Evolutionary Anthropology Faculty Database
Evolutionary Anthropology
Arts & Sciences
Duke University

 HOME > Arts & Sciences > BAA > Faculty    Search Help Login pdf version printable version 
Evaluations

Publications of Nancy M Major    :chronological  alphabetical  by type listing:

%%    
@article{fds133621,
   Author = {GA Toomayan and F Robertson and NM Major and BE Brigman},
   Title = {Upper extremity compartmental anatomy: clinical relevance to
             radiologists.},
   Journal = {Skeletal radiology, Germany},
   Volume = {35},
   Number = {4},
   Pages = {195-201},
   Year = {2006},
   Month = {April},
   ISSN = {0364-2348},
   Keywords = {Bone Neoplasms • Humans • Magnetic Resonance
             Imaging • Soft Tissue Neoplasms • Upper Extremity
             • anatomy & histology • pathology •
             radiography • radiography* • surgery},
   Abstract = {Malignant tumors of the upper extremity are uncommon, and
             their care should be referred to specialized facilities with
             experience treating these lesions. The Musculoskeletal Tumor
             Society (MSTS) staging system is used by the surgeon to
             determine appropriate surgical management, assess prognosis,
             and communicate with other healthcare providers. Magnetic
             resonance imaging (MRI) is employed pre-operatively to
             identify a lesion's compartment of origin, determine extent
             of spread, and plan biopsy and resection approaches.
             Involvement of neurovascular structures may result in
             devastating loss of upper extremity function, requiring
             amputation. Violation of high-resistance compartmental
             barriers necessitates more extensive surgical resection.
             Biopsy may be performed by the radiologist using imaging
             guidance. Knowledge of compartmental anatomy allows the
             radiologist or surgeon to use an easily excisable biopsy
             approach and prevent iatrogenic spread to unaffected
             compartments. Case examples are presented to illustrate the
             importance of compartmental anatomy in the management of
             benign and malignant upper extremity tumors.},
   Key = {fds133621}
}

@article{fds133622,
   Author = {TP Sundberg and GA Toomayan and NM Major},
   Title = {Evaluation of the acetabular labrum at 3.0-T MR imaging
             compared with 1.5-T MR arthrography: preliminary
             experience.},
   Journal = {Radiology, United States},
   Volume = {238},
   Number = {2},
   Pages = {706-11},
   Year = {2006},
   Month = {February},
   ISSN = {0033-8419},
   Keywords = {Acetabulum • Adult • Arthralgia •
             Arthrography • Female • Hip Joint • Humans
             • Joint Diseases • Magnetic Resonance Imaging*
             • Male • Prospective Studies • etiology
             • methods • methods* • pathology •
             pathology*},
   Abstract = {Institutional review board approval and informed consent
             were obtained for this HIPAA-compliant study. The purpose of
             this study was to prospectively compare imaging of the
             acetabular labrum with 3.0-T magnetic resonance (MR) imaging
             and 1.5-T MR arthrography. Eight patients (four male, four
             female; mean age, 38 years) with hip pain suspicious for
             labral disease were examined at both MR arthrography and MR
             imaging. Presence of labral lesions, paralabral cysts,
             articular cartilage lesions, subchondral cysts, osteophytes,
             and synovial herniation pits was recorded. There was
             arthroscopic correlation of findings in five patients. MR
             imaging depicted four surgically confirmed labral tears that
             were identified at MR arthrography, as well as one that was
             not visualized at MR arthrography. MR imaging helped
             identify all other pathologic conditions that were diagnosed
             at MR arthrography and helped identify one additional
             surgically confirmed focal articular cartilage lesion. These
             results provide encouraging support for evaluation with
             3.0-T MR imaging over 1.5-T MR arthrography.},
   Key = {fds133622}
}

@article{fds133625,
   Author = {GA Toomayan and WR Holman and NM Major and SM Kozlowicz and TP
             Vail},
   Title = {Sensitivity of MR arthrography in the evaluation of
             acetabular labral tears.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {186},
   Number = {2},
   Pages = {449-53},
   Year = {2006},
   Month = {February},
   ISSN = {0361-803X},
   Keywords = {Acetabulum • Adolescent • Adult • Arthroscopy
             • Cartilage, Articular • Chi-Square Distribution
             • Contrast Media • Female • Gadolinium DTPA
             • Humans • Magnetic Resonance Imaging • Male
             • Middle Aged • Retrospective Studies •
             Sensitivity and Specificity • diagnostic use •
             injuries* • methods*},
   Abstract = {OBJECTIVE: MRI has historically provided suboptimal
             visualization of tears of the acetabular labrum.
             Degenerative fraying and underlying cartilage abnormalities
             can often mimic tears of the labrum on conventional MRI.
             Administration of intraarticular gadolinium enhances the MRI
             appearance of the labrum to improve detection of labral
             abnormalities. This study examined the improved diagnostic
             sensitivity of MR arthrography compared with conventional
             MRI and the importance of confining the study to a small
             field of view. MATERIALS AND METHODS: Fifty-one hips were
             imaged in 48 patients. Fourteen hips underwent conventional
             MRI with a large field of view (30-38 cm). Seven hips
             underwent conventional MRI with a small field of view (14-20
             cm). Thirty hips underwent MR arthrography with a small
             field of view (14-20 cm). Labral tears were diagnosed when
             contrast material was identified within the labrum or
             between the labrum and the acetabulum, when a displaced
             fragment was noted, or when a paralabral cyst was
             identified. All study results were compared with findings at
             the time of hip arthroscopy. RESULTS: Conventional MRI with
             a large field of view was 8% sensitive in detecting labral
             tears compared with findings at the time of arthroscopy.
             Diagnostic sensitivity was improved to 25% with a small
             field of view. MR arthrography with a small field of view
             was 92% sensitive in detecting labral tears. CONCLUSION: A
             combination of MR arthrography and a small field of view is
             more sensitive in detecting labral abnormalities than is
             conventional MRI with either a large or a small field of
             view.},
   Key = {fds133625}
}

@article{fds133629,
   Author = {EL Giaroli and NM Major and DE Lemley and J Lee},
   Title = {Coracohumeral interval imaging in subcoracoid impingement
             syndrome on MRI.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {186},
   Number = {1},
   Pages = {242-6},
   Year = {2006},
   Month = {January},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Female • Humans •
             Humerus • Magnetic Resonance Imaging* • Male
             • Middle Aged • ROC Curve • Retrospective
             Studies • Scapula • Sensitivity and Specificity
             • Sex Factors • Shoulder Impingement Syndrome
             • Shoulder Joint • anatomy & histology •
             anatomy & histology* • diagnosis*},
   Abstract = {OBJECTIVE: The coracohumeral interval previously has been
             described as predictive of subcoracoid impingement on
             dynamic screening. The purpose of this study was to
             determine whether a coracohumeral interval acquired from
             routinely performed MRI can reliably diagnose subcoracoid
             impingement. MATERIALS AND METHODS: Preoperative MRI
             examinations of 19 patients (16 males, three females) with
             subsequent surgical confirmation of subcoracoid impingement
             were reviewed retrospectively and compared with MRI studies
             of 41 control subjects (22 males, 19 females). Axial and
             oblique sagittal coracohumeral interval measurements were
             taken. The morphology of the coracoid process and lesser
             tuberosity was assessed. Postanalysis application of the
             data to two smaller groups of patients was performed. The
             first group consisted of nine subjects (three males, six
             females) for whom subcoracoid impingement was diagnosed
             prospectively on the basis of abnormalities found by MRI.
             The second group consisted of seven patients (two males,
             five females) who were referred for MRI evaluation because
             of clinically suspected subcoracoid impingement. RESULTS:
             The average coracohumeral interval for females was 3 mm
             smaller than that for males. Using sex-adjusted data, we
             found a statistically significant difference between
             individuals with or without subcoracoid impingement in the
             axial coracohumeral interval (p = 0.01). This value,
             however, was poorly predictive (area under the receiver
             operating characteristic curve, 0.73). An 11.5-mm axial
             coracohumeral interval had 84% sensitivity but only 44%
             specificity. A 10.5-mm axial coracohumeral interval had 79%
             sensitivity and 59% specificity. The shoulder morphologic
             features assessed and intraarticular contrast use were not
             statistically significantly related to the coracohumeral
             interval. In postanalysis application of data, in the group
             of nine subjects without clinical diagnosis of subcoracoid
             impingement, all prospective MRI subcoracoid impingement
             diagnoses were falsely positive. However, if subcoracoid
             impingement was the referring diagnosis, prospective MRI
             evaluation more often was correct (n = 7 [three
             true-negatives, two true-positives, two false-negatives]).
             CONCLUSION: A sex-adjusted coracohumeral interval of
             10.5-11.5 mm, although statistically significantly related
             to subcoracoid impingement, is poorly predictive of this
             diagnosis when acquired via routinely performed MRI.
             Subcoracoid impingement is primarily a clinical diagnosis
             that may be supported, but not established, by this
             means.},
   Key = {fds133629}
}

