Книги по МРТ КТ на английском языке / MRI for Orthopaedic Surgeons Khanna ed 2010
.pdfPreface
Although the ability to evaluate MRI studies is critical to the practice of orthopaedic surgery, most orthopaedic surgeons learn this skill in an informal fashion and with experience throughout their training and in clinical practice. As a result, we may not have a thorough understanding of the science and physics of MR imaging and the various pulse sequences that are available for obtaining the images. Many of us—those in general orthopaedic surgery practice as well as those in subspecialties such as sports medicine, spine surgery, hand and upper extremity surgery, foot and ankle surgery, and orthopaedic oncology—prefer to read our patients’ MR imaging studies ourselves rather than rely solely on the “o cial” radiologist’s report. We learn to make preoperative, intraoperative, and postoperative decisions based on those readings. However, unlike radiologists who are trained to evaluate MRI studies in a systematic fashion, we may be more likely to rely on our anatomic expertise and experience, which may not be the most e ective method.
MRI for Orthopaedic Surgeons will help teach orthopaedic surgeons how to systematically evaluate and interpret MR imaging studies of the musculoskeletal system. Although there are many excellent books that focus on MR imaging of the musculoskeletal system, this one is unique in that it is written by orthopaedic surgeons and radiologists specifically for orthopaedic surgeons. As such, it is clinically oriented and presents the information from a perspective and at a level that an orthopaedic surgeon will appreciate. It is also an excellent reference for radiologists and others—such as physical medicine and rehabilitation clinicians, rheumatologists, and nonoperative musculoskeletal care specialists— who read musculoskeletal MR images and who would like to gain a better appreciation of the associated clinical aspects.
My desire to create this book stems from my interest and background in musculoskeletal imaging and from my recognition of the fact that the ability to accurately evaluate MR imaging studies is critical to the practice of orthopaedic surgery. Along these lines, my colleagues and I have developed
instructional materials and lectures for the orthopaedic surgery residents at our institution to teach them how to systematically evaluate MR imaging studies of the musculoskeletal system. In doing so, we realized that many of the textbooks and other resources on the topic of musculoskeletal MRI are written by radiologists and directed toward radiologists and radiologists in training. This perceived void of imaging resources for orthopaedic surgeons led me to compile and edit this textbook.
MRI for Orthopaedic Surgeons is organized into five sections: 1) core concepts, 2) upper extremity, 3) lower extremity, 4) spine, and 5) special considerations. Each of these five sections, or each chapter, can be read independently, but the textbook is best read in sequential chapter order. In particular, before reading the chapters on individual anatomic areas, the clinician should review Chapter 2, Normal MRI Anatomy of the Musculoskeletal System. That chapter provides a moderately comprehensive evaluation of the key anatomic structures and concepts with which one should be familiar when reviewing an MR imaging study of a particular region; it also serves as a reference point when evaluating the pathology images in a region-specific chapter.
The book features two di erent types of chapters: regionspecific and concept-specific. The region-specific chapters (for example, The Shoulder and The Cervical Spine) share a common organization, with sections on specialized pulse sequences and protocols, traumatic pathology, degenerative pathology, infectious conditions, and postoperative findings. The concept-specific chapters (for example, Advanced Techniques in Musculoskeletal MRI) are organized in a fashion that best suits the individual chapter’s content and the goal of providing orthopaedic surgeons with the information they need to maximize their proficiency in evaluating and interpreting MR imaging studies.
MRI for Orthopaedic Surgeons contains more than 700 MR images and 130 artist’s drawings that have been carefully selected and created to help illustrate and teach the essential anatomy and pathology that an orthopaedic surgeon,
xi
xii Preface
other clinician, or radiologist should be able to recognize and |
has been specifically designed with an orthopaedic surgeon |
define when evaluating an MRI study of the musculoskeletal |
audience in mind. The collaboration between orthopaedic |
system. As such, much of the material can be learned e ec- |
surgeons and radiologists that we have used to produce this |
tively by reviewing the images and illustrations along with |
textbook emulates the optimal relationship between these |
the associated figure legends. |
two subspecialties in clinical practice. |
Most of the chapters have been authored by both ortho- |
This book was envisioned to be a practical aid to develop |
paedic surgeons and radiologists. Some, such as the region- |
and/or refine the skills needed to e ectively and system- |
specific chapters, have orthopaedic surgeons as the primary |
atically evaluate MR imaging studies of the musculoskeletal |
authors, with radiologists as co-authors for accuracy and |
system. I hope that it accomplishes this goal for you. |
clarity from their standpoint. Others (for example, Essen- |
|
tials of MRI Physics and Pulse Sequences) have been written |
|
solely by radiologists, but the presentation of the material |
A. Jay Khanna, MD, MBA |
Acknowledgments
First and foremost, I would like to thank the many contributors to this text for their time, patience, and hard work. They have made this undertaking infinitely easier and allowed all of us to benefit from their years of experience.
