• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.2-20
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• 2020

MRI is a valuable imaging technique for the evaluation of intraarticular diseases. Accurate interpretation of joint MRI necessitates sound knowledge of anatomy. In the field of joint anatomy, in addition to the discovery of new structures, previously reported joint components of unexplained function are also detected. In this review, joint anatomy researched actively over the last decade is discussed. Joint components including the rotator cable and the superior capsule of the shoulder, posterolateral corner and the anterolateral ligament complex of the knee, and the distal tibiofibular syndesmosis of the ankle joint are introduced and correlated with their MRI features.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.242-247
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• 2011

Purpose: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation. Materials and Methods: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor. Results: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material. Conclusion: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.426-430
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• 2020

Magnetic resonance imaging and static ultrasound imaging do not indicate some cases of partial thickness tears of the supraspinatus tendon. The authors observed a partial thickness tear of the supraspinatus tendon that was not found using other imaging tools but was observed by resisted scaption in shoulder extension position dynamic ultrasound in several cases. This paper outlines this technique is reported by describing two cases.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.92-98
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• 2011

Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.55-59
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• 2007

Synovial chondroma is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. We would like to present the case of a 65-year-old man suffering from synovial chondroma of the right elbow responsible for radial nerve entrapment neuropathy. This is a case of synovial chondroma of the right elbow in an 65-year-old man presenting with pain and restricted joint movement of the right elbow, loss of extension and sensation of the right thumb and wrist. Plain radiographs showed narrowing of elbow joint space, bony spur on the edge of the joint, and radio-opaque sclerotic change of subchondral area. MRI revealed $16{\times}12$ mm sized round mass on the radial head, homogenous low signal on T1WI, heterogenous high and low signal on T2WI. The patient underwent marginal excision of the mass, compressing the radial nerve. Diagnosis was confirmed by histologic examination.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.276-279
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• 2009

Fibroma of tendon sheath is an uncommon benign soft tissue tumor with a predilection for the hand or upper extremities with extremely rare intra-articular involvement. It is mostly comprised of slow-growing fibrous lobules made up of scattered fibroblasts in a dense stroma with slit-like vascular channels. An unique case in a 54-year-old male patient involving the glenohumeral joint arising from postersuperior joint capsule is reported. Magnetic Resonance Imaging (MRI) reveals a focal nodular mass with decreased signal intensity on all pulse sequences and pathology confirmation was made with arthroscopic excision. Intra-articular fibroma of tendon sheath should be considered in the differential diagnosis of intra-articular soft tissue masses during shoulder arthroscopy.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.14-21
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• 2009

Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.115-125
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• 2009

Purpose: The purpose of the study is to evaluate the usefulness of CT arthrography (CTA) by conducting a comparative study of CTA and MR arthrography (MRA) with the arthroscopic findings in the same patients. Materials and methods: Forty nine patients who suffered from shoulder disease underwent MRA and CTA concurrently. The sensitivity and specificity of CTA was evaluated, as compared to MRA, in the case of four types of shoulder pathological lesions. The accuracy of CTA was evaluated by analyzing the arthroscopic findings of thirty four patients. Results: Compared to MRA, CTA showed a sensitivity of 90% and a specificity of 100% for diagnosing supraspinatus tendon (SST) full thickness tear, and CTA showed a sensitivity of 100% and a specificity of 97.5% for making the diagnosis of superior labrum anterior to posterior (SLAP) lesion. For diagnosing partial articular side supraspinatus avulsion (PASTA) lesion, some studies have shown the usefulness of CTA with a sensitivity of 71.4% and a specificity of 97.7%. However, for diagnosing SST bursal side partial tear, the sensitivity of CTA was as low as 10%. CTA has been shown to be relatively accurate when the diagnoses were verified with the arthroscopic findings; diagnosing SST full thickness tear and SLAP lesion with CTA has shown an accuracy of 100% and87.5% respectively, and CTA showed 71.4% diagnostic accuracy for PASTA lesion. Conclusion: CTA was a useful tool and it was equivalent to MRA for the assessment of SST full thickness tear, SLAP lesion and PASTA lesion, but not bursal side partial tear. Thus, it may be used preferably to diagnose shoulder pathology and for follow up as an inexpensive tool after operation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.513-519
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• 2021

Metallic suture anchors are very useful and common fixation devices that are inserted into the target bone to sustain the tendon of a patient with musculus supraspinatus tendon ruptures. On the other hand, the presence of a metallic material prosthesis, such as a metal suture anchor, causes severe MR imaging artifacts, including field distortion, signal loss, and failure of fat suppression. The difference in magnetic susceptibility between metal and other organic materials causes magnetic field distortion surrounding the prosthesis. The resulting magnetic field inhomogeneity makes the images with a lower signal-to-noise ratio and distortion. For a patient with a suture anchor implanted, MR imaging is the golden standard for determining the postoperative prognosis, and a fat-saturation sequence is one of the imaging methods most affected by metal-induced artifacts. In this study, three fat-saturation sequences were compared. Artifact quantification and contrast comparison between the supraspinatus tendon and the surrounding muscle were presented. The images obtained using the STIR pulse sequence showed fewer susceptibility artifacts and better visibility in the supraspinatus tendon and the tissue area. Therefore, the STIR sequence is the most appropriate fat-saturation imaging method for patients with a metallic prosthesis.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.135-140
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• 2013

We report a case of recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I. A twenty-year-old male patient with known neurofibromatosis type I presented with right shoulder dislocation and proximal humerus fracture following a minor trauma. His injured arm also had large plexiform neurofibromas on the elbow, and the dislocation of the shoulder joint was proven to be recurrent. Bony deformation of the humerus and scapula were revealed on X-ray and computed tomography, as well as multiple neurofibromatic changes of the deltoid and periscapular muscles were noted on magnetic resonance imaging. Open reduction and capsular reconstruction were performed and humeral fracture was stabilized with a reconstruction plate. Satisfactory union and functional result were achieved and the dislocation did not recur until the 7-month followup after the procedure. Recurrent shoulder dislocation and combined proximal humerus fracture in neurofibromatosis type I are rare complications. However, it should still be considered in the orthopaedic evaluation process of the diseases.