3251 Riverport Lane Maryland Heights, Missouri 63043 SKELETAL IMAGING: ATLAS OF THE SPINE AND EXTREMITIES, ISBN 978-1-4160-5623-2 SECOND EDITION Copyright © 2010, 2000 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: [email protected]. You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions. Notice Neither the Publisher nor the Authors assume any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient. The Publisher Library of Congress Control Number: 2009935763 Vice President and Publisher: Linda Duncan Senior Acquisitions Editor: Kellie White Associate Developmental Editor: Kelly Milford Publishing Services Manager: Catherine Jackson Senior Project Manager: Karen M. Rehwinkel Design Direction: Jessica Williams Working together to grow libraries in developing countries Printed in the United States of America www.elsevier.com | www.bookaid.org | www.sabre.org Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my parents and siblings, who taught me the importance of hard work and persistence; to my mentors who taught me the importance of lifelong learning; to my students who provide continuous motivation; and to my co-authors, Tudor Hughes and Donald Resnick. JAMT To my coauthor, John, who is clearly the fi rst author. And to my always-supportive family: my loving wife Kelly; my three wonderful boys, Geraint, Griffi th, and Rhett; and my learned parents, Dorothy and Fred. THH It was a great pleasure and a distinct honor for me to work with two skilled colleagues and friends, John Taylor and Tudor Hughes, whose efforts far overshadow my contributions to this text. They brought organization, dedication, and enthusiasm to the project, sprinkled with good old-fashioned energy. DR v P R E F A C E age of onset, sites of involvement, clinical features, and BACKGROUND general imaging features. This chapter was developed to We initially intended the Second Edition of Skeletal avoid repetition of background material about disorders Imaging to be merely a modifi cation of the First Edition. that affect several anatomic regions. Chapters 2 to 17 We planned only on updating the original and adding represent stand-alone monographs, each dealing with a new case material that illustrates the more recent specifi c anatomic site. The tables in these chapters advances in the imaging diagnosis of musculoskeletal emphasize only the site-specifi c manifestations of each disorders. After all, only 9 years had elapsed between entity, and they provide a sense of the range of disorders publication of the fi rst edition, and the beginning of that characteristically affect that site. Furthermore, in research for this edition. However, our survey of the each of these regional chapters, most of the important literature published since 2000 persuaded us that a conditions are illustrated with routine radiographs, some wealth of new information deserved synthesis and of which are supplemented with conventional tomo- recognition. Our major dilemma was not so much to grams, CT or bone scans, MR images, or combinations decide what to include, but what to exclude, and still of these. In addition, the chapters dealing with spinal meet our two principal objectives—to limit the atlas to regions and joints contain tables and illustrations of the a single volume and to address the most important mus- normal developmental anatomy of that region through culoskeletal disorders. Accordingly, we have focused on infancy, childhood, and adolescence. When reading these disorders most frequently encountered in practice and on chapters, it may be useful, or even necessary, to refer to how those disorders appear on conventional radiogra- Chapter 1 for a more detailed discussion of the general phy, CT scans, MR images, and to a lesser extent, radio- features of a particular disorder. nuclide imaging and diagnostic ultrasonography. The major emphasis of this work, however, is on the illustrations that the authors believe represent the most characteristic or typical presentations of disease entities. WHO WILL BENEFIT FROM THIS BOOK? For the most part, the cases include commonly encoun- Radiologists, chiropractors, and other clinicians who tered disorders, although some disorders that are seen routinely interpret images of the musculoskeletal system less commonly also are included because they are impor- will fi nd the second edition an indispensable everyday tant to consider with regard to differential diagnosis. reference. Radiology residents, chiropractic students, Purposely, the illustrations are as large as possible to best and other clinicians-in-training who are preparing for display the imaging fi ndings. Each is accompanied by a certifi cation examinations can use it in the classroom, at detailed legend beginning with the primary diagnosis the viewbox or monitor, and as a helpful study guide. followed by a discussion of the imaging fi ndings and any available and important clinical data. When MR imaging is displayed, detailed imaging parameters are included in ORGANIZATION the legend. The second edition retains the same organizational strat- At least one useful reference for each condition has egy: arranging musculoskeletal disorders according to been included. The references are cited not only in the anatomic region. This organization enhances the book’s tables but also in the fi gure legends. These reference cita- value as a reference tool for practitioners and is a practi- tions indicate the major sources of material and serve to cal way for students to learn a logical and methodical direct the reader to further discussion. In Chapter 1, a approach to patient assessment. Each chapter includes a bibliography of recommended readings includes many description of the appearance of normal developmental textbooks dealing with various aspects of skeletal radiol- anatomy and major anomalies and anatomic variants. It ogy that served as sources for information. also demonstrates the full range of the most frequently It is our hope that by retaining the successful features encountered pathologic conditions, including dysplasias, and format of the First Edition, updating the text to physical injuries, internal derangements of joints, articu- refl ect new information, and adding more case material lar disorders, and bone tumors, as well as metabolic, that this edition will be as favorably received by readers hematologic, and infectious diseases. and reviewers. Specifi cally, Chapter 1, “Introduction to Skeletal Dis- orders: General Concepts,” consists of 19 tables sum- John A. M. Taylor marizing the general characteristics of the most common Tudor H. Hughes disorders discussed and illustrated throughout the text. Donald Resnick These tables offer an overview of information, such as vii A C K N O W L E D G M E N T S For the Second Edition Many colleagues and friends who generously contrib- The original two authors of Skeletal Imaging are enor- uted so much to the fi rst edition have done so again, in mously indebted to Dr. Tudor Hughes, a well-respected a variety of ways, for this revised second edition of musculoskeletal radiologist and educator at the Univer- Skeletal Imaging. We are enormously indebted to Dr. sity of California, San Diego, and the second edition’s Brian Howard for contributing many more excellent case recently recruited third author. His extensive knowledge studies from his teaching fi les; to Stephanie Brown, DC, and understanding of musculoskeletal disorders is for compiling research material in the formative stages matched by equally impressive skills in researching, fact- of revision; and to Gary Smith, DC, DACBR, Matthew checking, writing, and editing. In addition to contribut- Richardson, DC, and Laurie Rocco, DC, for carefully ing hundreds of fascinating cases from his vast digital and thoroughly proofreading every chapter, word by teaching fi les, he improved every chapter of Skeletal word. We thank Pete Broomhall for editorial advice and Imaging by making them more accessible to and produc- assistance and Karen Rehwinkel and the other profes- tive for the reader. sionals of the Elsevier team and Saunders for providing encouragement, advice, and assistance at every turn. We John A. M. Taylor are particularly indebted to our editors, Kellie White and Donald Resnick Kelly Milford, for patiently and gently guiding us through every stage of production and for attempting to keep us on task and on schedule. John A. M. Taylor Tudor H. Hughes Donald Resnick ix
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