Special thanks go to Kay Conerly, Dominik Pucek, and Torsten Scheihagen at Thieme for their expertise and outstanding e orts in bringing this book through the publishing process. Thanks also go to Tony Pazos, medical illustrator extraordinaire, for his skill, attention to detail, and willingness to work through many rounds of revisions.
Finally, I would like to express my greatest appreciation to Elaine Henze, Medical Editor for The Johns Hopkins University’s Department of Orthopaedic Surgery. She, with the support of Sara Cleary, has spent countless hours at work and on her own time helping me edit the first and second (and fifth!) iterations of every chapter, table, image, and legend. Without her commitment to accuracy, focus on quality, and resolution in handling innumerable e-mails, telephone calls, and personal visits with me and the contributors, this book would never have been completed.
xiii
Contributors
EDITOR
A. Jay Khanna, MD, MBA
Associate Professor
Departments of Orthopaedic Surgery
and Biomedical Engineering
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Co-Director
Division of Spine Surgery
Johns Hopkins Orthopaedic Surgery at Good
Samaritan Hospital
Baltimore, Maryland
CONTRIBUTORS
Mark W. Anderson, MD
Professor
Departments of Radiology and Orthopaedic Surgery
University of Virginia
Charlottesville, Virginia
Chief
Division of Musculoskeletal Radiology
University of Virginia
Charlottesville, Virginia
Douglas P. Beall, MD
Chief of Radiology Services
Clinical Radiology of Oklahoma
Oklahoma City, Oklahoma
Clinical Professor
Department of Orthopaedic Surgery and Rehabilitation
University of Oklahoma College of Medicine
Oklahoma City, Oklahoma
Lance M. Brunton, MD
Assistant Professor
Department of Orthopaedic Surgery
University of Pittsburgh School of Medicine
University of Pittsburgh Medical Center
Division of Hand, Upper Extremity, and Microsurgery
Pittsburgh, Pennsylvania
Jacob M. Buchowski, MD, MS
Assistant Professor of Orthopaedic and Neurological
Surgery
Washington University in St. Louis
St. Louis, Missouri
Director
Center for Spinal Tumors
Washington University in St. Louis
St. Louis, Missouri
John T. Campbell, MD
Attending Orthopaedic Surgeon
Institute for Foot and Ankle Reconstruction Mercy Medical Center
Baltimore, Maryland
John A. Carrino, MD, MPH
Associate Professor
Russell H. Morgan Department of Radiology
and Radiological Science
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Section Chief
Musculoskeletal Radiology
Russell H. Morgan Department of Radiology
and Radiological Science
The Johns Hopkins Hospital
Baltimore, Maryland
Brett M. Cascio, MD
Head Team Physician
McNeese State University
Lake Charles, Louisiana
Medical Director
Lake Charles Memorial Sports Medicine
Lake Charles, Louisiana
Gratis Faculty
Louisiana State University
Baton Rouge, Louisiana
Major
U.S. Army Reserve
xv
xvi Contributors
A. Bobby Chhabra, MD
Associate Professor and Vice Chair
Department of Orthopaedic Surgery
University of Virginia Health System
Charlottesville, Virginia
Chief
Division of Hand and Upper Extremity Surgery
University of Virginia Health System
Charlottesville, Virginia
Andrew J. Cosgarea, MD
Professor
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Division Chief
Sports Medicine and Shoulder Surgery
The Johns Hopkins Hospital
Baltimore, Maryland
Aditya R. Daftary, MBBS
Consultant Radiologist
Innovision Imaging
Mumbai, India
J. Dana Dunleavy, MD
Resident
Russell H. Morgan Department of Radiology
and Radiological Science
The Johns Hopkins University School of Medicine
The Johns Hopkins Hospital
Baltimore, Maryland
Daniel J. Durand, MD
Senior Resident
Russell H. Morgan Department of Radiology
and Radiological Science
The Johns Hopkins University School of Medicine