@article{fds133630,
   Author = {NM Major},
   Title = {Role of MRI in prevention of metatarsal stress fractures in
             collegiate basketball players.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {186},
   Number = {1},
   Pages = {255-8},
   Year = {2006},
   Month = {January},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Basketball • Bone Marrow
             Diseases • Edema • Fractures, Stress • Humans
             • Magnetic Resonance Imaging • Male •
             Metatarsal Bones • diagnosis* • injuries* •
             methods* • prevention & control*},
   Abstract = {OBJECTIVE: Metatarsal stress fractures are common and
             represent debilitating and potentially season-ending
             injuries for basketball players. Bone marrow edema is
             readily visualized on MRI and can be a sign of stress
             changes. Twenty-six asymptomatic male National Collegiate
             Athletic Association basketball players were imaged before
             the 2003-2004 season and 14 players were reimaged after the
             conclusion of the season with a screening study of long- and
             short-axis fat-suppressed T2-weighted images (TR/effective
             TE, 3,500/56) to identify bone marrow edema in the
             metatarsals. CONCLUSION: Six (12%) of 52 feet showed a
             signal indicating bone marrow edema in the metatarsals. MRI
             depicts bone marrow edema in the feet before a fracture
             becomes evident. Identification of this edema may reveal
             stress changes, allowing early treatment and prevention of
             debilitating stress fractures.},
   Key = {fds133630}
}

@article{fds133623,
   Author = {EL Giaroli and NM Major and LD Higgins},
   Title = {MRI of internal impingement of the shoulder.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {185},
   Number = {4},
   Pages = {925-9},
   Year = {2005},
   Month = {October},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Arthroscopy • Athletic
             Injuries • Female • Humans • Magnetic
             Resonance Imaging • Male • Prospective Studies
             • Retrospective Studies • Shoulder Impingement
             Syndrome • methods* • pathology*},
   Abstract = {OBJECTIVE: Internal impingement is a condition that occurs
             in athletes in which the shoulder is put in extreme
             abduction and external rotation during overhead movements.
             During this motion, the posterior fibers of the
             supraspinatus tendon, anterior fibers of the infraspinatus
             tendon, or both can get impinged between the humeral head
             and the posterior glenoid. The purpose of this study was to
             evaluate the ability of MRI to show the findings of internal
             impingement of the shoulder. CONCLUSION: As opposed to our
             six patients with clinically and surgically diagnosed
             internal impingement, the control patients had isolated
             pathology in the rotator cuff, labrum, or humeral head. We
             found that the constellation of findings of undersurface
             tears of the supraspinatus or infraspinatus tendon and
             cystic changes in the posterior aspect of the humeral head
             associated with posterosuperior labral pathology is a
             consistent finding diagnostic of internal
             impingement.},
   Key = {fds133623}
}

@article{fds133626,
   Author = {GB Blackmon and NM Major and CA Helms},
   Title = {Comparison of fast spin-echo versus conventional spin-echo
             MRI for evaluating meniscal tears.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {184},
   Number = {6},
   Pages = {1740-3},
   Year = {2005},
   Month = {June},
   ISSN = {0361-803X},
   Keywords = {Adult • Case-Control Studies • Female •
             Humans • Magnetic Resonance Imaging • Male •
             Menisci, Tibial • Sensitivity and Specificity •
             injuries* • methods*},
   Abstract = {OBJECTIVE: We compare sensitivities of conventional
             spin-echo and fast spin-echo sequences in the evaluation of
             meniscal tears. Furthermore, we reevaluate the results from
             prior studies comparing these two sequences to understand
             why there are differing conclusions regarding the efficacy
             of fast spin-echo sequences as a commensurate replacement
             for conventional spin-echo sequences. MATERIALS AND METHODS:
             We used records from a control group of 64 patients (128
             menisci) who had undergone arthroscopy to determine the
             sensitivity of conventional spin-echo sequences for
             detecting meniscal tears. Two hundred sixteen consecutive
             patients (432 menisci) were then imaged using conventional
             spin-echo and fast spin-echo sequences to evaluate for
             meniscal tears. Both sequences were proton density-weighted
             with fat suppression. RESULTS: Of the 432 menisci, 170 tears
             were detected on conventional spin-echo imaging. Only 128
             tears were detected on the fast spin-echo sequence. The
             sensitivities of conventional spin-echo and fast spin-echo
             imaging were found to be 93% and 80%, respectively. In
             addition, findings from conventional spin-echo and fast
             spin-echo sequences were discordant for 72 menisci (17%, p <
             0.01). CONCLUSION: The sensitivities of conventional
             spin-echo and fast spin-echo imaging for detecting meniscal
             tears have been shown to be greater than 90% and
             approximately 80%, respectively. However, some authors
             advocate substituting conventional spin-echo imaging with
             fast spin-echo imaging. We urge the abandonment of fast
             spin-echo imaging for evaluating meniscal tears because a
             loss of greater than 10% in sensitivity is
             unacceptable.},
   Key = {fds133626}
}

@article{fds133628,
   Author = {GA Toomayan and F Robertson and NM Major},
   Title = {Lower extremity compartmental anatomy: clinical relevance to
             radiologists.},
   Journal = {Skeletal radiology, Germany},
   Volume = {34},
   Number = {6},
   Pages = {307-13},
   Year = {2005},
   Month = {June},
   ISSN = {0364-2348},
   Keywords = {Adult • Aged • Biopsy • Bone Neoplasms •
             Female • Humans • Lower Extremity • Male
             • Middle Aged • Muscle Neoplasms •
             Musculoskeletal Diseases • Neoplasm Seeding •
             Neoplasm Staging • Tomography, X-Ray Computed •
             anatomy & histology* • diagnosis* • methods •
             pathology • radiography*},
   Abstract = {A thorough understanding of compartmental anatomy is
             necessary for the radiologist participating in the care of a
             patient with a lower extremity musculoskeletal malignancy.
             Localization of tumor to compartment of origin and
             identification of extracompartmental spread preoperatively
             are needed to correctly stage a tumor and determine the
             appropriate surgical management. An understanding of the
             locations of fascial boundaries, extracompartmental tissues,
             and neurovascular structures of the thigh and lower leg
             facilitates this diagnostic process. For the radiologist
             planning to biopsy a suspicious musculoskeletal lesion,
             consultation with the referring orthopaedic surgeon is
             recommended in order to jointly select an appropriate
             percutaneous biopsy approach. Adequate preprocedural
             planning ensures selection of an approach which prevents
             iatrogenic tumor spread beyond the compartment of origin,
             protects neurovascular structures, and allows complete
             resection of the biopsy tract and scar at the time of
             surgical resection without jeopardizing a potential
             limb-sparing procedure. Cross-sectional anatomic review and
             case examples demonstrate the importance of a detailed
             understanding of compartmental anatomy when approaching the
             patient with a lower extremity musculoskeletal
             tumor.},
   Key = {fds133628}
}

@article{fds133620,
   Author = {KR Lindauer and NM Major and DP Rougier-Chapman and CA
             Helms},
   Title = {MR imaging appearance of 180-360 degrees labral tears of the
             shoulder.},
   Journal = {Skeletal radiology, Germany},
   Volume = {34},
   Number = {2},
   Pages = {74-9},
   Year = {2005},
   Month = {February},
   ISSN = {0364-2348},
   Keywords = {Adolescent • Adult • Arthroscopy • Female
             • Humans • Magnetic Resonance Imaging* • Male
             • Middle Aged • Retrospective Studies •
             Shoulder • Treatment Outcome • injuries* •
             radiography* • surgery},
   Abstract = {Glenoid labral tears exceeding 180 degrees are an uncommon
             entity in which characteristic clinical and MR imaging
             features can lead to a more accurate preoperative diagnosis.
             We provide a description of glenoid labral tears that exceed
             180 degrees, and their characteristic magnetic resonance
             imaging features. In the young, heavily muscled male
             athlete, the identification of multiple sites of labral
             pathology and isolated, extensive posterior labral injuries
             are features that should raise suspicion for labral tears
             that exceed 180 degrees.},
   Key = {fds133620}
}

