About W. Fischer

Wolfgang Fischer has been working as a specialized MSK radiologist for more than 20 years. He published the comprehensive textbooks "MRI-ESSENTIALS.COM" and the app MRI-ESSENTIALS. In this blog he informs about new literature and new MRI cases that are being incorporated into the app.
14 06, 2020

Posterolateral corner of the knee

By |2020-06-14T21:07:27+02:00June 14th, 2020|Reviewed chapters|

The main stabilizers of the posterolateral corner of the knee are the lateral collateral ligament, the biceps femoris tendon and the popliteus tendon (Figs. [see App]). Since they play a major role in joint stability, it is crucial to detect their injury (Figs. [see App]). Injuries to the posterolateral corner often occur with tears of the anterior or posterior cruciate ligament. They are particularly common when there are contusions of the anteromedial femoral condyle and the posteromedial tibial plateau. Gaeslin et al. 2010 Furthermore, the term "posterolateral corner" refers to a unit of [...]

20 04, 2020

Turf toe

By |2020-04-20T22:53:19+02:00April 20th, 2020|Reviewed chapters|

The term turf toe refers to hyperextension injuries of the first metatarslophalangeal joint, originally described in football players on artificial turf ("astroturf"). Anatomy: The sesamoid bones are fixed proximally by thin, usually invisible metatarso-sesamoid ligaments and distally by strong sesamophalangeal ligaments. In addition, the tendons of the two heads of the flexor hallucis brevis muscle attach proximally into the sesamoid bones. Laterally, they are connected to the capsule by the accessory collateral ligaments. The abductor hallucis tendon merges laterally with this complex and the adductor hallucis tendon and the deep transverse [...]

19 02, 2020

References for lecture: Hip / FAI

By |2020-06-14T21:24:10+02:00February 19th, 2020|References|

Bensler S, Dietrich TJ, Zubler V et al.: Pincer-type MRI morphology seen in over a third of asymptomatic healthy volunteers without femoroacetabular impingement. J Magn Reson Imaging. 2019; 49: 1296-1303. Sueoka T, Tanitame K, Honda Y et al.: Utility of radial reformation of three-dimensional fat-suppressed multi-echo gradient-recalled-echo images for the evaluation of acetabular labral injuries and femoroacetabular impingement. Skeletal Radiol. 2019; 48: 267-273. Dickenson EJ, Wall PDH, Hutchinson CE, Griffin DR: The prevalence of cam hip morphology in a general population sample. Osteoarthritis Cartilage. 2019; 27: 444-448. Schmitz MR, Campbell SE, Fajardo [...]

15 02, 2020

References for lecture: post-OP ACL

By |2020-06-14T21:25:28+02:00February 15th, 2020|References|

McConkey MO, Amendola A, Ramme AJ et al.:Arthroscopic agreement among surgeons on anterior cruciate ligament tunnel placement. Am J Sports Med 2012; 40: 2737-46. Pedneault C, Laverdière C, Hart A et al.: Evaluating the Accuracy of Tibial Tunnel Placement After Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2019; 47: 3187-3194. Muramatsu K, Hachiya Y, Izawa H: Serial evaluation of human anterior cruciate ligament grafts by contrast-enhanced magnetic resonance imaging: comparison of allografts and autografts. Arthroscopy 2008; 24: 1038–1044 Ntoulia A, Papadopoulou F, Zampeli F et al.: Evaluation with contrast-enhanced [...]

13 02, 2020

Muscle atrophy after surgery urgery of a radial tunnel syndrome.

By |2020-02-13T23:12:22+01:00February 13th, 2020|New cases|

T1 axial before and 5 months after surgery of a radial tunnel syndrome (= supinator syndrome). The postoperative examination was performed because of increasing weakness in the forearm. It shows a marked atrophy (purple arrows) and denervation edema (orange arrows) of the superficial part of the supinator muscle. Red arrows: Normal supinator muscle, superficial part. Green arrow: Normal supinator muscle, deep part. Blue arrow: Arcade of Frohse with deep branch of radial nerve.

7 02, 2020

Delaminating rotator cuff tears

By |2020-02-07T00:29:09+01:00February 7th, 2020|New cases, New literature|

It has already been pointed out, that the tendon quality is a very important factor regarding the outcome of rotator cuff reconstruction.[Chung SW et al.] Above all, in addition to the signs of tendinopathy, a delamination of the torn tendon should be highlighted. It is an additional negativ prognostic factor and complicates cuff repair. In delaminated tears the articular layer is usually retracted more than the bursal layer.[Bierry G et al.] Yet, imaging accuracy for determining the quality of a torn tendon is not known. Delaminating tear of the supraspinatus tendon. [...]

3 02, 2020

Hill-Sachs defect and Glenoid bone loss

By |2020-02-03T21:18:25+01:00February 3rd, 2020|New literature|

The concept of the "glenoid track" attempts to define critical and non-critical Hill-Sachs defects in relation to the extent of the glenoid bone loss [Di Giacomo G et al., Funakoshi T et al]. Although the concept and the corresponding measurements are the subject of ongoing discussion [Moroder et al.], it is currently recommended that the following information is provided in the report: the distance from the medial border of the Hill-Sachs-defect to the ISP footprint the depth of the Hill-Sachs-lesion and the amount of glenoid bone loss. This glenoid bone loss is [...]

27 01, 2020

References for lecture: Labrum shoulder

By |2020-06-14T21:24:44+02:00January 27th, 2020|Uncategorized|

Snyder SJ, Karzel RP, Del Pizzo W et al. SLAP lesions of the shoulder. Arthroscopy 1990; 6: 274-279. https://doi.org/10.1016/0749-8063(90)90056-j Nacey NC, Fox MG, Bertozzi CJ et al.: Incidence of gadolinium or fluid signal within surgically proven glenoid labral tears at MR arthrography. Skeletal Radiol 2019; 48: 1185-1191. https://doi.org/10.1007/s00256-018-3143-x Symanski JS, Subhas N, Babb J et al.: Diagnosis of Superior Labrum Anterior-to-Posterior Tears by Using MR Imaging and MR Arthrography: A Systematic Review and Meta-Analysis. Radiology. 2017; 285: 101-113 https://doi.org/10.1148/radiol.2017162681 Arirachakaran A, Boonard M, Chaijenkij K et al.: A systematic review and meta-analysis of diagnostic test of MRA [...]

19 01, 2020

SLAP: Nacey NC et al., Skeletal Radiol 2019

By |2020-01-20T14:17:07+01:00January 19th, 2020|New literature|

The sensitivity and specificity of MR arthrography for SLAP lesions is about 80% and 90% (Symanski et al., Arirachakaran et al.). Nacey et al. pointed out that in 1/3 of the patients who underwent arthroscopic SLAP repair, the lesions in MR arthrography did not show signal intensity of fluid / gadolinium in T2 / T1. The authors also found that the diagnosis of a SLAP lesion in the absence of fluid / Gd signal is still possible if secondary findings support a SLAP lesion (lateral orientation of signal, extension posterior to the [...]

19 01, 2020

Acromion morphology, recent literature

By |2020-01-20T14:19:36+01:00January 19th, 2020|New literature|

For the association between acromion morphology and rotator cuff tears, two independent meta-analyses confirmed moderate evidence that a far lateral extension of the acromion is a risk factor for rotator cuff tears (Andrade R et al., Docter S et al.). The risk for a re-tear after primary rotator cuff repair also appears to increase with far lateral extension of the acromion (Docter S et al., Sheean AJ et al.). However, a reliable cut-off value cannot be given. This limits the clinical utility of the “critical shoulder angle” and the “acromion index”. For [...]

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