Preface: Normal Variants and Pitfalls in Musculoskeletal MRI ... xi
William B. Morrison and Adam C. Zoga
Shoulder MR Imaging Normal Variants and Imaging Artifacts ..... 615
Darren Fitzpatrickand Daniel M. Walz
The appearance of osseous, labral, hyaline cartilage,
ligament, muscle, and tendon variants and pitfalls are
discussed with attention to the keys to distinguishing each
of the findings from pathologic lesions of the shoulder.
Elbow Magnetic Resonance Imaging Variants and Pitfalls ........ 633
Marcos Loreto Sampaio and Mark E. Schweitzer
Imaging variants of the elbow and pitfalls can be
disconcerting and can lead to diagnostic mistakes.
Inhomogeneities in the magnetic field and coil position can
result in signal changes that may simulate abnormality. Bone
signal and morphology variants, such as the islands of red
marrow and the pseudodefect of the capitellum and
intraarticular inclusions such as plicae, may be mistaken
for abnormal findings. Variations of the distal biceps and
triceps tendons and different aspects of the ligaments and
their insertions, as well as nonpathologic signal and width
changes in the ulnar nerve, are other examples of common
pitfalls in magnetic resonance imaging of the elbow.
Pitfalls of Wrist MR Imaging .................................. 643
W. James Malone, Robert Snowden, Fozail Alvi, and Joel
C. Klena
The radiologist serves as an indispensable consultant for
those patients with wrist pain, by determining the causes
of the pain and severity of the injury, helping to determine
treatment options, and providing preoperative guidance for
surgery, if planned. This article reviews normal anatomic
variants and potential danger areas encountered by the
radiologist when interpreting magnetic resonance imaging
of the wrist.
MR Imaging of the Hip: Normal Anatomic Variants and Imaging
Pitfalls ...................................................... 663
David F. DuBois and Imran M. Omar
MR imaging of the hip is one of the most common
musculoskeletal MR imaging studies performed today to
assess for occult fractures, acetabular labral tears,
hyaline cartilage loss, and musculotendinous injuries.
Several developmental variations are seen in the hip, which
can be mistaken for disease or potentially even contribute
to the development of a pathologic condition. As in any
imaging study, it is important to be cognizant of these
variations as well as associated findings that help
distinguish between true abnormality and developmental
variation when in-terpreting an MR image of the hip.
This article describes the numerous variants of the hip
that are frequently seen on arthrographic and
nonarthrographic MR imaging examinations.
Magnetic Resonance Imaging Pitfalls and Normal Variations:
The Knee ...................................................... 675
Thomas Slattery and Nancy Major
This article reviews useful diagnostic criteria and imaging
pitfalls more commonly encountered in the knee. Knowledge of
the anatomy and pathologic conditions presented can lead to
more accurate and useful interpretation that can assist
clinicians in patient care.
Normal Variants and Pitfalls in MR Imaging of the Ankle and
Foot .......................................................... 691
Soterios Gyftopoulos and Jenny T. Bencardino
This article focuses on the variants and imaging pitfalls
in the ankle and foot.
Magnetic Resonance Imaging of the Midfoot and Forefoot:
Normal Variants and Pitfalls .................................. 707
Conor P. Shortt
Magnetic resonance imaging of the midfoot and forefoot are
increasingly requested examinations for a variety of
symptoms. This region has its own particular anatomic
variants, which the interpreting radiologist needs to be
aware of, including accessory ossicles, sesamoid variants,
and tarsal coalitions. In addition, certain pulse sequences
used in this region are predisposed to artifact, which may
lead to false-positive findings. These topics are discussed
in this content in addition to the inclusion of pointers to
help avoid pitfalls in interpretation of common diseases.
MR Imaging Features of Common Variant Spinal Anatomy .......... 717
Daniel J. Durand, Thierry A.G.M. Huisman, and John
A. Carrino
The spine is one of the most commonly imaged body parts for
all age groups, with indications ranging from congenital
abnormalities at birth to degenerative pathology toward the
end of life. Because of the importance of softtissue
contrast when imaging the spine, MR imaging has become the
most important modality in its evaluation. One of the key
challenges in the clinical analysis of spinal MR imaging
lies in the wide range of so-called normal variability. The
goal of this article is not to provide the reader with an
exhaustive atlas detailing the appearance of every known
variant. Instead, the authors review the MR appearance of
the most important variants and provide a logical and,
they hope, memorable framework for assimilating this
information into practice. To understand why these
variations occur, the authors examine the aberrant
pathways of embryology, growth, and development that
lead to their formation.
Bone Marrow ................................................... 727
Darra T. Murphy, Michael R. Moynagh, Stephen J. Eustace, and
Eoin C. Kavanagh
This article describes the composition of bone marrow and
the normal progression of bone marrow changes as they occur
throughout the aging process, and provides examples of
pitfalls and variants that may simulate disease.
Index ......................................................... 737
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