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Ganglion Anatomy

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82. Chronic Knee Pain

and there is clinical evidence or concern for lumbar spine pathology. CT Knee CT without intravenous (IV) contrast may be indicated to evaluate the patellofemoral anatomy in the setting of chronic knee pain related to repetitive patellofemoral subluxation or maltracking [15]. CT can also be used to evaluate trochlear morphology and the tibial tubercle-trochlear groove distance. CT with IV contrast is usually not indicated when initial radiograph is negative or demonstrates a joint effusion. CT without and with IV (...) , adhesive capsulitis, medial plicae, discoid meniscus, tumors, ganglion cysts, pigmented villonodular synovitis, osteophytes, and osteonecrosis [15,19,36-45]. MRI without and with IV contrast is not usually indicated when initial radiograph is negative or demonstrates a joint effusion. However, contrast-enhanced images may be more accurate in diagnosing other causes of chronic knee pain, such as Hoffa’s disease, deep infrapatellar bursitis, patellofemoral friction syndrome, and adhesive capsulitis [15

2018 American College of Radiology

83. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

, ligamentum flavum hypertrophy, spondylolisthesis, or spondylosis, which may compress the epidural venous plexus within tight epidural spaces. Moreover, patients, after various spine surgeries, may develop fibrous adhesions and scar tissue, thus further compromising the capacity of the epidural space and distorting the anatomy of the epidural vessels. The risk of bleeding is further increased in pain patients taking several concomitant medications with antiplatelet effects including NSAIDs, ASA (...) the risk of bleeding and neurological injury secondary to impairment of coagulation in the setting of implantable neurostimulation devices in the spine, brain, and periphery. These recommendations are aligned with the recommendations published here. | Anatomical Considerations for Hematoma Development in Spinal and Nonspinal Areas Although most cases of a spinal hematoma have a multifactorial etiology, certain anatomical features may pose higher risks secondary to the anatomy and vascular supply

2018 American Society of Regional Anesthesia and Pain Medicine

84. Shoulder Pain - Atraumatic

, demonstrating accuracies in the detection of rotator cuff and adjacent soft-tissue abnormalities equivalent to MRI [6]. US is usually well tolerated and, as with MRI, involves no ionizing radiation. Imaging in real time allows direct functional assessment of the shoulder during provocative maneuvers (ie, impingement) as well as providing guidance for a variety of interventions. As in other modalities, the upper extremity must be positioned to optimally visualize the anatomy of interest. Discussion (...) of neurogenic pain. US Shoulder Paralabral cysts that extend to the spinoglenoid notch, suprascapular notch, and quadrilateral space can be identified by US. Based on loss in muscle bulk and increased echogenicity due to replacement by fat, US can also evaluate associated loss of muscle bulk. Paralabral or ganglion cyst aspiration under US guidance can be attempted [92,93]. The suprascapular nerve may occasionally be visualized on US in the spinoglenoid notch adjacent to the suprascapular artery [94]. Bone

2018 American College of Radiology

85. Chronic Pelvic Pain

colpopexy: management of postoperative pudendal nerve entrapment. Obstet Gynecol, 1996. 88: 713. 218. Fisher, H.W., et al. Nerve injury locations during retropubic sling procedures. Int Urogynecol J, 2011. 22: 439. 219. Moszkowicz, D., et al. Where does pelvic nerve injury occur during rectal surgery for cancer? Colorectal Dis, 2011. 13: 1326. 220. Ashton-Miller, J.A., et al. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci, 2007. 1101: 266. 221. Amarenco, G., et al. [Perineal neuropathy

2018 European Association of Urology

88. CRACKCast 107 – Peripheral Nerve Disorders

), or a local issue, e.g., atrophic, dry skin. Refer to figure 97.2 in Rosen’s 9 th Edition for schematic representation of the anatomy of the peripheral nervous system and its interface with the central nervous system When something goes wrong with the PNS, 1 of 3 issues may develop: Myelinopathies , in which the primary site of involvement is limited to the myelin sheath surrounding the axon; Axonopathies , in which the primary site of involvement is the axon, with or without secondary demyelination (...) names of a radial mononeuropathy? How does it present? Remember your anatomy? Yeah… that is what we thought: Anatomy: Rises from the C5 to T1 nerve roots. “After exiting the brachial plexus, it passes behind the proximal humerus in the spiral groove and takes a lateral (radial) course down the upper arm (Fig. 97.3). At about the level of the antecubital fossa, it bifurcates into the posterior interosseous (pure motor) and superficial radial (pure sensory) nerves.” – Steward JD 3 rd Edition Motor

