The prevalence, imaging features, and etiologies of pediatric intra-articular soft tissue masses are not well described in the literature. Therefore, intra-articular masses can present diagnostic dilemmas for pediatric radiologists. The purpose of this study was to further evaluate pediatric intra-articular soft tissue masses. Our hypothesis was that intra-articular masses have a limited differential diagnosis and are mostly benign. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Nadim Bardia, Samet Jonathan

Keywords: intra-articular mass, PVNS, knee MRI

Background & Purpose: Fractures on MRI can be difficult to see, particularly if they are small or surrounded by edema and other heterogeneous signal changes. This is made more challenging if an x-ray is not available for review when reading an MRI, or if the injury on x-ray is subtle. The purpose of this exhibit is to review the different appearances and types of fractures by MRI, including avulsion, acute osteochondral, physeal related, and stress fractures, and help the learner develop a pattern-based approach when reviewing an MRI, in order to improve detection and confidence. Learning Objectives: 1. Recognize the different ways an acute fracture can appear by MRI, including understanding mechanisms of injury and any associated ligamentous or tendinous involvement. 2. Learn to approach each MRI the same way, with a careful assessment of bone marrow edema heterogeneity, joint fluid heterogeneity, and articular surfaces. 3. Develop awareness of subtle, small, or unusual fractures that may be hiding amidst edema or fluid. Content: This exhibit will portray and explain the imaging appearances of different fractures on MRI including: incomplete, avulsion, acute osteochondral, physeal related, and stress fractures. Different joint centered abnormalities will be emphasized, particularly the knee, shoulder, and pelvis. A pattern based approach will be reviewed in order to avoid missing subtle findings. This will include: 1. Searching within the heterogeneity of marrow edema patterns on both T1 and T2 weighted sequences to find linearity, subtle cortical depressions, or incomplete fracture lines. 2. Looking for healing or more chronic changes, including periosteal reaction by MRI. 3. Following articular cartilage and the physis to make sure they have normal contours and are smooth. 4. Examining joint fluid for avulsed joint bodies, with attention to any linear appearing signal changes in the dependent recesses of joints. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Wyers Mary, Ganesh Ashwin, Samet Jonathan

Keywords: fracture, MRI, Physis

Clear MRI criteria for discoid meniscus in the pediatric population is limited in the literature. This has resulted in a range of meniscal sizes and shapes being called discoid. While the diagnosis may be correct, features that could predict patient symptoms or increase the likelihood of meniscal surgery are unknown. The purpose of this study was to assess MRI features of intact discoid menisci and correlate with clinical outcomes in order to improve the prognostic utility of MRI. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Hesse Derek, Finlayson Craig, Gladstein Aharon, Samet Jonathan

Keywords: discoid, meniscus

MRI interpretation of pediatric bone marrow is a challenging task due to the highly variable appearance. The bone marrow composition, especially the cellularity, changes with age, benign and malignant hematologic conditions, medications, among other etiologies. Detection of a marrow replacement process on MRI can be missed even by experienced radiologists. Normal hematopoietic bone marrow from birth to 9 years ranges from 20-40% fat (inversely related to cellularity). In malignant marrow replacement processes such as leukemia, bone marrow is highly cellular and fat percentage is low. Currently, no technique is routinely used in clinical practice to quantify bone marrow fat percentage on MRI. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Samet Jonathan, Schafernak Kristian, Arva Nicoleta, Deng Jie

Keywords: Bone Marrow, Fat fraction, leukemia