Division of Musculoskeletal Radiology
The Johns Hopkins Hospital
Baltimore, Maryland
Adam J. Farber, MD
Orthopaedic Surgeon
Arizona Orthopedic Surgical Specialists
Chandler, Arizona
Laura M. Fayad, MD
Associate Professor
Russell H. Morgan Department of Radiology
and Radiological Science
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Radiologist
The Johns Hopkins Hospital
Baltimore, Maryland
Li Foong Foo, MD
Assistant Professor
Radiology
Weill Medical College
Cornell University
New York, New York
Assistant Attending Radiologist
New York Presbyterian Hospital
New York, New York
Frank J. Frassica, MD
Chairman and Robert A. Robinson Professor
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Sergio A. Glait, MD
Resident
Department of Orthopaedic Surgery
New York University Hospital for Joint Diseases New York, New York
Ziya L. Gokaslan, MD, FACS
Donlin M. Long Professor
Professor of Neurosurgery, Oncology, and Orthopaedic
Surgery
Vice-Chair
Department of Neurosurgery
Director
Neurosurgical Spine Program
Department of Neurosurgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Timothy S. Johnson, MD
Assistant Professor
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Orthopaedic Surgeon
National Sports Medicine Institute
Lansdowne, Virginia
Bryan T. Kelly, MD
Assistant Professor
Orthopaedic Surgery
Weill Medical College
Cornell University
New York, New York
|
Contributors xvii |
||
Assistant Attending |
Joseph R. O’Brien, MD, MPH |
|
|
Department of Orthopaedic Surgery |
Assistant Professor |
||
Hospital for Special Surgery |
Departments of Orthopaedic Surgery and Neurosurgery |
||
New York Presbyterian Hospital |
The George Washington University School of Medicine |
||
New York, New York |
Washington, District of Columbia |
||
Edward F. McCarthy, MD |
Associate Director of Orthopaedic Spine Surgery |
||
The George Washington University Hospital |
|||
Professor |
|||
Washington, District of Columbia |
|||
Departments of Pathology and Orthopaedic Surgery |
|||
|
|
||
The Johns Hopkins University School of Medicine |
Gbolahan O. Okubadejo, MD |
||
Baltimore, Maryland |
|||
Orthopaedic Spine Surgeon |
|||
|
|||
Attending Orthopaedic Surgeon and Pathologist |
Active Joints Orthopaedics |
||
The Johns Hopkins Hospital |
Englewood Hospital |
||
Baltimore, Maryland |
Englewood, New Jersey |
||
Edward G. McFarland, MD |
Orthopaedic Spine Surgeon |
||
Holy Name Hospital |
|||
Wayne H. Lewis Professor of Orthopaedics |
|||
Teaneck, New Jersey |
|||
and Shoulder Surgery |
|||
|
|
||
Vice-Chairman |
Orthopaedic Spine Surgeon |
||
Department of Orthopaedic Surgery |
Meadowlands Hospital |
||
The Johns Hopkins University School of Medicine |
Secaucaus, New Jersey |
||
Baltimore, Maryland |
|
|
|
Douglas N. Mintz, MD |
Derek F. Papp, MD |
||
Chief Resident |
|||
Associate Professor |
|||
Department of Orthopaedic Surgery |
|||
Clinical Radiology |
|||
The Johns Hopkins University School of Medicine |
|||
Weill Medical College |
|||
The Johns Hopkins Hospital |
|||
Cornell University |
|||
Baltimore, Maryland |
|||
New York, New York |
|||
|
|
||
Attending Physician |
Hollis G. Potter, MD |
||
Hospital for Special Surgery |
Chief |
||
New York Presbyterian Hospital |
MRI Division |
||
New York, New York |
Department of Radiology and Imaging |
||
Ali Moshirfar, MD |
Hospital for Special Surgery |
||
New York, New York |
|||
Assistant Professor |
Professor |
||
Department of Orthopaedic Surgery |
|||
Radiology |
|||
The Johns Hopkins University School of Medicine |
|||
Weill Medical College |
|||
Baltimore, Maryland |
|||
Cornell University |
|||
|
|||
Director |
New York, New York |
||
Center for Advanced Orthopaedics and Pain Management |
Priya D. Prabhakar, MD, MPH |
||
Ashburn, Virginia |
|||
Luis E. Moya, MD |
