Musculoskeletal In Magnetic Resonance Imaging (Essay Sample)

Musculoskeletal In Magnetic Resonance Imaging
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Musculoskeletal In Magnetic Resonance Imaging
Femoroacetabular impingement (FAI)
Femoroacetabular impingement (FAI) is a pathomechanical process that takes place when the proximal femur gets into contact with the rim of the acetabular (Bardakos, vasconcelos & Villar 2008). This condition can occur in the normal hips in the extreme flexion and rotation of the internal or from the morphological changes, which results in immature contact of different structures. Persistent microtrauma due to recurring impingement may cause acetabular labral tears and the breaking down of the articular cartilage, which often leads to osteoarthritis. FAI resulting from the radiographically subtle of morphological abnormalities has been thought to be the susceptible cause of idiopathic cases and primary osteoarthritis. Medics recommend early diagnosis. Intervention can be done through surgery to give abrupt relief of pain, and if the surgery is carried out before the cartilage breakage starts, it can help prevent any future loss of the cartilage resulting from the osteoarthritis defect. FAI might result from morphological abnormalities on either the acetabular or femoral side of the joint (Bardakos, vasconcelos & Villar 2008).
Types of Femoroacetabular Impingement
Cam-type FAI
For the hip to be flexible normally without any impingement, the head of the femoral should be round. Additionally, there should be a space at the junction of the femoral head-neck (the femoral waist). If the femoral head is spherical or the head-neck of the femoral is offset, then the proximal femur area abnormally pressurizes the acetabular cartilage rim during the hip flexion process causing chondral and labral damage. The mechanical cam, similar to the combustion engine camshaft, is usually a spherical structure that rotates and hence lifting the adjacent structure, thus the name name ‘cam-type FAI’ (Lewin, Lieberman & Buly 2006).
A hip with a lesion of the cam, during rotation, the head of the femoral brings a broader radius to the margin of the acetabular, typically an anterosuperiorly, compressing the cartilage hyaline at the site thus pushing it medially (Lewin, Lieberman & Buly 2006). This, at first forms wavy appearance of the cartilage separated from the underneath bone. It is followed by a chondral flapping tear, same to the carpet that has been pushed to the side, a ‘carpet lesion'. Subsequent to this injury, at this site there exists pressure that leads to labrum tear or detaching from the cartilage of hyaline margin. Due to the labral injury and chondral progression damage, the hip can at a later time become unstable and can also develop the damages to the femoral head cartilage.
Pincer-type FAI
Due to the fact that the prominent acetabular rim presses down upon a proximal femur, which is similar to a pincer action, the FAI type was named after this consideration. The prominent acetabular rim becomes reflected due to the presence of the over coverage of the femoral head acetabular. For this type, damage to the cartilage take place after the labral injury, which is initially concentrated on the thin strip anterosuperiorly, and later spreading to the larger areas of poster inferiorly, which is known as the ‘countercoups lesion’.
From the labrum, the injury develops to the myxoid tearing and degeneration occurs. With a lower degree, there could be damages to thin layers adjacent to the acetabular strip cartilage (Palmer, 2005). Later, when the dystrophic ossification has developed, prominent acetabular rim functions as the fulcrum, leveraging the head of the femoral poster inferiorly and leading to chondral injury at the same site.
Coil selection is something that is critical in obtaining quality, good musculoskeletal MR images. Diagnostic devices for imaging such as the magnetic resonance (MR) scanners do acquire any data by use of the receiver series. Also, improved devices for imaging can employ assembly of the phased array coil in acquiring the desired data of the field-of-view (FOV) (Buehrer et al., 2007). These phased array coils are put in use since they give a higher signal-to-noise ratio (SNR) and an increased coverage of the space over the FOV. With these known imaging technique, the imaging data produced for each of the phased array coils is put together to form the diagnostic image. Despite the implementation of the phased array coils, the combining of images from each of the coil can end up producing a ghost in the final desired image due to the unwanted noise and artifacts.