2017 CandiEM

89. CRACKCast E085 – Aortic Dissection

on the topic. As with anything in medicine, its all about the anatomy and what goes wrong with it: Made up of three layers: intima, media, and adventitia Dissecting aorta is the correct term, as the common dissecting aortic aneurysm is a misnomer: most dissections do not have aneurysm. The Aorta is tres importante: Rupture through it or occlusion of it will kill you pretty quick. Pathophysiology: As the heart pendulum’s (swings) side to side it applies force (flexion forces) to ascending and descending (...) Tamponade Pericardium Hemothorax Thorax Horner Syndrome Superior cervical sympathetic ganglion Stroke / Syncope Brachiocephalic, common carotid, left subclavian Upper extremity pulselessness, hypotension, pain Subclavian Paraplegia Intercostal / Spinal / Vertebral arteries Back or flank pain: renal failure Renal artery Abdo pain: mesenteric ischemia Celiac / mesenteric arteries Lower extremity pain / pulselessness / weakness Common iliac artery Next, we need to talk diagnostic tests: CT Chest

2017 CandiEM

90. Health Technology Update — Issue 18

, called neurostimulation, may offer patients with cluster headaches an alternative form of pain relief. How It Works The Sphenopalatine Ganglion The sphenopalatine ganglion (SPG) is a triangular collection of neurons located in the middle of the face. 5 Because the SPG plays a role in controlling blood flow and the activity of chemical messengers — neurotransmitters — that influence pain, researchers are interested in how stimulating or blocking nerve signals in the SPG can affect pain, including pain (...) Following preoperative imaging to determine the mid-facial anatomy of the patient and select an appropriate size of implant, patients receive general anesthesia, and then the device is implanted through a small incision in the top of the mouth near the first or second molars. 9,10 The device is implanted on the side of the head where the cluster headaches most often occur. 9 Correct placement of the device is confirmed using imaging during the surgery and again one day after the procedure. 9 Who Might

2017 CADTH - Health Technology Update

91. Cranial Neuropathy

should be emphasized: 1. Because of the complex anatomic structures within the brain and brain stem and because the cranial nerves may take long, circuitous routes to their destinations, a detailed knowledge of cranial nerve anatomy is essential for proper clinical localization of potential lesions and for appropriate application of specific imaging protocols. 2. Because some individual nerve fibers, such as the autonomic nerves, may travel with several different cranial nerves from their nuclei (...) that predicting the prognosis is difficult [95]. CT CT provides useful information regarding temporal bone fractures and trauma, presurgical osseous anatomy, nerve involvement with inflammatory middle ear disease, foraminal expansion, patterns of bone erosion, and intrinsic bone tumor matrices [83,84,96-98]. In patients with risk for contrast allergy and contrast-induced nephropathy, noncontrast CT may be sufficient if patients cannot undergo MRI. A dedicated temporal bone CT with thin sections should

2017 American College of Radiology

92. Chronic Wrist Pain

wrist with IV contrast Usually Not Appropriate ? CT wrist without and with IV contrast Usually Not Appropriate ? CT arthrography wrist Usually Not Appropriate ? X-ray arthrography wrist Usually Not Appropriate ? Tc-99m bone scan wrist Usually Not Appropriate ??? ACR Appropriateness Criteria ® 5 Chronic Wrist Pain Variant 9: Chronic wrist pain. Palpable mass or suspected occult ganglion cyst. Radiographs normal or nonspecific. Next study. Procedure Appropriateness Category Relative Radiation Level (...) abnormalities compared with MRI. High-resolution (typically multidetector) CT of the wrist following contrast injection into one or more wrist compartments (CT arthrography) is a powerful tool for diagnosing intra-articular abnormalities [14,15]. The intraobserver agreement on CT arthrogram images is extremely high and better than that reported for MRI [14,16]. US US of the wrist is useful for examining extra-articular soft tissues, such as suspected ganglion cysts [17], because its accuracy is similar

