MRI findings in the heel pain

Transcrição

1 MRI findings in the heel pain Poster No.: C-1992 Congress: ECR 2016 Type: Educational Exhibit Authors: C. FONTES, A. A. S. M. D. Santos, H. Shimidu, M. A. saad, L. Nunes, D. C. Alexandre, E. Casagrande, S. Bustamante ; NITEROI - RJ/BR, Niterói - Rio de Janeiro, RJ/BR, Niterói - Rio 4 de Janeiro/BR, Niterói, RJ/BR Keywords: Trauma, Outcomes, Image verification, Perception image, Outcomes analysis, Observer performance, MR, Musculoskeletal system DOI: /ecr2016/C-1992 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 17

2 Learning objectives The aim of this study is to evaluate the most frequent findings in examinations of patients with chronic pain in the heel, correlating with the findings in MRI. Background Chronic pain in the heel is a common clinical complaint in adult patients and may interfere with the patient's routine activities, and to be disabling. Even performing a detailed clinical examination and anamnesis, its necessary choose a method of examination by appropriate imaging able to perform the correct final diagnosis, since many diseases can cause this kind of pain. In addition to clinical history and physical examination, diagnostic imaging methods are needed for accurate diagnosis, because chronic pain calcaneal has a large number of pathologies, and imaging tests play a key role in the diagnosis and treatment. Plain radiography is still a requested method for initial evaluation for its ease and low cost. MRI allows to provide accurate diagnosis, determining treatment, and also allows you to monitor the response to therapy. The MRI offers superior softtissue contrast resolution and can be helpful in diagnosis as well as in presurgical planning. Findings and procedure details We present a review of causes of pain in the heel in adult patients, correlating with the clinical and imaging findings in MRI. The studies were evaluated by two radiologists with expertise in the musculoskeletal system, which reached consensus. The main MRI findings were : Bone and soft tissue injuries as well as plantar fasciitis, fibromatosis and trauma cases. Findings in the posterior heel ( FIGS 1-16): Among the various causes of pain in the heel, such as neurological diseases, arthritis, traumatic, neoplastic, infectious and vascular, we have the mechanical origin as more frequent, being the most affected sites the posterior heel and plantar surface. Page 2 of 17

3 Findings in plantar surface (FIGS 17-21). Findings in medial region (FIG. 22). Findings in superior region (FIGS 23-24). Other findings ( FIGS 25-33) Images for this section: Fig. 1 Page 3 of 17

4 Fig. 2 Fig. 3: FIGURES 3,4. Page 4 of 17

5 Fig. 4: FIGS 5,6 Fig. 5: FIGS 7,8 Page 5 of 17

6 Fig. 6: FIGS 9,10 Fig. 7: FIG 11 Page 6 of 17

7 Fig. 8: FIG 12. Fig. 9: FIG 13,14 Page 7 of 17

8 Fig. 10: FIG 15 Fig. 11: FIG 16. Page 8 of 17

9 Fig. 12: FIG. 17. Fig. 13: FIG.18, 19 Page 9 of 17

10 Fig. 14: FIG. 20 Fig. 15: FIG 21 Page 10 of 17

11 Fig. 16: FIG.22 Fig. 17: FIG.23 Page 11 of 17

12 Fig. 18: FIG 24 Fig. 19: FIG. 25. Page 12 of 17

13 Fig. 20: FIG 26 Fig. 21: FIG 27 Page 13 of 17

14 Fig. 22: FIG 28,29 Fig. 23: FIG 30. Page 14 of 17

15 Fig. 24: FIG 31 Fig. 25: FIG 32,33. Page 15 of 17

16 Page 16 of 17

17 Conclusion MRI is effective in the evaluation of patients with pain in the heel may be obtained sure diagnoses. MRI of the calcaneus consists of screening method for image easy to perform, causing no discomfort to the patient, and with few indications for implementation phase with intravenous contrast. Personal information References 1 Resnik D, Kang HS, Pretterklieber ML. Internal Derangements of Joints. 2nd ed. Philadelphia: Saunders Elsevier; Kaplan PA, Helms CA, Dussault R, et al.ressonância Magnética Músculoesquelética.1ed.Rio de Janeiro: Guanabara Koogan; Stoller DW, Tirman PFJ, Bredella MA, et al. Diagnostic Imaging - Orthopaedics. 1st ed.salt Lake City: Amirsys; Javier Arnaiz J, Piedra T, Lucas EM, et al.imaging Findings of Lower Limb Apophysitis.AJR 2011;196:W316-W The Diagnosis and Treatment of Heel Pain. A clinical practice guideline revision 2010.Thomas JL, Christensen JC, Kravitz SR, et al. J Foot Ankle Surg 2010;49:S1-S19. Page 17 of 17