@article{fds133618,
   Author = {RS Bikkina and CA Tujo and AB Schraner and NM Major},
   Title = {The "floating" meniscus: MRI in knee trauma and implications
             for surgery.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {184},
   Number = {1},
   Pages = {200-4},
   Year = {2005},
   Month = {January},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Female • Humans •
             Knee Injuries • Magnetic Resonance Imaging* • Male
             • Menisci, Tibial • Middle Aged •
             Retrospective Studies • diagnosis* • injuries*
             • surgery},
   Abstract = {OBJECTIVE: We describe 21 cases involving meniscal injury in
             which the meniscus appears free-floating on MRI of the knee.
             In these cases, the meniscus is completely surrounded by
             fluid. Correlation with surgical reports shows that the
             "floating" meniscus corresponds to a meniscal avulsion or
             detachment from the tibial plateau with an associated
             disruption of the meniscotibial coronary ligaments, which
             attach the meniscus to the tibia, allowing fluid to
             encompass the meniscus. A floating meniscus on MRI may
             represent a new specific finding for an uncommon form of
             meniscal injury known as meniscal avulsion. CONCLUSION: The
             presence of a floating meniscus on MRI is a result of
             significant trauma to the knee leading to meniscal avulsion
             and is often associated with significant ligamentous injury.
             Alerting the surgeon to the presence of a meniscal avulsion
             facilitates appropriate surgical planning with meniscal
             reattachment to the tibial plateau.},
   Key = {fds133618}
}

@article{fds133624,
   Author = {SM Jackson and NM Major},
   Title = {Pathologic conditions mimicking osteonecrosis.},
   Journal = {The Orthopedic clinics of North America, United
             States},
   Volume = {35},
   Number = {3},
   Pages = {315-20, ix},
   Year = {2004},
   Month = {July},
   ISSN = {0030-5898},
   Keywords = {Bone Cysts • Diagnosis, Differential • Female
             • Femur Head Necrosis • Hip Joint • Humans
             • Magnetic Resonance Imaging • Male •
             Osteoarthritis, Hip • Osteoporosis • Risk
             Assessment • diagnosis • pathology*},
   Abstract = {MRI has become increasingly helpful in establishing an early
             diagnosis of avascular necrosis(AVN). AVN often demonstrates
             a classic pattern on MRI; findings earlier in the course of
             the disease are less specific. Many pitfalls can complicate
             interpretation, and a number of pathologic conditions can
             share features of early AVN on MRI and plain
             radiographs.These entities should be distinguished from AVN,
             because treatment and prognosis may differ
             significantly.},
   Key = {fds133624}
}

@article{fds133619,
   Author = {CJ Barnes and LD Higgins and NM Major and CJ Basamania},
   Title = {Magnetic resonance imaging of the coracoclavicular
             ligaments: its role in defining pathoanatomy at the
             acromioclavicular joint.},
   Journal = {Journal of surgical orthopaedic advances, United
             States},
   Volume = {13},
   Number = {2},
   Pages = {69-75},
   Year = {2004},
   ISSN = {1548-825X},
   Keywords = {Acromioclavicular Joint • Adult • Humans •
             Joint Instability • Ligaments, Articular •
             Magnetic Resonance Imaging • Male • Wounds and
             Injuries • classification • pathology* •
             radiography},
   Abstract = {Four patients with acromioclavicular joint injuries (one
             type II, two type III, one type V), two patients without
             acromioclavicular joint injury, and a fresh-frozen cadaver
             underwent magnetic resonance imaging (MRI) and plain
             radiographs. The normal conoid and trapezoid ligaments were
             easily identified in the cadaver and the two uninjured
             patients. Magnetic resonance imaging revealed disruption of
             both coraclavicular ligaments in the three patients with
             type II and type III injuries. However, the patient with the
             type V injury had disruption of the trapezoid ligament
             alone. Thus, the grade of injury, as determined by the
             change in the coracoclavicular interval onplain radiography
             and defined by the Rockwood classification system, failed to
             correlate with the pathoanatomy seen on MRI in two of the
             four injured patients. These findings suggest that
             improvements in the classification of these injuries may be
             necessary.},
   Key = {fds133619}
}

@article{fds133603,
   Author = {DG Trembath and R Dash and NM Major and LG Dodd},
   Title = {Cytopathology of mesenchymal chondrosarcomas: a report and
             comparison of four patients.},
   Journal = {Cancer, United States},
   Volume = {99},
   Number = {4},
   Pages = {211-6},
   Year = {2003},
   Month = {August},
   ISSN = {0008-543X},
   Keywords = {Adolescent • Adult • Biopsy, Needle • Bone
             Neoplasms • Chondrosarcoma, Mesenchymal • Female
             • Humans • Male • Middle Aged • Neoplasm
             Metastasis • Prognosis • pathology* •
             secondary*},
   Abstract = {BACKGROUND: Mesenchymal chondrosarcoma (MC) is an infrequent
             neoplasm, representing approximately 1% of all
             chondrosarcomas. Cytologic descriptions of MCs have been
             confined to rare case reports. In the current report, the
             authors describe their experience with the cytologic
             features of four MCs: two primary tumors and two metastatic
             lesions. METHODS: Four patients were diagnosed with MC at
             the authors' institution from 1994 to 2002. Three of four
             patients underwent fine-needle aspiration (FNA) biopsy as
             part of their diagnosis; in the fourth patient, imprint
             cytology was performed. Each tumor also received histologic
             confirmation. RESULTS: The patients studied included three
             females and one male. In three patients, the tumor presented
             initially as a soft tissue mass; whereas, in the remaining
             patient, the MC presented in the tibia. FNA results
             demonstrated small, oval-to-spindled cells with high
             nuclear-to-cytoplasmic ratios. Cells occurred singly and in
             clumps in a background of basophilic extracellular matrix.
             Histologic examination of each lesion demonstrated biphasic
             tumors, including focal areas of relatively mature cartilage
             formation as well as a small cell population. CONCLUSIONS:
             MC is a rare soft tissue tumor that occurs frequently in
             extraskeletal locations. FNA of these tumors can be
             diagnostic if the tumor is sampled appropriately and of
             critical features, such as the background extracellular
             matrix, are recognized. Given the propensity of these tumors
             to metastasize and the poor prognosis of patients with MC,
             early identification by FNA biopsy may allow earlier, more
             aggressive interventions.},
   Key = {fds133603}
}

@article{fds133588,
   Author = {EN Vinson and NM Major},
   Title = {MR imaging of ankylosing spondylitis.},
   Journal = {Seminars in musculoskeletal radiology, United
             States},
   Volume = {7},
   Number = {2},
   Pages = {103-13},
   Year = {2003},
   Month = {June},
   ISSN = {1089-7860},
   Keywords = {Bone and Bones • Humans • Magnetic Resonance
             Imaging* • Spondylitis, Ankylosing • diagnosis*
             • pathology • physiopathology},
   Abstract = {Ankylosing spondylitis (AS) is one of a group of disorders
             characterized by association with HLA-B27 histocompatibility
             complex, seronegativity for rheumatoid factor, and
             propensity for inflammation at entheses, synovial
             articulations, and cartilaginous articulations. The
             radiographic hallmark of the disease is ankylosis, and the
             principle sites of involvement are the sacroiliac joints and
             spine, with less frequent involvement of other joints,
             including the pubic symphysis, hips, shoulders, knees,
             hands, feet, and sternoclavicular, acromioclavicular,
             sternomanubrial, and temporomandibular joints. Following a
             brief discussion of the basic pathophysiology and typical
             clinical findings of AS, we describe the typical magnetic
             resonance imaging features of the disease as it is manifests
             in the axial skeleton. Finally, a brief mention of special
             considerations in the radiographic evaluation of the AS
             patient in the setting of trauma is made.},
   Key = {fds133588}
}

@article{fds133608,
   Author = {RL Cothran and PM McGuire and CA Helms and NM Major and DE
             Attarian},
   Title = {MR imaging of infrapatellar plica injury.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {180},
   Number = {5},
   Pages = {1443-7},
   Year = {2003},
   Month = {May},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Female • Humans •
             Magnetic Resonance Imaging* • Male • Patella*
             • Retrospective Studies • Synovial Membrane •
             injuries* • pathology*},
   Abstract = {OBJECTIVE: Injury to the infrapatellar plica (ligamentum
             mucosum) has not been previously described in the radiology
             literature to our knowledge. This article shows the MR
             imaging appearance of injury to the infrapatellar plica.
             CONCLUSION: Injury to the infrapatellar plica is uncommon
             but should be considered as a potential source of knee pain,
             especially if no other evidence indicates internal
             derangement. MR imaging can reveal a typical appearance for
             infrapatellar plica injury.},
   Key = {fds133608}
}