Unwanted artifacts usually result due to the acquiring of data from a phased array coil that through dimensions exceeds the subject’s FOV. Nevertheless, for a medical patient, a known MR system that utilizes the coil system with six-phased array coils usually employs the use of four of the six coils during a spinal imaging scan (Mueller et al. 2006). But in other examinations based on the spine, imaging the FOV can be covered with only two or three of the six coils and the sufficient data for a complete image is acquired. Due to this, using unnecessary or extra coils, artifacts and noise to the FOV selected are included in the final image, and this leads to undesirable ghosting of the final result. To reduce this unwanted ghosting, undesirable coils should not be put to use.
Systems which are known tend to keep the FOV sensitivity by manually permitting selection of coils, which is done basing on the patients positioning and other tools positions prior to the session of imaging (Staewen & Johnson, 2007). During the diagnosis, the MR technician manually deselects coils so that those deselected coils are not allowed to receive any data during the scanning process.
For proper deselection of the necessary coils, the technician must be aware of the coils to be deactivated before the scan, which at times is difficult, time-consuming and requires guesswork. The coils to be deselected are made difficult by the fact that, the patient and the patient table do change positions during the scanning session. Also, deselecting the proper coils is cumbersome and prone to human errors that could result in the need of a full rescan.
The patient positioning involves: positioning the patient in supine, the head pointing towards the magnet (head followed by the supine), the patient positioned over the spine coil with the body coil being over the pelvic (iliac crest down to the mid-thigh). The body coil should be securely tightened by the use of the straps so as to prevent respiratory artifacts. To facilitate comfort, a pillow is placed under the head but no cushions under the legs. The laser beam is then centred over the hip joints always four inches below the iliac crest (Giuffrel & Moss, 2004).
Tennis elbow according to Kellman & Arai (2007) is the pain felt on the outer side of one's elbow. For medical language, tennis elbow is referred to as the lateral epicondylitis. This is so since the pain is usually felt in the lateral epicondyle area (lower, outer, bumpy area of the humerus bone of the upper arm).
In many people suffering from this defect, the felt pain occurs when the forearm and the wrist are in use, specifically in twisting times like door handle turning or opening a jar. For some, the pain is always constant and occurs when one is resting, so it affects their sleep. The pain can spread towards the arm wrist, finding it difficult in holding stuffs like fork, knife or even stretching out the arm.
The joint at the elbow comprises of three bones. The ulna, humerus and the radius. The bone bumps at the humerus bottom are named epicondyles. The other bony bump on the outer side of the elbow is the lateral epicondyle. Together, the tendons, ligaments and muscles hold the joint at the elbow (Garceau, 2013). The forearm muscles extend the fingers and wrist. The tendons in the forearm also called extensors, attach the muscles to the aligning bone. The tendon that is associated with the tennis elbow is Extensor Carpi Radialis Brevis (ECRB) (Nimura & Fujishiro, 2014).
As the name indicates, tennis elbow is at times experienced by those individuals involved in playing tennis. The muscles attached to the elbow are overused in straightening the wrist arm severally. Since the tendons and the muscles are strained, inflammation and tiny tears do develop near the bony lump (lateral epicondyle) of the outer elbow. A direct blow to the elbow can lead to the tendon swelling and causing degeneration. Also, an abrupt extreme force or action causes an injury to the tendon (Goguin & Rush, 2003).
This defect is a condition that can be limited by a person, which implies that it can at last get better even with no medical assistant. Certain treatments can be employed to improve the symptom or speed up the recovery process. The arm can be rested and avoid any strenuous conditions that worsen this situations. Also holding a cold compress, like frozen ice bags wrapped in a towel and pressing it against the elbow a few minutes every day can relief the pain. In extreme cases, surgery is the last option for this condition (Latham, 2014).
A tennis elbow brace, the band, can be worn over the forearm muscle, just underneath the elbow reduces tendon tension allowing it to heal. Also, anti-inflammatory steroids can be injected into the affected area, taking note not to administer more than three injections (Quan, Marie-Jose & Patrick, 2004). Golfer's elbow is the name that describes the same condition that produces inner side of the elbow paining.
A wide variety of coils from which to select is offered for any imaging exam. Every coil for any imaging purpose is available as long as one takes time in analysing the possible coils required. For coil selection, there are rules to...