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Musculoskeletal MR Imaging Applications at Ultra-High (7T) Field Strength.
Menon, RG, Chang, G, Regatte, RR
Magnetic resonance imaging clinics of North America. 2021;(1):117-127
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Abstract
Regulatory approval of ultrahigh field (UHF) MR imaging scanners for clinical use has opened new opportunities for musculoskeletal imaging applications. UHF MR imaging has unique advantages in terms of signal-to-noise ratio, contrast-to-noise ratio, spectral resolution, and multinuclear applications, thus providing unique information not available at lower field strengths. But UHF also comes with a set of technical challenges that are yet to be resolved and may not be suitable for all imaging applications. This review focuses on the latest research in musculoskeletal MR imaging applications at UHF including morphologic imaging, T2, T2∗, and T1ρ mapping, chemical exchange saturation transfer, sodium imaging, and phosphorus spectroscopy imaging applications.
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PET/MR Imaging in Musculoskeletal Precision Imaging - Third wave after X-Ray and MR.
Hancin, EC, Borja, AJ, Nikpanah, M, Raynor, WY, Haldar, D, Werner, TJ, Morris, MA, Saboury, B, Alavi, A, Gholamrezanezhad, A
PET clinics. 2020;(4):521-534
Abstract
18F-Fluorodeoxyglucose PET has been used to evaluate a wide array of inflammatory and neoplastic pathologies. MR imaging has great soft tissue resolution and high accuracy for detection of edema. Combining PET with MR imaging offers substantial advantages in musculoskeletal imaging. Specifically, evidence demonstrates the potential of imaging of bone marrow, soft tissue, and synovia by PET/MR imaging. Because of inherent limitations of 1H-MR to image cortical bone, there are some challenges; however, the use of 18F-sodium fluoride for PET/MR imaging could change the landscape. This article reviews the literature regarding PET/MR imaging in identification and management of many musculoskeletal diseases.
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Epidemiology of the association between serum 25-hydroxyvitamin D levels and musculoskeletal conditions among elderly individuals: a literature review.
Arima, K, Mizukami, S, Nishimura, T, Tomita, Y, Nakashima, H, Abe, Y, Aoyagi, K
Journal of physiological anthropology. 2020;(1):38
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Abstract
BACKGROUND Vitamin D deficiency is associated with osteoporosis, fracture, muscle weakness, falls, and osteoarthritis in adults. Elderly individuals are more likely to present with poor musculoskeletal conditions. Recently, several epidemiological studies have assessed the correlation between serum 25-hydroxyvitamin D (25(OH)D) levels and musculoskeletal conditions in elderly individuals. MAIN TEXT Osteoporosis is a skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Numerous studies have shown a positive association between serum 25(OH)D levels and bone mineral density. Only a few studies have reported an association between serum 25(OH)D levels and quantitative ultrasound (QUS) parameters. Low serum 25(OH)D level may be a risk factor for hip fracture. However, data on the association between vitamin D deficiency and the incidence of non-hip fracture are contrasting. Falls are a major cause of mortality and morbidity in older adults. Several prospective population-based cohort studies have shown that low 25(OH)D levels are associated with an increased risk of falls. Reduced muscle strength and physical performance are risk factors for adverse events, including disability, institutionalization, and mortality. The role of vitamin D in musculoskeletal functionality (muscle weakness and physical performance) among elderly individuals is still controversial. Osteoarthritis (OA) is the most common form of arthritis and is a leading cause of disability among older adults. Data on the association between serum 25(OH)D levels and OA are contrasting. CONCLUSION Some studies have shown that vitamin D deficiency may be a risk factor for poor musculoskeletal conditions, such as osteoporosis, fracture, muscle weakness, falls, and osteoarthritis in adults. However, other studies did not find an association between serum 25(OH)D levels and musculoskeletal conditions.
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Contrast-Enhanced Ultrasound for Musculoskeletal Applications: A World Federation for Ultrasound in Medicine and Biology Position Paper.
Fischer, C, Krix, M, Weber, MA, Loizides, A, Gruber, H, Jung, EM, Klauser, A, Radzina, M, Dietrich, CF
Ultrasound in medicine & biology. 2020;(6):1279-1295
Abstract
This World Federation for Ultrasound in Medicine and Biology position paper reviews the diagnostic potential of ultrasound contrast agents for clinical decision-making and provides general advice for optimal contrast-enhanced ultrasound performance in musculoskeletal issues. In this domain, contrast-enhanced ultrasound performance has increasingly been investigated with promising results, but still lacks everyday clinical application and standardized techniques; therefore, experts summarized current knowledge according to published evidence and best personal experience. The goal was to intensify and standardize the use and administration of ultrasound contrast agents to facilitate correct diagnoses and ultimately to improve the management and outcomes of patients.
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Applications of Photobiomodulation Therapy to Musculoskeletal Disorders and Osteoarthritis with Particular Relevance to Canada.