@article{fds133609,
   Author = {NM Major and MC Banks},
   Title = {MR imaging of complications of loose surgical tacks in the
             shoulder.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {180},
   Number = {2},
   Pages = {377-80},
   Year = {2003},
   Month = {February},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Arthroscopy • Diagnosis,
             Differential • Foreign Bodies • Humans •
             Ligaments, Articular • Magnetic Resonance Imaging*
             • Male • Middle Aged • Polyglycolic Acid
             • Postoperative Complications • Shoulder Joint*
             • Shoulder Pain • Surgical Instruments* •
             Synovitis • complications • diagnosis •
             diagnosis* • etiology • pathology •
             surgery},
   Abstract = {OBJECTIVE: Loose surgical tacks in the shoulder joint are a
             potential cause of new-onset shoulder pain after
             arthroscopic repair of an anterior-to-posterior lesion of
             the superior labrum. We report the MR imaging appearance of
             loose surgical tacks in this anatomic location. CONCLUSION:
             MR imaging is valuable in the evaluation of postoperative
             shoulder pain. Synovitis is a commonly considered clinical
             diagnosis; our report illustrates that loose tacks are
             another potential complication after shoulder
             surgery},
   Key = {fds133609}
}

@article{fds133594,
   Author = {NM Major and LN Beard and CA Helms},
   Title = {Accuracy of MR imaging of the knee in adolescents.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {180},
   Number = {1},
   Pages = {17-9},
   Year = {2003},
   Month = {January},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Anterior Cruciate Ligament • Child
             • Female • Humans • Knee Injuries • Knee
             Joint • Magnetic Resonance Imaging* • Male •
             Menisci, Tibial • Posterior Cruciate Ligament •
             Retrospective Studies • Sensitivity and Specificity
             • diagnosis* • injuries • pathology •
             pathology*},
   Abstract = {OBJECTIVE: A report in the orthopedics literature states
             that MR imaging for internal derangement of the knee has a
             lower accuracy in adolescents than in adults and may even
             provide spurious information that alters clinical
             management. This assertion has not been specifically
             addressed in the radiology literature. The purpose of our
             study was to determine the accuracy of MR imaging in
             adolescents with regard to injury of the cruciate ligaments
             and menisci. MATERIALS AND METHODS: A database search of our
             institution's records from January 1998 to July 2000 yielded
             2140 MR examinations of the knee, all of which had been
             performed with a standard knee protocol on a 1.5-T magnet.
             Of these 2140 examinations, 156 included patients younger
             than 18 years. Fifty-nine of these patients underwent
             surgery, and the orthopedic surgeons' operative reports were
             used as the gold standard with which the MR imaging results
             were compared. Thirty-four boys and 25 girls who ranged in
             age from 11 to 17 years (mean age, 15 years) were examined.
             The clinical notes for the remaining 97 patients were
             evaluated for information about management and clinical
             improvement. RESULTS: The sensitivity and specificity values
             for MR imaging of the menisci and cruciate ligaments in
             adolescents were as follows: medial meniscus, 92%
             sensitivity and 87% specificity; lateral meniscus, 93%
             sensitivity and 95% specificity; anterior cruciate ligament,
             100% sensitivity and 100% specificity; and posterior
             cruciate ligament, 0% sensitivity and 100% specificity.
             CONCLUSION: Our data suggest that MR imaging of the knee in
             adolescents is sensitive, specific, and accurate.},
   Key = {fds133594}
}

@article{fds133610,
   Author = {NM Major and CA Helms},
   Title = {MR imaging of the knee: findings in asymptomatic collegiate
             basketball players.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {179},
   Number = {3},
   Pages = {641-4},
   Year = {2002},
   Month = {September},
   ISSN = {0361-803X},
   Keywords = {Adult • Basketball • Data Collection • Female
             • Humans • Knee Injuries • Knee Joint •
             Ligaments, Articular • Magnetic Resonance Imaging*
             • Male • Tendon Injuries • Tendons •
             abnormalities • abnormalities* • injuries •
             injuries* • pathology • pathology*},
   Abstract = {OBJECTIVE: The purpose of our study was to evaluate the
             knees of asymptomatic high-level collegiate basketball
             players before the beginning of the basketball season to
             gain an understanding of nonclinical findings in this
             patient population. SUBJECTS AND METHODS: Bilateral knee MR
             imaging examinations of 17 varsity basketball players (12
             men and five women) were performed before basketball season
             began. All of the subjects were imaged on a 1.5-T magnet.
             The MR imaging studies were reviewed by two musculoskeletal
             radiologists. Structures analyzed were the menisci,
             ligaments, cartilage, plicae, and bone marrow. The presence
             of a joint effusion was also noted. RESULTS: Fourteen (41%)
             of the 34 knees had bone marrow edema, eight (24%) showed
             signal in the patellar tendon, and 14 (41%) had abnormal
             cartilage signal or a focal abnormality. Twelve (35%) of the
             34 knees showed a joint effusion. Two knees (6%) showed
             abnormal signal along the infrapatellar plica. Four knees
             (12%) were noted to have a discoid meniscus. CONCLUSION: An
             MR examination of the knees of high-level collegiate
             basketball players may show changes unique to this
             population. The changes seen on MR imaging in these athletes
             may be asymptomatic abnormalities. For instance, changes
             suggestive of patellar tendinopathy were identified in these
             asymptomatic subjects.},
   Key = {fds133610}
}

@article{fds133595,
   Author = {LG Dodd and NM Major},
   Title = {Fine-needle aspiration cytology of articular and
             periarticular lesions.},
   Journal = {Cancer, United States},
   Volume = {96},
   Number = {3},
   Pages = {157-65},
   Year = {2002},
   Month = {June},
   ISSN = {0008-543X},
   Keywords = {Arthritis, Rheumatoid • Biopsy, Needle •
             Chondromatosis, Synovial • Chondrosarcoma •
             Ganglia • Gout • Humans • Joints •
             Sarcoma • Synovitis, Pigmented Villonodular •
             pathology • pathology*},
   Abstract = {BACKGROUND: The cytologic diagnosis of joint and articular
             surface-based lesions traditionally has been accomplished by
             examination of fluids or effusions. Although exfoliative
             cytology remains an accurate diagnostic test, not all
             joint-based lesions will produce effusions that are amenable
             to this type of examination. Fine-needle aspiration (FNA)
             represents an excellent alternative to traditional cytologic
             or histologic methods of diagnosis in joint
             pathology.METHODS: The authors reviewed FNA materials for
             the period 1992-2001 from lesions of joint spaces and
             periarticular soft tissues. All diagnoses based on cytologic
             materials that were included in this study were confirmed
             with histologic follow-up. Cytologic and histologic
             materials were prepared using standard methods.RESULTS: The
             authors found six relatively common lesions that were
             amenable to diagnosis by FNA. These included rheumatoid
             nodule, gouty tophi, ganglion cysts, pigmented villonodular
             synovitis, synovial chondromatosis, and synovial sarcoma.
             There are potential pitfalls in discriminating gout from
             pseudogout and synovial chondromatosis from
             chondrosarcoma.CONCLUSIONS: In most instances,
             mass-producing lesions of the joint space or the
             periarticular soft tissues can be diagnosed successfully by
             FNA. The common lesions are easily recognizable and are
             cytologically distinctive.},
   Key = {fds133595}
}

@article{fds133605,
   Author = {CJ Weaver and NM Major and WE Garrett and JE Urbaniak},
   Title = {Femoral head osteochondral lesions in painful hips of
             athletes: MR imaging findings.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {178},
   Number = {4},
   Pages = {973-7},
   Year = {2002},
   Month = {April},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Athletic Injuries • Bone
             Marrow • Cartilage, Articular • Cumulative Trauma
             Disorders • Female • Femur Head • Hip
             Injuries • Hip Joint • Humans • Magnetic
             Resonance Imaging* • Male • Osteochondritis •
             Pain • Retrospective Studies • diagnosis •
             diagnosis* • etiology • pathology •
             pathology* • radiography},
   Abstract = {OBJECTIVE: This study describes the MR imaging findings of
             focal osteochondral lesions found in the hips of 11 athletes
             with persistent pain and normal findings on radiographs.
             CONCLUSION: Osteochondral lesions of the femoral head are
             seen on MR imaging as focal, medial areas of high
             T2-weighted and low T1-weighted signals and should be
             considered as a possible cause of persistent hip or groin
             pain in young, high-level athletes because the institution
             of appropriate treatment may help to prevent late
             degenerative sequelae.},
   Key = {fds133605}
}