2017 American College of Radiology

94. AIUM Practice Parameter for the Performance of a Musculoskeletal Ultrasound Examination

, peripheral nerve sheath tumor, or lipoma), ganglion, epidermal inclusion cyst, foreign body, or isolated tendon injury. Tenosynovitis, nerve entrapment syndromes, and peripheral nerve disorders such as carpal tunnel syndrome can also be evaluated. In a patient with suspected inflammatory arthritis, the hands and wrists should be evaluated for synovial hypertrophy, joint effusion, bony erosions, tenosynovitis, crystal deposition, and tendon rupture. Power or color Doppler imaging should also be used (...) and the radial artery for occult ganglion cysts, which can originate from the radiocarpal joint capsule, scaphotrapezial joint, or flexor carpi radialis tendon sheath itself. On the ulnar side, branches of the ulnar nerve and artery lie within the ulnar tunnel. The flexor carpi ulnaris tendon and pisiform bone border the ulnar aspect of the tunnel. All of the tendons can be followed to their sites of insertion if clinically indicated. 2. Ulnar—Placing the transducer transversely on the ulnar styloid

2017 American Institute of Ultrasound in Medicine

96. Radiologic Management of Mesenteric Ischemia

mesenteric venous anatomy [10]. Overview of Therapeutic Modalities Treatments for mesenteric ischemia attempt to reverse the underlying cause, with the goal of prevention of bowel infarction. Treatment choice depends on the underlying etiology of ischemia. For patients with mesenteric arterial occlusive disease there has been a shift away from surgical treatment (eg, embolectomy, endarterectomy, and arterial bypass) towards endovascular approaches including thrombolysis and clot retrieval in cases (...) been postulated to limit blood flow to the bowel, with resulting ischemic symptoms, or to irritate the celiac ganglion, which results in abdominal pain. Compression of the celiac artery may be a normal finding in asymptomatic patients and is well characterized [24]. Therefore, supportive treatment with analgesics and continued diagnostic evaluation for alternate causes of abdominal pain might be reasonable first steps in patients with suspected median arcuate ligament syndrome. Patients

2016 American College of Radiology

98. Neuroblastoma Treatment (PDQ®): Health Professional Version

of neuroblastoma without clinical detection in the first year of life is at least as prevalent as clinically detected neuroblastoma.[ - ] Epidemiologic studies have shown that environmental or other exposures have not been unequivocally associated with increased or decreased incidences of neuroblastoma.[ ] Anatomy Neuroblastoma originates in the adrenal medulla and paraspinal or periaortic regions where sympathetic nervous system tissue is present (refer to ). Figure 1. Neuroblastoma may be found (...) diarrhea caused by the secretion of vasoactive intestinal peptide by the tumor, or they may have protein-losing enteropathy with intestinal lymphangiectasia.[ ] Vasoactive intestinal peptide secretion may also occur with chemotherapeutic treatment, and tumor resection reduces vasoactive intestinal peptide secretion.[ ] Presence of Horner syndrome: Horner syndrome is characterized by miosis, ptosis, and anhidrosis. It may be caused by neuroblastoma in the stellate ganglion, and children with Horner

2018 PDQ - NCI's Comprehensive Cancer Database

99. Non-Small Cell Lung Cancer Treatment (PDQ®): Health Professional Version

at diagnosis.[ ] Anatomy NSCLC arises from the epithelial cells of the lung of the central bronchi to terminal alveoli. The histological type of NSCLC correlates with site of origin, reflecting the variation in respiratory tract epithelium of the bronchi to alveoli. Squamous cell carcinoma usually starts near a central bronchus. Adenocarcinoma and bronchioloalveolar carcinoma usually originate in peripheral lung tissue. Anatomy of the respiratory system. Pathogenesis Smoking-related lung carcinogenesis

2018 PDQ - NCI's Comprehensive Cancer Database

100. Childhood Central Nervous System Embryonal Tumors Treatment (PDQ®): Health Professional Version

years are considered cured of their tumor. Survival rates for other embryonal tumors are generally poorer, ranging from less than 5% to 50%; specifics are discussed within each subgroup in the summary.[ - ] Figure 1. Anatomy of the inside of the brain, showing the pineal and pituitary glands, optic nerve, ventricles (with cerebrospinal fluid shown in blue), and other parts of the brain. The posterior fossa is the region below the tentorium, which separates the cortex from the cerebellum

2018 PDQ - NCI's Comprehensive Cancer Database

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