Gendron, DJ, Hamblin, MR
Photobiomodulation, photomedicine, and laser surgery. 2019;(7):408-420
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Abstract
Background: Musculoskeletal disorders caused by osteoarthritis (MSDs/OA) are a growing problem in the modern industrialized society in Canada. Overall aging of the general population and a progressive lack of exercise contribute to this alarming increase. Moreover, a range of chronic conditions including cardiovascular and mental diseases show significantly higher comorbidity with MSDs/OA. Conventional medical treatment for MSDs/OA includes nonsteroidal anti-inflammatory drugs and opiate pain killers. These drugs have major drawbacks such as a relative lack of efficacy, potential for addiction, and even death (Vioxx scandal). Photobiomodulation (PBM) was discovered over 50 years ago but has still not attained widespread acceptance by the medical community. This is partly due to uncertainty about the precise molecular mechanisms of action and a bewildering array of different wavelengths and dosimetric parameters employed in reported studies. Objective: The goal of this review was to survey literature reports of PBM, also known as low-level laser therapy used for treatment of MSDs/OA, concentrating on the growth over time, different wavelengths employed, and application to different joints. Methods: We searched the PubMed database for publication of study on PBM to treat the most common joints. Results: We show that the field of PBM to treat MSDs/OA is expanding exponentially over the past 20 years. A trend has emerged over time for more power to achieve better effective treatments, and the understanding of the physiological effect of safe parameters has improved. There is, however, no consensus on the best set of parameters to treat a specific patient indication. Conclusions: Finally, we highlight gaps in our knowledge and the barriers to further clinical trials. We suggest that the growing body of evidence indicating efficacy, and the almost total lack of side effects, should encourage continued clinical research to support clinical applications where better rehabilitation treatments are much needed.
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Top-Ten Tips for Dual-Energy CT in MSK Radiology.
Walstra, FE, Hickle, J, Duggan, P, Alsharhan, R, Murray, N, Mallinson, P, Munk, P, Ouellette, H
Seminars in musculoskeletal radiology. 2019;(4):392-404
Abstract
Dual-energy computed tomography (DECT) has the potential to detect musculoskeletal pathology with greater sensitivity than conventional CT alone at no additional radiation dose to the patient. It therefore has the potential to reduce the need for further diagnostic imaging or procedures (e.g., joint aspirations in the case of gout or magnetic resonance imaging to confirm undisplaced fractures).DECT is a well-established technique for the detection of gout arthropathy. Multiple newer applications have shown clinical potential including bone marrow edema detection and metal artifact reduction. Collagen analysis, bone marrow lesion detection, and iodine mapping in CT arthrography are areas of possible future application and development.This article outlines 10 tips on the use of DECT imaging of the musculoskeletal system, explaining the technique and indications with practical suggestions to help guide the radiologist.
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The application of dual-energy computed tomography in the diagnosis of musculoskeletal disorders: a review of current concepts and applications.
Carotti, M, Salaffi, F, Beci, G, Giovagnoni, A
La Radiologia medica. 2019;(11):1175-1183
Abstract
With the assistance of innovations in scanner engineering and software design, dual-energy computed tomography (DECT) is an advanced imaging method that has been developed over the last decade. With its unique ability to differentiate materials by their atomic number, DECT has opened new perspectives in imaging. The principal advantages of DECT over conventional CT in the musculoskeletal setting relate to the additional information provided regarding tissue composition, artifact reduction and image optimization. In musculoskeletal imaging, uric acid material decomposition images can help identify articular deposition of uric acid crystals (in addition to the detection of uric acid renal stones). Material separation can also help detect bone marrow edema on CT in the case of trauma, algoneurodystrophy, inflammation (osteitis) or malignant bone marrow infiltrates, such as metastases. DECT also offers means to reduce the radiation exposure of patients by replacing multiphase exams with more specific single acquisitions. The first part of this article reviews the basic principles and technical aspects of DECT. The second part focuses on applications of DECT to musculoskeletal imaging including that of gout and other crystal-induced arthropathies, virtual non-calcium images for the study of bone marrow lesions, the study of collagenous structures, as well as the detection of hemosiderin and metal particles.
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Pediatric Musculoskeletal Imaging: The Indications for and Applications of PET/Computed Tomography.
Khalatbari, H, Parisi, MT, Kwatra, N, Harrison, DJ, Shulkin, BL
PET clinics. 2019;(1):145-174
Abstract
The use of PET/computed tomography (CT) for the evaluation and management of children, adolescents, and young adults continues to expand. The principal tracer used is 18F-fluorodeoxyglucose and the principal indication is oncology, particularly musculoskeletal neoplasms. The purpose of this article is to review the common applications of PET/CT for imaging of musculoskeletal issues in pediatrics and to introduce the use of PET/CT for nononcologic issues, such as infectious/inflammatory disorders, and review the use of 18F-sodium fluoride in trauma and sports-related injuries.
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Orthopaedic Primer of Nutritional Requirements for Patients with Musculoskeletal Problems.
Messana, J, Uhl, RL, Aldyab, M, Rosenbaum, AJ
JBJS reviews. 2018;(3):e2
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The Role of Dual-Energy Computed Tomography in Musculoskeletal Imaging.
Fukuda, T, Fukuda, K
PET clinics. 2018;(4):567-578
Abstract
Dual-energy computed tomography (DECT) enables material decomposition and virtual monochromatic images by acquiring 2 different energy X-ray data sets. DECT can detect musculoskeletal pathologic conditions that CT alone cannot, and that would otherwise require MR imaging. In this review, the authors discuss several useful techniques and applications of DECT in musculoskeletal research: virtual monochromatic images, virtual noncalcium images, gout, iodine map, and tendons.