@article{fds133596,
   Author = {NM Major and ST Crawford},
   Title = {Elbow effusions in trauma in adults and children: is there
             an occult fracture?},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {178},
   Number = {2},
   Pages = {413-8},
   Year = {2002},
   Month = {February},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Aged • Aged, 80 and over
             • Body Fluids* • Child • Child, Preschool
             • Elbow Joint • Female • Fractures, Closed
             • Humans • Joint Diseases • Magnetic
             Resonance Imaging • Male • Middle Aged •
             Prospective Studies • complications* • etiology
             • injuries* • pathology},
   Abstract = {OBJECTIVE: The purpose of this study was to evaluate whether
             a detectable abnormality was present on MR imaging without a
             visible fracture on conventional radiography in the setting
             of trauma. A recent retrospective study based on the
             presence or absence of periosteal reaction on follow-up
             radiographs concluded that fractures were not always
             present. The discrepancies in the literature over the
             usefulness of joint effusions as an indicator of fracture
             caused us to evaluate whether fractures were present more
             often than identified by conventional radiography. To do
             this, we used MR imaging. MATERIALS AND METHODS: Thirteen
             consecutive patients (age range, 4-80 years; seven children
             and six adults), whose post-trauma elbow radiographs showed
             an effusion but no fracture, underwent screening MR imaging.
             RESULTS: All patients showed bone marrow edema. Four of the
             seven children had fractures on screening MR imaging, and
             all adults had some identifiable fractures. CONCLUSION:
             Preliminary data using screening MR imaging suggests that an
             occult fracture usually is present in the setting of
             effusion without radiographically visualized
             fracture.},
   Key = {fds133596}
}

@article{fds133589,
   Author = {TA Dorsay and NM Major and CA Helms},
   Title = {Cost-effectiveness of immediate MR imaging versus
             traditional follow-up for revealing radiographically occult
             scaphoid fractures.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {177},
   Number = {6},
   Pages = {1257-63},
   Year = {2001},
   Month = {December},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Cost-Benefit Analysis •
             Female • Follow-Up Studies • Fractures, Bone
             • Humans • Magnetic Resonance Imaging • Male
             • Predictive Value of Tests • Scaphoid Bone •
             Time Factors • economics* • pathology*},
   Abstract = {OBJECTIVE: For suspected scaphoid fractures with no
             radiographic evidence of fracture, treating symptoms with
             immobilization and radiographic follow-up has long been the
             standard of care. Modified MR imaging of the wrist is
             offered at our institution in screening for radiographically
             occult scaphoid fractures at the time of initial
             presentation to the emergency department. We show the
             advantages and comparative costs of this modified protocol
             versus a traditional protocol. MATERIALS AND METHODS: Our
             modified protocol consists of coronal thin-section
             T1-weighted and fast spin-echo T2-weighted MR images with
             fat saturation. A review of the literature was performed to
             assess the accuracy of clinical examination, radiography,
             and other modalities in the evaluation of scaphoid fractures
             of the wrist. Charges for this procedure are compared with
             charges for traditional follow-up. RESULTS: Three of four
             patients with positive results at clinical examination and
             negative findings on initial radiographs will be needlessly
             immobilized and monitored. The charges to the patient at our
             institution for screening MR imaging of the wrist are $770.
             The total charges to the patient with the traditional
             protocol, which would not be necessary with screening MR
             imaging, are $677 or more if a diagnosis is not made at this
             time. Bone scanning or routine MR imaging is often
             eventually used. CONCLUSION: Cost analysis at our
             institution suggests the two protocols are nearly equivalent
             from a financial standpoint. The loss of productivity for
             patients who are unnecessarily in casts or splints may be
             substantial. Screening MR imaging of the wrist in this
             setting is becoming accepted at our institution in a manner
             similar to screening MR imaging of the hip.},
   Key = {fds133589}
}

@article{fds133591,
   Author = {RL Cothran and NM Major and CA Helms and LD Higgins},
   Title = {MR imaging of meniscal contusion in the knee.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {177},
   Number = {5},
   Pages = {1189-92},
   Year = {2001},
   Month = {November},
   ISSN = {0361-803X},
   Keywords = {Adult • Anterior Cruciate Ligament • Arthroscopy
             • Contusions • Diagnosis, Differential •
             Female • Humans • Knee Injuries • Magnetic
             Resonance Imaging* • Male • Menisci, Tibial •
             Quality Assurance, Health Care • Sensitivity and
             Specificity • diagnosis* • injuries •
             injuries* • pathology • surgery},
   Abstract = {OBJECTIVE: We describe focal abnormal signal of the meniscus
             in the knees of six patients who had a history of acute
             trauma to the knee. This signal abuts the articular surface
             of the meniscus on MR imaging but does not meet criteria for
             a meniscal tear or degeneration. CONCLUSION: Acute trauma to
             the knee may cause an abnormal signal in the meniscus that
             does not meet the previously described criteria for a
             meniscal tear or an intrasubstance degeneration. This
             abnormal signal could be misinterpreted as a tear because of
             its contact with the articular surface; this signal is seen
             most often in our series in the setting of an anterior
             cruciate ligament tear with adjacent bone contusions. We
             suggest that this signal may be due to a contusion of the
             meniscus and that the signal may resolve over time in some
             patients.},
   Key = {fds133591}
}

@article{fds133597,
   Author = {NM Major},
   Title = {Imaging of the subcoracoid bursa.},
   Journal = {AJR. American journal of roentgenology, United
             States},
   Volume = {176},
   Number = {3},
   Pages = {812-3},
   Year = {2001},
   Month = {March},
   ISSN = {0361-803X},
   Keywords = {Bursa, Synovial • Humans • Magnetic Resonance
             Imaging • Rotator Cuff • Shoulder Pain* •
             etiology • injuries* • pathology*},
   Key = {fds133597}
}

@article{fds133613,
   Author = {S Bonsell and AW Pearsall and RJ Heitman and CA Helms and NM Major and KP
             Speer},
   Title = {The relationship of age, gender, and degenerative changes
             observed on radiographs of the shoulder in asymptomatic
             individuals.},
   Journal = {The Journal of bone and joint surgery. British volume,
             England},
   Volume = {82},
   Number = {8},
   Pages = {1135-9},
   Year = {2000},
   Month = {November},
   ISSN = {0301-620X},
   Keywords = {Acromioclavicular Joint* • Adult • Age Factors
             • Aged • Aged, 80 and over • Aging •
             Arthritis • Bias (Epidemiology) • Chi-Square
             Distribution • Diagnosis, Differential • Female
             • Humans • Logistic Models • Male •
             Middle Aged • Predictive Value of Tests •
             Reference Values • Rotator Cuff • Severity of
             Illness Index • Sex Characteristics • Shoulder
             Impingement Syndrome • Shoulder Joint* •
             Single-Blind Method • classification • etiology
             • injuries* • pathology* • physiopathology
             • radiography*},
   Abstract = {Radiographs of the shoulders of 84 asymptomatic individuals
             aged between 40 and 83 years were evaluated to determine
             changes in 23 specific areas. Two fellowship-trained
             orthopaedic radiologists graded each area on a scale of 0 to
             II (normal 0, mild changes I, advanced changes II). Logistic
             regression analysis indicated age to be a significant
             predictor of change (p < 0.05) for sclerosis of the medial
             acromion and lateral clavicle, the presence of subchondral
             cysts in the acromion, formation of osteophytes at the
             inferior acromion and clavicle, and narrowing and
             degeneration of the acromioclavicular joint. Gender was not
             a significant predictor (p > 0.05) for radiological changes.
             Student's t-test determined significance (p < 0.05) between
             age and the presence of medial acromial and lateral
             clavicular sclerosis, subchondral acromial cysts, inferior
             acromial and clavicular osteophytes, and degeneration of the
             acromioclavicular joint. Radiological analysis in conditions
             such as subacromial impingement, pathology of the rotator
             cuff, and acromioclavicular degeneration should be
             interpreted in the context of the symptoms and normal
             age-related changes.},
   Key = {fds133613}
}

@article{fds133592,
   Author = {NM Major and CA Helms and WJ Richardson},
   Title = {The "mini brain": plasmacytoma in a vertebral body on MR
             imaging.},
   Journal = {AJR. American journal of roentgenology, UNITED
             STATES},
   Volume = {175},
   Number = {1},
   Pages = {261-3},
   Year = {2000},
   Month = {July},
   ISSN = {0361-803X},
   Keywords = {Adult • Aged • Female • Humans •
             Magnetic Resonance Imaging* • Male • Middle Aged
             • Plasmacytoma • Spinal Cord Neoplasms •
             pathology*},
   Abstract = {OBJECTIVE: Patients with solitary plasmacytoma in the spine
             frequently require a biopsy for diagnosis of their
             condition. We report an appearance of plasmacytoma in the
             spine, which is sufficiently pathognomonic to obviate
             biopsy. CONCLUSION: Identification of a "mini brain" in an
             expansile lesion in the spine is characteristic of
             plasmacytoma. It is important that radiologists note this
             characteristic because biopsy can be avoided in patients
             with this appearance. Although biopsy might still be
             required at many institutions, at our institution, surgeons
             find this appearance sufficiently pathognomonic to bypass
             biopsy and start treatment.},
   Key = {fds133592}
}

