Paweł Szaro1,2,3, Mateusz Polaczek4, Jan Świątkowski5, Hanna Kocoń5. 1. Sahlgrenska Universitetssjukhuset - Mölndals Sjukhus, Göteborgsvägen 31, 431 30, Göteborg, Sweden. pawel.szaro@vgregion.se. 2. Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland. pawel.szaro@vgregion.se. 3. Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland. pawel.szaro@vgregion.se. 4. Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Warsaw, Poland. 5. Department of Orthopaedics, Medical University of Warsaw, Warsaw, Poland.
Abstract
PURPOSE: The study was conducted to search for confident radiological signs in symptomatic cases of accessory bones. A normal accessory bone appearance on X-ray does not exclude that the accessory bone is the source of the discomfort; because of this, MRI examination can later be applied as part of the diagnosis. METHODS: We retrospectively analysed cases of 64 patients with recognized 70 symptomatic accessory bones of the foot. The average age was 29.2 (range 8-42) years. We included only patients with X-ray and MRI examinations. We investigated the following radiological features of the bone (structural and signal) in relation to soft tissue. RESULTS: The most constant symptoms identified in our study were bone marrow oedema (93%) and soft tissue oedema (77%). Changes in structures in which accessory bones were located or in adjacent structures to accessory bone were identified: tendon changes 51%, fluid adjacent to bone 51% and tenosynovitis 46%. MRI revealed changes in bone structure that are not seen on X-ray, including changes in contour (28%), sclerosis (3%) or osteonecrosis (3%). CONCLUSIONS: MRI plays an important role in determining whether accessory bones cause symptoms because it shows specific and accurate changes in accessory bone and/or in adjacent soft tissue.
PURPOSE: The study was conducted to search for confident radiological signs in symptomatic cases of accessory bones. A normal accessory bone appearance on X-ray does not exclude that the accessory bone is the source of the discomfort; because of this, MRI examination can later be applied as part of the diagnosis. METHODS: We retrospectively analysed cases of 64 patients with recognized 70 symptomatic accessory bones of the foot. The average age was 29.2 (range 8-42) years. We included only patients with X-ray and MRI examinations. We investigated the following radiological features of the bone (structural and signal) in relation to soft tissue. RESULTS: The most constant symptoms identified in our study were bone marrow oedema (93%) and soft tissue oedema (77%). Changes in structures in which accessory bones were located or in adjacent structures to accessory bone were identified: tendon changes 51%, fluid adjacent to bone 51% and tenosynovitis 46%. MRI revealed changes in bone structure that are not seen on X-ray, including changes in contour (28%), sclerosis (3%) or osteonecrosis (3%). CONCLUSIONS: MRI plays an important role in determining whether accessory bones cause symptoms because it shows specific and accurate changes in accessory bone and/or in adjacent soft tissue.
Entities:
Keywords:
Bone marrow oedema; MRI bone; MRI foot; Painful accessory bone; Symptomatic accessory bone
Authors: Flavia Cobianchi Bellisari; Luigi De Marino; Francesco Arrigoni; Silvia Mariani; Federico Bruno; Pierpaolo Palumbo; Camilla De Cataldo; Ferruccio Sgalambro; Nadia Catallo; Luigi Zugaro; Ernesto Di Cesare; Alessandra Splendiani; Carlo Masciocchi; Andrea Giovagnoni; Antonio Barile Journal: Radiol Med Date: 2021-05-18 Impact factor: 3.469