Clinical Assistant Professor |
||
Department of Radiology |
|||
Clinica Alemana de Santiago |
Je erson Medical College |
||
Santiago, Chile |
Thomas Je erson University |
||
Rick W. Obray, MD |
Philadelphia, Pennsylvania |
||
Sta Radiologist |
|||
Fellow |
|||
Interventional Pain Medicine |
Albert Einstein Medical Center |
||
Mayo Clinic |
Philadelphia, Pennsylvania |
||
Rochester, Minnesota |
|
|
xviii Contributors
Douglas E. Ramsey, MD
Instructor
Diagnostic Radiology
Russell H. Morgan Department of Radiology
and Radiological Science
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Fellow
Musculoskeletal Radiology
Russell H. Morgan Department of Radiology
and Radiological Science
The Johns Hopkins Hospital
Baltimore, Maryland
John D. Reeder, MD, FACR
Director of Imaging
Proscan Imaging Columbia
Columbia, Maryland
Daniel M. Sciubba, MD
Assistant Professor
Department of Neurosurgery
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Director
Minimally Invasive Spine Surgery
Department of Neurosurgery
The Johns Hopkins Hospital
Baltimore, Maryland
Director
Spine Research
Department of Neurosurgery
The Johns Hopkins Hospital
Baltimore, Maryland
Meena W. Shatby, MD
The Woodlands Sports Medicine
The Woodlands, Texas
Michael K. Shindle, MD
Orthopaedic Fellow
Hospital for Special Surgery
New York, New York
Paul D. Sponseller, MD, MBA
Professor and Executive Vice Chair
Pediatrics Division Chief
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
The Johns Hopkins Hospital
Baltimore, Maryland
Uma Srikumaran, MD
Chief Resident
Department of Orthopaedic Surgery
The Johns Hopkins University School of Medicine
The Johns Hopkins Hospital
Baltimore, Maryland
Bruce A. Wasserman, MD
Associate Professor
Russell H. Morgan Department of Radiology
and Radiological Science
The Johns Hopkins University School of Medicine
Baltimore, Maryland
Director of Diagnostic Neurovascular Imaging
The Johns Hopkins Hospital
Baltimore, Maryland
Monica D. Watkins, MD
Fellow
Neuroradiology
The Johns Hopkins Hospital
Baltimore, Maryland
Radiologist
American Radiology
Baltimore, Maryland
Lukas P. Zebala, MD
Chief Resident
Department of Orthopaedic Surgery
Washington University in St. Louis School of Medicine
Barnes-Jewish Hospital at Washington University Medical
Center
St. Louis, Missouri
Abbreviations
Abbreviation |
Definition |
Abbreviation |
Definition |
2D |
two-dimensional |
MCP |
metacarpophalangeal |
3D |
three-dimensional |
MFH |
malignant fibrous histiocytoma |
AC |
acromioclavicular |
MGHL |
middle glenohumeral ligament |
ACL |
anterior cruciate ligament |
MR |
magnetic resonance |
AIDS |
acquired immune deficiency |
MRI |
magnetic resonance imaging |
|
syndrome |
MTP |
metatarsophalangeal |
AP |
anteroposterior |
OCD |
osteochondritis dissecans |
CSF |
cerebrospinal fluid |
|
OR osteochondral defect |
CT |
computed tomography |
PCL |
posterior cruciate ligament |
CVJ |
craniovertebral junction |
PVNS |
pigmented villonodular synovitis |
ECU |
extensor carpi ulnaris |
RA |
rheumatoid arthritis |
FDA |
Food and Drug Administration |
RCL |
radial collateral ligament |
FHL |
flexor hallucis longus |
RF |
radiofrequency |
FSE |
fast spin echo |
SE |
spin echo |
HAGHL |
humeral avulsion of the |
SLAP |
superior labrum anterior and |
|
glenohumeral ligament |
|
posterior (lesions) |
HIV |
human immunodeficiency virus |
SPONK |
spontaneous osteonecrosis of |
IGHL |
inferior glenohumeral ligament |
|
the knee |
IP |
interphalangeal |
STIR |
short tau inversion recovery |
ITB |
iliotibial band |
TE |
echo time |
LCL |
lateral collateral ligament |
TFCC |
triangular fibrocartilage complex |
LUCL |
lateral ulnar collateral ligament |
TR |
repetition time |
MCL |
medial collateral ligament |
UCL |
ulnar collateral ligament |
xix