@article{fds133617,
   Author = {NM Major and CA Helms and RC Fritz and KP Speer},
   Title = {The MR imaging appearance of longitudinal split tears of the
             peroneus brevis tendon.},
   Journal = {Foot & ankle international / American Orthopaedic Foot and
             Ankle Society [and] Swiss Foot and Ankle Society, UNITED
             STATES},
   Volume = {21},
   Number = {6},
   Pages = {514-9},
   Year = {2000},
   Month = {June},
   ISSN = {1071-1007},
   Keywords = {Adolescent • Adult • Aged • Ankle Injuries
             • Ankle* • Female • Humans • Magnetic
             Resonance Imaging* • Male • Middle Aged •
             Retrospective Studies • Rupture • Tendon Injuries
             • Tendons • complications • diagnosis* •
             pathology*},
   Abstract = {PURPOSE: Longitudinal split tears of the peroneus brevis
             tendon have been increasingly reported as a source of
             lateral ankle pain and disability. MR imaging is useful in
             identifying the appearance of longitudinal split tears of
             the peroneus brevis tendon to differentiate this entity from
             other causes of chronic lateral ankle pain. We observed
             variations in anatomy associated with these tears. MATERIALS
             AND METHODS: Twenty-two patients (eleven males, eleven
             females) were identified as having longitudinal split tears
             of the peroneus brevis tendon. These cases were reviewed
             retrospectively to evaluate for the following: shape of the
             peroneus brevis tendon, high signal in the peroneus brevis
             tendon, tendon subluxation, appearance of the superior
             peroneal retinaculum, presence of osseous changes in the
             ankle, lateral ankle ligaments, presence of a bony fibular
             spur, flattening of the peroneal groove of the fibula and
             presence of a peroneus quartus. A control group consisted of
             twenty ankles imaged for reasons other than lateral ankle
             pain. The same structures were assessed in this group. A
             Fisher's exact P-value was used to determine the
             significance of each finding in the two groups. RESULTS:
             Statistically significant associated findings were chevron
             shaped tendon (p = .0001), high signal in the peroneus
             brevis (p = .0017), bony changes (p = .0001), flat peroneal
             groove (p = .0001), abnormal lateral ligaments (p = .0004),
             and lateral fibular spur (p = .0006). CONCLUSIONS: MR
             imaging is useful in differentiating longitudinal split
             tears of the peroneus brevis tendon from other lateral ankle
             disorders. It can show the extent of the abnormality in the
             tendon and the associated findings of soft tissue and/or
             bone variations which must be addressed at the time of
             surgery.},
   Key = {fds133617}
}

@article{fds133615,
   Author = {NM Major and CA Helms},
   Title = {Sacral stress fractures in long-distance
             runners.},
   Journal = {AJR. American journal of roentgenology, UNITED
             STATES},
   Volume = {174},
   Number = {3},
   Pages = {727-9},
   Year = {2000},
   Month = {March},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Athletic Injuries •
             Diagnosis, Differential • Female • Fractures,
             Stress • Humans • Male • Middle Aged •
             Running • Sacrum • Sciatica • Spinal
             Fractures • diagnosis • diagnosis* •
             injuries* • pathology},
   Abstract = {OBJECTIVE: Sacral stress fractures in athletes are rare but
             important to recognize because the symptoms often mimic
             sciatica and can lead to delay in diagnosis and treatment.
             The radiographic findings are characteristic and can
             facilitate early diagnosis and lead to appropriate
             treatment. CONCLUSION: The clinical presentation of runners
             with sacral stress fractures can mimic disk disease.
             However, stress fractures in athletes, especially
             long-distance runners, must be treated differently. The
             imaging characteristics appear as linear abnormal signal
             intensity paralleling the sacroiliac joint on MR imaging and
             linear sclerosis with cortical disruption on CT. Imaging
             with bone scintigraphy shows increased uptake that parallels
             the sacroiliac joint.},
   Key = {fds133615}
}

@article{fds133616,
   Author = {BK Brodwater and NM Major and RD Goldner and LJ Layfield},
   Title = {Macrodystrophia lipomatosa with associated fibrolipomatous
             hamartoma of the median nerve.},
   Journal = {Pediatric surgery international, GERMANY},
   Volume = {16},
   Number = {3},
   Pages = {216-8},
   Year = {2000},
   ISSN = {0179-0358},
   Keywords = {Child, Preschool • Fingers • Gigantism •
             Hamartoma • Humans • Male • Median Nerve*
             • Peripheral Nervous System Diseases •
             abnormalities* • complications* •
             surgery},
   Abstract = {Macrodystrophia lipomatosa (MDL) is a rare disease typically
             causing localized gigantism and is often associated with a
             fibrolipomatous hamartoma (FH) of the median or plantar
             nerve. A previously unreported case of MDL with associated
             FH of the median nerve is presented.},
   Key = {fds133616}
}

@article{fds133590,
   Author = {NM Major},
   Title = {MR imaging after therapeutic injection of the subacromial
             bursa.},
   Journal = {Skeletal radiology, GERMANY},
   Volume = {28},
   Number = {11},
   Pages = {628-31},
   Year = {1999},
   Month = {November},
   ISSN = {0364-2348},
   Keywords = {Acromion • Adult • Anesthetics, Local •
             Bursa, Synovial • Cartilage, Articular • Female
             • Humans • Injections, Intra-Articular •
             Lidocaine • Male • Prospective Studies •
             Rotator Cuff • Shoulder Impingement Syndrome •
             Shoulder Joint • Synovial Membrane •
             administration & dosage* • diagnosis* • drug
             therapy • pathology* • therapeutic
             use},
   Abstract = {OBJECTIVE: As a therapeutic injection into the subacromial
             bursa (SAB) is commonly performed for impingement syndrome,
             it is important to know whether this fluid can be retained
             for a period of time and cause confusion with a pathologic
             collection of fluid. This study identifies and describes the
             appearance of recent subacromial injection using MR imaging,
             and the appearance of a potential complication. DESIGN AND
             PATIENTS: Fourteen asymptomatic shoulders were studied with
             MR imaging using fast spin echo T2-weighted imaging (1.5 T)
             prior to injection with 7 cm(3) of xylocaine. Four shoulders
             had subacromial fluid and were eliminated from the study.
             The remaining 10 (9 men, 1 woman; age range 27-36 years,
             average age 33 years) were then re-imaged immediately, and
             at 6, 12 and 24 h after the injection or until fluid
             resolved. Each set of images was reviewed for the presence
             of fluid in the SAB and for additional abnormalities.
             RESULTS: Fluid was identified in all subjects in the SAB in
             the immediate, 6 and 12 h post-injection images. At 24 h,
             fluid was not identified within the SAB in eight of 10
             patients. In one patient fluid resolved in 48 h. The other
             continued to demonstrate fluid in the SAB and in the joint
             as well as abnormal signal in the infraspinatus muscle from
             a presumed myositis. Imaging was performed up to 10 days
             after the injection in this patient. CONCLUSIONS: It is
             known that fluid identified in the SAB without evidence of a
             cuff tear may be due to bursitis. However, if MR imaging is
             performed within 24 h of injection, the presence of the
             fluid may be iatrogenic. In addition, the history of recent
             therapeutic injection is very important as complications
             such as myositis can occur as a result of the injection.
             Knowledge of injection prior to imaging is vital for
             accurate interpretation of MR shoulder examinations.},
   Key = {fds133590}
}

@article{fds133593,
   Author = {NM Major and CA Helms and WJ Richardson},
   Title = {MR imaging of fibrocartilaginous masses arising on the
             margins of spondylolysis defects.},
   Journal = {AJR. American journal of roentgenology, UNITED
             STATES},
   Volume = {173},
   Number = {3},
   Pages = {673-6},
   Year = {1999},
   Month = {September},
   ISSN = {0361-803X},
   Keywords = {Adult • Aged • Female • Humans • Lumbar
             Vertebrae • Magnetic Resonance Imaging* • Male
             • Middle Aged • Spondylolysis •
             pathology*},
   Abstract = {OBJECTIVE: Spondylolysis is reported in up to 7% of the
             population. An uncommon process that can accompany a pars
             interarticularis defect is a fibrocartilaginous mass, which
             can cause impression on the nerve roots and thecal sac.
             Recognition is important so that the presence may be
             addressed at the time of surgery. This report describes the
             MR imaging appearance and clinical significance of a
             fibrocartilaginous mass in association with spondylolysis.
             MATERIALS AND METHODS: We reviewed data regarding 336
             patients who had lumbar spine imaging at our institution
             during a 12-month period. Contiguous axial and sagittal MR
             imaging using T1-weighted and fast spin-echo T2-weighted
             sequences was used. Images were evaluated for a mass of
             tissue surrounding the pars defect with MR characteristics
             of cartilaginous and fibrous low signal intensity on
             T1-weighted images and low to intermediate signal intensity
             on T2-weighted images. The position of the
             fibrocartilaginous mass and its relation to the thecal sac
             were noted. Surgical correlation between those patients with
             a fibrocartilaginous mass and those without was examined.
             RESULTS: Twenty-nine (8.6%) of 336 patients were identified
             as having a pars interarticularis defect. A
             fibrocartilaginous mass was present in 26 (90%) of 29
             patients. Six (21%) of the 29 patients had a mass effect on
             the thecal sac. Of the remaining 23 patients, 20 had a
             fibrocartilaginous mass external to the thecal sac, and
             three did not show any fibrocartilaginous mass. Histologic
             analysis in one patient confirmed the fibrous and
             cartilaginous nature of the lesion at the pars defect.
             CONCLUSION: A fibrocartilaginous mass was present in 90% of
             the patients with spondylolysis. Mass effect on the thecal
             sac that required surgery was identified in 21% of the
             patients with spondylolysis. Awareness of this mass and
             proper imaging protocols will enable the radiologist to
             preoperatively alert the surgeon to its presence.},
   Key = {fds133593}
}

