| Medial tibial pain: a dynamic contrast-enhanced MRI study. | |
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MedLine Citation:
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PMID: 10463643 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment. |
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Authors:
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K T Mattila; M E Komu; S Dahlström; S K Koskinen; J Heikkilä |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Magnetic resonance imaging Volume: 17 ISSN: 0730-725X ISO Abbreviation: Magn Reson Imaging Publication Date: 1999 Sep |
Date Detail:
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Created Date: 1999-10-15 Completed Date: 1999-10-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8214883 Medline TA: Magn Reson Imaging Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 947-54 Citation Subset: IM |
Affiliation:
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Department of Radiology, Turku University and Turku University Hospital, Finland. kimmo.mattila@TYKS.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Bone Marrow / pathology Chronic Disease Compartment Syndromes / complications, diagnosis* Contrast Media* Cumulative Trauma Disorders / diagnosis Diagnosis, Differential Edema / diagnosis Gadolinium DTPA / diagnostic use Humans Leg Magnetic Resonance Imaging* / methods Male Military Personnel Muscle, Skeletal / pathology Pain / etiology*, pathology Periosteum / pathology Prospective Studies Sensitivity and Specificity Tibia / pathology* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 80529-93-7/Gadolinium DTPA |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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