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Reliability Assessment of Arthroscopic Findings Versus MRI in ACL Injuries of the Knee
(ScopeMed, 2014-04)
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Introduction: This study was conducted to analyze the reliability of clinical diagnosis in ACL tear injuries. Material and methods: All patients attending our clinic with knee pain from 2009 to 2013 underwent systematic and thorough clinical assessment. From one hundred and three patients with knee problems in 73 were arhroscopicaly diagnosed ACL tears. All these patients underwent therapeutic arthroscopic knee surgery. The clinical diagnosis was confirmed during this procedure. The accuracy, sensitivity and specificity were calculated based on these arthroscopic findings. Results: The accuracy of clinical diagnosis in our study was 82.5% for ACL tears. Our study revealed high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an appropriate screening tool for therapeutic arthroscopy, making diagnostic arthroscopy unnecessary in most patients. Conclusion: Magnetic resonance imaging is accurate and non invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation in patients with soft tissue trauma to knee.
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MRI diagnosis of Baker cyst and significance of associated medial compartment knee osteoarthritis
(Walter de Gruyter GmbH, 2008-01-01)
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Szeimies, Urlike
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Staebler, Axel
Background. The purpose was to evaluate the enlargement of the Baker cyst and the significance of medial compartment knee osteoarthritis. Patients and methods. In a period of two years we evaluated 66 patients with MRI signs of the Baker cyst and medial compartment knee osteoarthritis (median age 56 years, age range 34-84 years, 23 males and 43 females). One group was with MRI signs of the large Baker cyst and the other one with the small Baker cyst. Following graded criteria for medial compartment were used: cartilage thickness, meniscus degeneration, bone marrow oedema, effusion. Lateral compartment was normal. Results. In the group with the large Baker cyst, 26/31 cases (84%) had medial compartment cartilage loss. Eighteen from them had associated 3dh degree meniscal degeneration. Five/31 (16%) cases had only medial meniscus involvement. In the second group, 17/35 (48%) cases had cartilage loss, with 3dh degree meniscal degeneration was 14 (82%). In 18/35 (52%) cases only meniscus degeneration was present, 67% had 1st degree of meniscus degeneration. There was a statistically significant difference in the group with the distended Baker cyst between different degrees of medial meniscus degeneration. Conclusion. The size of the Baker cyst, as a soft tissue tumour, is strongly correlated with degenerative changes of the cartilage and with the degree of meniscus degeneration on the medial compartment of the knee joint.
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DILEMMAS IN THE DIAGNOSIS OF DORSALLY SEQUESTERED DISC IN THE THORACIC SPINE AS A RARE CONDITION
(SHMSHM / AAMD, 2021)
Antuleska Becheska, Gordana
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Posterior migration of sequestered disc of thoracic spine is an extremely rare case and can mimics spinal lesions like tumor, abcess, disc space infection or another space-occupying lesions. Our case is about 54 years old patient, female, who was admitted to the Neurosurgery Clinic due to severe paraparesis of the lower extremities with preserved sensitivity. MRI was very effective for the diagnosis of this rare pathological condition. Peripheral rim enhancement around the nonenhancing disc fragment is typical appearance on contrast MRI for disc fragment. Using the DWI sequence, we showed that there is no restriction of diffusion, which once again confirmed that it is not about an inflammation, not a tumor lesion. So, MRI as a diagnostic procedure offers opportunities to eliminate dilemmas regarding diagnosis in one fell swoop, which is necessary for the timely resolution of the patient’s condition.
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The Contribution of SPECT/CT Bone Scintigraphy in the Localization of an Infective (Purulent) Sacroiliitis – A Case Report
(ID Design 2012/DOOEL Skopje, 2020-09-03)
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Popovski, Neron
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Popovska, Hristina
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Pesevska-Todorcevska, Aleksandra
<jats:p>BACKGROUND: Infectious sacroiliitis (ISI) is an inflammation of one or both of the sacroiliac (SI) joints, relatively rare disorder, affecting between 1% and 2% of all patients with septic arthritis. The variety of symptom presentation makes the diagnosis quite challenging. Combination of laboratory hematological tests, together with diagnostic imaging tools, such as magnetic resonance imaging (MRI), computed tomography (CT), and bone scan (BS), as well as microbiological tests contribute the final diagnosis, which may take up to several months. CASE REPORT: We present a case of a 33-year-old male patient with a history of lower back pain with propagation of the pain in the right leg, accompanied by febrility and hematuria. Laboratory tests showed high values of C-reactive protein, high degradation products and hyperkalemia, leading to a diagnose of acute renal failure stage 3. MRI of the lower spine and pelvis revealed hetero- signal change more to the right where the spinal canal was expanded, accumulating contrast and involved the caudate and the right radix. Тhe displayed sequences were accompanied by an altered morphology of the spinal musculature, with intense accumulation of contrast in parts of the muscle. Paravertebral abscess was detected in the intercaudal and iliac muscles, along with inflammatory edema of the right SI with a suspicion of a sacroiliitis. One week after, a three phase BS showed positive accumulation in the right SI joint in all three phases. The SI index for the right SI joint was 2.09, while for the left SI joint was 1.125. The patient underwent surgical intervention for drainage of the paravertebral abscess. CONCLUSION: The condition of ISI may be sometimes very difficult to be recognized in many patients. Considering the diversity of the clinical manifestations, it is of great importance to select the right imaging modality. The nuclear medicine technique triple phase bone and the hybrid imaging SPECT/CT have been suggested to improve the sensitivity and specificity of the bone scan, providing better characterization of equivocal lesions, especially in the acute form for disease localization.</jats:p>
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Disk herniations and cauda equine compression in different lumbosacral transitional anatomy types
(Medical faculty, Ss Cyril and Methodius University Skopje, Macedonia, 2018)
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Chabukovska Radulovska, Jasmina
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