@article{fds133611,
   Author = {AB Schraner and NM Major},
   Title = {MR imaging of the subcoracoid bursa.},
   Journal = {AJR. American journal of roentgenology, UNITED
             STATES},
   Volume = {172},
   Number = {6},
   Pages = {1567-71},
   Year = {1999},
   Month = {June},
   ISSN = {0361-803X},
   Keywords = {Adolescent • Adult • Aged • Bursa, Synovial
             • Female • Humans • Magnetic Resonance
             Imaging* • Male • Middle Aged • Retrospective
             Studies • Shoulder • Shoulder Pain •
             diagnosis • etiology • instrumentation •
             pathology*},
   Abstract = {OBJECTIVE: The subcoracoid bursa, a bursa anterior to the
             shoulder joint, can be identified on MR images. Awareness of
             the MR appearance and location of this bursa, which can
             connect with the subacromial-subdeltoid bursa, enables
             appropriate diagnosis in patients with shoulder pain.
             MATERIALS AND METHODS: Dictated reports involving all MR
             imaging of the shoulder (n = 1545) performed at our
             institution from June 1993 to February 1998 were reviewed
             from computer archives. Films were reviewed in 16 cases
             describing a subcoracoid bursa; in nine MR imaging correctly
             revealed this bursa, whereas in seven MR imaging revealed
             the subscapular recess, an outpouching of the glenohumeral
             joint often confused with the subcoracoid bursa. RESULTS: Of
             the 1545 shoulders examined, MR imaging revealed the
             subcoracoid bursa in nine (0.6%) patients. Two cases from a
             teaching file were also included, for a total of 11 cases.
             In five (45%) of the 11 cases, the subcoracoid bursa
             contained a small amount of fluid (<1 cm in largest diameter
             on sagittal images). In the remaining six cases (55%), the
             subcoracoid bursa contained a moderate (1-2 cm in largest
             diameter) or a large amount (>2 cm in largest diameter) of
             fluid. Of the 11 cases, six (55%) also showed connection
             with the subacromial-subdeltoid bursa. CONCLUSION: It is
             important to correctly identify the subcoracoid bursa on MR
             imaging because it is believed to cause isolated shoulder
             pain. Fluid in the subcoracoid bursa can also communicate
             with the subacromial-subdeltoid bursa.},
   Key = {fds133611}
}

@article{fds133607,
   Author = {NM Major and CA Helms},
   Title = {Pelvic stress injuries: the relationship between osteitis
             pubis (symphysis pubis stress injury) and sacroiliac
             abnormalities in athletes.},
   Journal = {Skeletal radiology, GERMANY},
   Volume = {26},
   Number = {12},
   Pages = {711-7},
   Year = {1997},
   Month = {December},
   ISSN = {0364-2348},
   Keywords = {Adolescent • Adult • Aged • Diagnosis,
             Differential • Female • Fractures, Stress •
             Humans • Magnetic Resonance Imaging • Male •
             Middle Aged • Osteitis • Pelvic Bones •
             Prospective Studies • Pubic Bone • Sacroiliac
             Joint • Spinal Osteophytosis • Sports •
             Tomography, X-Ray Computed • abnormalities* •
             complications • complications* • diagnosis •
             diagnosis* • etiology • injuries • injuries*
             • pathology • radiography • radionuclide
             imaging},
   Abstract = {OBJECTIVE: To demonstrate with radiographic imaging the
             association between pubic stress injury and sacroiliac
             abnormalities in athletes. DESIGN AND PATIENTS: Eleven
             athletes (9 men and 2 women), comprising seven male
             long-distance runners, one male soccer player, one male and
             two female basketball players, were imaged with plain films
             for complaints of pubic symphysis pain, sciatica, groin
             pain, or a combination of these complaints. In addition to
             the plain films, four patients were imaged with CT, two
             patients had MR imaging, and a bone scan was performed in
             three patients. Anteroposterior plain films of the pelvis of
             20 patients without back pain or pubic pain were evaluated
             for comparison as a control group (ages 18-72 years, average
             49 years; 11 women and 9 men). RESULTS: All athletes showed
             plain film evidence of either sclerosis, erosions or offset
             at the pubic symphysis. Four had avulsion of cortical bone
             at the site of insertion of the gracilis tendon. Four
             patients demonstrated sacroiliac joint abnormalities on
             plain films consisting of sclerosis, erosions and
             osteophytes, and in one of these athletes, bilateral
             sacroiliac changes are present. Two patients with normal
             sacroiliac joints on plain films had a bone scan showing
             increased radionuclide uptake bilaterally at the sacroiliac
             joints. One patient with both plain film and CT evidence of
             sacroiliac abnormalities had an MR examination showing
             abnormal signal at both sacroiliac joints and at the pubic
             symphysis. A sacral stress fracture was found on CT in one
             patient with complaints of sciatica. In the control group,
             six patients, all over the age of 55 years, had mild
             sclerosis of the symphysis, but no plain film evidence of
             sacroiliac abnormalities. CONCLUSION: We have found a group
             of athletes in whom stress injuries to the pubic symphysis
             are associated with changes in the sacroiliac joint as
             demonstrated by degenerative changes or in the sacrum as
             manifested as a sacral stress fracture. These findings are
             probably due to abnormal stresses across the pelvic ring
             structure that lead to a second abnormality in the pelvic
             ring. The abnormality in the sacrum is not always well seen
             with conventional imaging. Recognition of the association of
             stress injury of the symphysis with back pain is important
             in that it can help avoid inappropriate studies and
             diagnostic confusion.},
   Key = {fds133607}
}

@article{fds133587,
   Author = {NM Major and J Tehranzadeh},
   Title = {Musculoskeletal manifestations of AIDS.},
   Journal = {Radiologic clinics of North America, UNITED
             STATES},
   Volume = {35},
   Number = {5},
   Pages = {1167-89},
   Year = {1997},
   Month = {September},
   ISSN = {0033-8389},
   Keywords = {AIDS-Related Opportunistic Infections • Arthritis
             • Bacterial Infections • Bone Diseases • Bone
             Marrow Diseases • Bone Neoplasms • Humans •
             Lymphoma, AIDS-Related • Muscle Neoplasms •
             Muscular Diseases • Myositis • Osteoarthropathy,
             Secondary Hypertrophic • Osteomyelitis •
             Osteonecrosis • Reflex Sympathetic Dystrophy •
             Sarcoma, Kaposi • diagnosis • diagnosis*},
   Abstract = {Musculoskeletal manifestations in the HIV- and AIDS-infected
             patient are not as common as in other organ systems. A
             variety of musculoskeletal abnormalities are discussed in
             this article, including infection, arthritis, and neoplasms.
             A brief discussion of miscellaneous conditions, such as
             avascular necrosis, hypertrophic osteoarthropathy, reflex
             sympathetic dystrophy, and bone marrows abnormalities is
             also included.},
   Key = {fds133587}
}

@article{fds133586,
   Author = {NM Major and CA Helms},
   Title = {Idiopathic transient osteoporosis of the
             hip.},
   Journal = {Arthritis and rheumatism, UNITED STATES},
   Volume = {40},
   Number = {6},
   Pages = {1178-9},
   Year = {1997},
   Month = {June},
   ISSN = {0004-3591},
   Keywords = {Diagnosis, Differential • Hip • Humans • Male
             • Middle Aged • Osteonecrosis • Osteoporosis
             • etiology* • radiography*},
   Key = {fds133586}
}

@article{fds133600,
   Author = {N.M. Major},
   Title = {Major NM, Helms CA. Idiopathic transient osteoporosis of the
             hip. Radiologic Vignettes. Arthritis and Rheumatism
             1997;40:1178-1179},
   Year = {1997},
   Key = {fds133600}
}

@article{fds133601,
   Author = {N.M. Major},
   Title = {Major NM, Helms CA. Pelvic stress injuries. the relationship
             between osteitis pubis (symphysis pubis stress injury) and
             sacroiliac abnormalities in athletes. Skeletal Radiology
             1997;26:711-717},
   Year = {1997},
   Key = {fds133601}
}

