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ARRS Meeting 2001 -> May 1^st

101st American Roentgen Ray Society Meeting: May 1st
reported by Joseph Gagliardi, M.D.

Today I sat in on Scientific Session 12, Musculoskeletal 3: Foot and Ankle. The keynote address, given by John J. Smith, M.D., J.D., (Massachusetts General Hospital) focused on musculokeletal intervention. His service not only offers diagnosis of abnormalities but also provides treatment, a valuable service for both the referring physician and patient.

Dr. Smith provided several helpful hints:

• do not overfill the joint with contrast which limits the amount of medication to be given,
• use lymphangiogram tubing which allows the examiners hands to be out of the field of exposure, and
• place the needle directly into the tendon and slowly retract until resistance is lost thus confirming that the needle tip is in the sheath.

This was a thought provoking and well-illustrated presentation.

Paper 95. Hindfoot Valgus and Fibulocalcaneal Abutment: Additional Secondary MR Imaging Signs of Posterior Tibialis Tendon Dysfunction
W. Morrison and colleagues (Thomas Jefferson University Hospital) noted that hindfoot valgus can be easily measured on MR images and that useful additional findings include fibulocalcaneal abutment, deltoid insufficiency, and sinus tarsi abnormalities. In all patients, the posterior tibialis tendon was noted to be abnormal as well.

Paper 96. Imaging of Os Peroneum Fracture and Peroneus Longus Tendon Tear
M. Klume and colleagues (University of Michigan) concluded that certain routine radiographic findings suggest the possibility of a complete tear of the peroneus longus tendon. These findings include:

• a distance of greater than eight mm between the bony fragments
• a distance of greater than 20 mm between the proximal fragment and the calcaneocuboid junction.

Both MR and ultrasound was useful in this diagnosis.

Paper 97. MR Spectrum of Distal Peroneal Symptomatology.
Dr. Parellada and colleagues (Thomas Jefferson University) found that MR can define causes of lateral ankle pain in patients without fractures and distinguish between different entities such as tendonopathy and bone marrow edema in the cuboid bone.

Paper 98. Muscle Edema and Fatty Infiltration: Are They MR Markers of Diabetes?
S. Viswamitra and colleagues concluded that diabetes is indeed associated with intrinsic muscle edema and fatty infiltration. Thus diabetes can be suggested by the radiologist at an earlier stage and the presence of muscle edema does not need to be from myositis rather, it may be a part of the spectrum of diabetic foot.

Paper 99. Osteosynthetic Treatment of Talus Fractures: Limited Utility of MRI in Detection of Posttraumatic Complications Due to Metal Induced Artifacts?
F. Lomoschitz and colleagues found that the vast majority of patients in this study, 84%, had mild artifacts as a result of the metal present. Moderate and severe artifacts were equally split at 8% each. In all cases, the metal artifacts did not limit diagnosis of abnormalities in these patients who had persistent pain or limited function following surgery using a 1 Tesla magnet. Diagnoses made included avascular necrosis, collapse of the talar dome, nonunion, sinus tarsi syndrome, and degenerative arthritis.