Selective Nerve Root Block 614
Interventional Evaluation and Treatment of Joint Pathology 615
Indications for Therapeutic Arthrography 615
General Technique for Arthrography 616
Shoulder Arthrography 617
Elbow Arthrography 618
Wrist Arthrography 618
Hip Arthrography 618
Knee Arthrography 619
Ankle Arthrography 620
Side Effects and Complications of Arthrography 621
Viscosupplementation vs. Corticosteroid Injection 622
Percutaneous Procedures Targeting Musculoskeletal Lesions 623
Biopsies of the Musculoskeletal System 623
Indications and Contraindications 623
Technique 624
General Technique for Skeletal Lesion Biopsy 624
Spinal Biopsy 624
Biopsy of Appendicular Bone 625
Soft Tissue Lesion Biopsy 625
Cartilaginous Lesion Biopsy 626
Discussion of Musculoskeletal Lesion Biopsies 626
Percutaneous Therapy of Benign lesions 627
Osteoid Osteoma 627
Indications 627
Technique 627
Discussion 627
Intraosseous Cyst injection 627
Indications 627
Technique 628
Discussion 628
Ultrasound-Guided Interventional Procedures 628
Technique 629
Aspiration of Fluid-Filled Lesions 629
Discussion 630
Further Readings 630
Interventional Spinal Procedures 630
Discography 630
Percutaneous Discectomy 631
Percutaneous Laser Disc Decompression 631
Facet and SI Joint Injections 631
Epidural Block 631
Percutaneous Vertebroplasty 631
Interventional Evaluation and Treatment of Joint Pathology 632
Percutaneous Procedures Targeting Musculoskeletal Lesions 632
Biopsies of the musculoskeletal system 632
Percutaneous Treatment of Benign Lesions 632
Ultrasound Guided Interventional Procedures 632
Subject Index 633