Imaging of Trabecular Microfracture and Bone Marrow Edema and Hemorrhage

Yong-Whee Bahk, Professor Emeritus, M.D., Ph.D. The Catholic University of Korea School of Medicine Affiliated Yangji Hospital, Seoul, South Korea

1. Introduction.- 2. Pinhole Bone Scanning.- 3. Gamma Correction.- 4. Technical Processing of Gamma Correction.- 5. Gamma Correction Pinhole Bone Scan.- 6. Experimental Gamma Correction 99mTc-HDP Pinhole Bone Scan, Diagnosis of Trabecular Microfracture in Young Rats.- 7. Preoperative Confirmatory Imaging Diagnosis of Femoral Neck Fracture.- 8. Gamma Correction Pinhole Scan of Surgical Specimen and Correlation of Thereof and H&E Stain Findings for Histological Identification.- 9. Hematoxylin-Eosin Stain of Calcifying Calluses in Trabecular Microfractures.- 10. Identification of Trabecular Microcalluses in GCPBS and H&E Stain.- 11. Quantitation of 99mTc-HDP Uptake in Microcallus Using Pixelized Method.- 12. Quantitation of Gamma Correction Pinhole Bone Scan and H&E Stain.- 13. Reciprocal Correlation of Shapes of Tracer Uptake and Findings of Surgical Specimen, GCPBS and H&E Stain.- 14. Morphobiochemical Diagnosis of Acute Trabecular Microcallus  Using Gamma Correction 99mTc-HDP Pinhole Bone Scan with  Histological Verification.- 15. Preoperative Diagnosis by Radiography and 99mTcHDP Pinhole Bone Scan.- 16. Surgical Specimens from Human Subjects.- 17. Preoperative Diagnosis by Radiography and 99mTcHDP Pinhole Bone Scan.- 18. Gamma Correction Pinhole Scanof Surgical Specimen and Correlation of Thereof and H&E Stain Findings for Histological Identification.- 19. Gamma Correction Pinhole Bone Scan.- 20. Identification of Trabecular Microfractures in GCPBS and H&E Stain.- 21. Quantification of Micro-Fracture Tracer Uptake Using Pixelized Measurement.- 22. Overall Considerations.- 23. Precise Differntial Diagnosis of Acute Bone Marrow Edema and Hemorrhage and Trabecular Microfracture Using Nave and Gamma Correction Pinhole Bone Scans, NIH ImageJ Densitometry, and Pixelized.- 24. Micofracture Measurement.- 25. Introduction.- 26. Clinical Materials.- 27. Techniques of Seriated Nave and Gamma Correction Pinhole Bone Scanning and Reference Conventional Radiography andCorroborative Coronal FS T2 weighted MRI.- 28.  NIH ImageJ Densitometry of 99mTc-HDP Uptake Intensity Measurement in Bone Marrow Edema and Hemorrhage and Trabecular Microfracture on Seriated Naive and Gamma Correction Pinhole Bone Scans.- 29. Mathematic Measurement of Trabecular Microfracture Size with Unsuppressed 99mTc-HDP uptake.- 30. Differential 99mTc-HDP Uptake Intensity Measurement of Bone Marrow Edema and Hemorrhage Using ImageJ Densitometry.- 31. Histopathological Validation.- 32. Differential Diagnosis of Bone Marrow Edema and Hemorrhage Using ImageJ Densitometry.- 33. Innocuousness of Bone Marrow Edema to Intact Trabecula on Nave Pinhole Scan Showing Mild Tracer Uptake Which is Suppressed.- 34. Differential Image J Densitometry Intensity Values of 99mTc-HDP Uptake in Bone Marrow Edema and Hemorrhage and Trabecular Microfracture.- 35. Fractured Trabeculae with Unsuppressed Enhanced Tracer Uptake.- 36. Innocuousness of Edema to Intact Trabecula and Injuriousness of Hemorrhage to Already Broken Trabecula.- 37. H&E Stain Validation of Additive Bone Marrow Hemorrhage Which Injures Already.- 38. NIH Image J Densitometric Analysis of an Old MR Image of Histologically Proven "Edemalike"Bone Marrow Change in Knee.- 39. Discussion.- 40. Summary and Conclusions.