@article{fds133606,
   Author = {NM Major and CA Helms},
   Title = {Absence or interruption of the supra-acetabular line: a
             subtle plain film indicator of hip pathology.},
   Journal = {Skeletal radiology, GERMANY},
   Volume = {25},
   Number = {6},
   Pages = {525-9},
   Year = {1996},
   Month = {August},
   ISSN = {0364-2348},
   Keywords = {Acetabulum • Female • Hip Joint • Humans
             • Joint Diseases • Magnetic Resonance Imaging
             • Male • Middle Aged • Neoplasms •
             pathology • radiography • radiography*},
   Abstract = {OBJECTIVE: To show that absence or interruption of the
             supra-acetabular line is a subtle plain film indicator of
             pathology in the acetabulum. DESIGN: Nineteen hips from 17
             patients with known disease processes involving the
             acetabulum as demonstrated by subsequent magnetic resonance
             imaging, bone scan or plain film follow-up were evaluated
             with antero-posterior (AP) plain films of the pelvis. Three
             additional cases were diagnosed prospectively using
             interruption of the supra-acetabular line as the criterion
             for inclusion. Fifty AP plain films of the pelvis in
             patients without hip pain were examined prospectively to
             determine normal imaging criteria. RESULTS AND CONCLUSIONS:
             The normal supra-acetabular line measures 2-3 mm in
             thickness superiorly and is a thin sclerotic line in the
             medial aspect. In all 22 hips (with pathology) in this
             series, the line was interrupted or absent. Loss or
             interruption of the supra-acetabular line may thus be a
             subtle pain film indicator of a disease process involving
             the acetabulum. This plain film sign has not previously been
             reported.},
   Key = {fds133606}
}

@article{fds133585,
   Author = {N.M. Major},
   Title = {Major NM, Helms CA. Absence or Interruption of the
             Supra-acetabular Line: A Subtle Plain Film Indicator of Hip
             Pathology. Skeletal Radiology 1996; 25: 525-529.},
   Year = {1996},
   Key = {fds133585}
}

@article{fds133604,
   Author = {CA Helms and NM Major},
   Title = {Proper protocols key to CT of lumbar spine.},
   Journal = {Diagnostic imaging, UNITED STATES},
   Volume = {16},
   Number = {11},
   Pages = {118-21},
   Year = {1994},
   Month = {November},
   ISSN = {0194-2514},
   Keywords = {Humans • Intervertebral Disk Displacement • Lumbar
             Vertebrae • Magnetic Resonance Imaging • Spinal
             Stenosis • Spondylolysis • Tomography, X-Ray
             Computed • diagnosis • methods* • pathology
             • radiography*},
   Abstract = {MRI is clearly superior to CT in imaging the lumbar spine
             for evaluation of the postoperative back. The one area in
             which CT has been shown to be superior to MRI in the lumbar
             spine is in diagnosing spondylolysis. Pars defects can be
             very difficult to appreciate with MRI, yet are easily seen
             with CT. Other than spondylolysis, the postoperative spine,
             and bone marrow imaging, CT and MRI appear to be
             diagnostically equivalent.},
   Key = {fds133604}
}

@article{fds133602,
   Author = {NM Major and CA Helms and HK Genant},
   Title = {Calcification demonstrated as high signal intensity on
             T1-weighted MR images of the disks of the lumbar
             spine.},
   Journal = {Radiology, UNITED STATES},
   Volume = {189},
   Number = {2},
   Pages = {494-6},
   Year = {1993},
   Month = {November},
   ISSN = {0033-8419},
   Keywords = {Adult • Aged • Aged, 80 and over • Calcinosis
             • Female • Humans • Intervertebral Disk
             • Intervertebral Disk Displacement • Low Back Pain
             • Lumbar Vertebrae • Magnetic Resonance Imaging*
             • Male • Middle Aged • Spinal Diseases •
             Tomography, X-Ray Computed • diagnosis •
             diagnosis* • methods • pathology* •
             radiography},
   Abstract = {PURPOSE: To report that calcification of lumbar disks may
             not show the usual low signal intensity on T1-weighted
             magnetic resonance (MR) images. MATERIALS AND METHODS: The
             authors present five cases of high signal intensity on
             T1-weighted MR images of a lumbar disk that reflect the
             presence of calcium deposition. RESULTS: In four cases there
             was conventional radiographic confirmation and in one case
             there was computed tomographic confirmation of the disk
             calcification, which corresponded to the high signal
             intensity seen on the MR studies. One patient had undergone
             surgical removal of a partially calcified protruding disk.
             CONCLUSION: Lumbar disk calcification can vary in signal
             intensity from low to high on T1-weighted MR
             images.},
   Key = {fds133602}
}

@article{fds133614,
   Author = {CA Helms and NM Major},
   Title = {Rapid triple-compartment wrist arthrography with diluted
             contrast medium.},
   Journal = {Canadian Association of Radiologists journal = Journal
             l'Association canadienne des radiologistes,
             CANADA},
   Volume = {44},
   Number = {3},
   Pages = {227-9},
   Year = {1993},
   Month = {June},
   ISSN = {0846-5371},
   Keywords = {Diatrizoate • Humans • Injections, Intra-Articular
             • Methods • Wrist Joint • administration &
             dosage • diagnostic use* • radiography*},
   Abstract = {Triple-compartment wrist arthrography is currently
             considered the optimal technique for evaluating carpal
             instability, because injection of contrast agent into the
             radiocarpal joint alone can fail to reveal ligamentous
             disruption due to a ball-valve tear. Unfortunately,
             triple-compartment arthrography can be time consuming for
             both the patient and the radiologist. This report describes
             a technique for rapid triple-compartment wrist arthrography
             with standard (as opposed to digital subtraction)
             fluoroscopy. This technique reduces the time necessary to
             perform the study to 30 to 45 minutes without sacrificing
             diagnostic accuracy.},
   Key = {fds133614}
}

@article{fds133598,
   Author = {N.M. Major},
   Title = {Helms CA, Major NM. Rapid Triple compartment wrist
             arthrography using diluted contrast medium. Jour of Canadian
             Assoc Radiol 1993; 44; 227-229.},
   Year = {1993},
   Key = {fds133598}
}

@article{fds133599,
   Author = {N.M. Major},
   Title = {Major NM, Helms CA, Genant HK. Calcification demonstrated as
             high signal on T1-weighted MR images in the discs of the
             lumbar spine. Radiology 1993; 189: 494-496.},
   Year = {1993},
   Key = {fds133599}
}

@article{fds133627,
   Author = {RW Coonrad and TF Roush and NM Major and CJ Basamania},
   Title = {The drop sign, a radiographic warning sign of elbow
             instability.},
   Journal = {Journal of shoulder and elbow surgery / American Shoulder
             and Elbow Surgeons ... [et al.], United States},
   Volume = {14},
   Number = {3},
   Pages = {312-7},
   ISSN = {1058-2746},
   Keywords = {Dislocations • Elbow Joint • Humans • Humerus
             • Joint Instability • Ulna • injuries* •
             physiopathology • radiography* •
             surgery*},
   Abstract = {Persistent instability or redislocation is uncommon but of
             significant concern in treating elbow dislocations. Finding
             an objective, static radiographic sign that might correlate
             with the presence of instability was the purpose of this
             study. Pre- and post-reduction radiographs of 10 consecutive
             simple and complete adult elbow dislocations were reviewed
             and compared with radiographs of 20 consecutive adult elbows
             without any trauma history. A statistically significant
             measured increase in static ulnohumeral distance was noted
             on the routine unstressed post-reduction lateral radiographs
             of patients sustaining dislocation. We have termed this
             increased distance the drop sign. It differs from the
             radiographic ulnohumeral separation noted during
             O'Driscoll's test for posterolateral rotary instability,
             which is present only with axial compression. The drop sign
             becomes concerning only if persistent after the first
             reduction radiograph and may be a warning sign of the
             presence of instability.},
   Key = {fds133627}
}

@article{fds133612,
   Author = {NM Major},
   Title = {Magnetic resonance imaging of the elbow.},
   Journal = {Current problems in diagnostic radiology, UNITED
             STATES},
   Volume = {29},
   Number = {1},
   Pages = {27-40},
   ISSN = {0363-0188},
   Keywords = {Arthritis, Rheumatoid • Bone Neoplasms • Elbow
             • Humans • Magnetic Resonance Imaging* •
             Sarcoma • anatomy & histology* • diagnosis •
             injuries • physiopathology},
   Key = {fds133612}
}


Duke University * Arts & Sciences * BAA * Faculty All * Postdoc Staff * Non-PHD Staff * Staff * Grads * Reload * Login