Sternoclavicular Joint: MR Imaging-Anatomic

Joachim
Brossmann,
Debra Trudell,
RA
MD #{149}Axel Stabler,
MD
Donald
Resnick,
MD
Sternoclavicular
MR Imaging-Anatomic
PURPOSE:
resonance
clavicular
tions.
To correlate
magnetic
(MR) images
of the sternojoint with anatomic
sec-
imaging
AND
was
MR
METHODS:
performed
on
14 sterno-
clavicular
joints in seven
specimens
from cadavers
(three men and four
women
64-94
years
of age at death;
mean, 84 years).
MR arthrography
was
performed
in four
specimens
(eight joints),
after injection
of gadopentetate
dimeglumine.
After imaging,
the specimens
were frozen
and
cut into 3-mm-thick
slices
along the
MR imaging
planes.
Images
were
correlated
with the anatomic
slices.
RESULTS:
MR imaging
depicted
the
anatomy
of the sternoclavicular
joint
and surrounding
soft tissue.
T2weighted
and proton-density-weighted
images
images
were
superior
in depiction
to Ti-weighted
of the intraarticu-
lar disk. MR arthrography
depicted
best the intraarticular
disk and four
of five perforations
and delineated
the joint capsule.
All perforations
also were depicted
on T2-weighted
images.
CONCLUSION:
MR imaging
allows
delineation
of all structures
of the
sternoclavicular
joint. MR arthrography
tions
allows
of the
Index
terms:
delineation
intraarticular
Joints,
Joints,
sternoclavicular,
473.92
Radiology
1996;
of perforadisk.
MR. 473.121411,
473.12141
473.122
1, 473.122,
198:193-198
I From
the Department
of Radiology,
Veterans Administration
Medical
Center,
3350 La
Jolla Village
Dr, San Diego,
CA 92161. From the
1995 RSNA scientific
assembly.
Received
May
15, 1995; revision
requested
June 20; revision
received
July 10; accepted
July 14. Supported
in
part by Veterans
Administration
grant SA360
and Deutsche
Forschungsgemeinschaft
grant
BR 149911-1.
Address
reprint
requests
to DR.
1996
MD
Preidler,
Correlation’
T
HE stemnoclavicular
only
upper
joint
is the
that joins
the
articulation
extremity
the
wide
and
the
range
torso.
Dc-
of motion
and
the great mange of forces on this joint,
abnormalities
of the stcmnoclaviculam
joint are mare, and only infrequently
is
it injured
in sports
and accidents.
The
stemnoclavicular
joint can be affected,
however,
infections
by numerous
diseases
and
(1-5).
Assessment
of dislo-
cation
in a patient
who has sustained
trauma
is another
important
indication for imaging
of the sternoclaviculam joints
(6,7).
Plain radiography
tional
tomography
diagnosis
ties, but
and convenare helpful
in the
of most
of these
abnormalibecause
of superimposed
computed
tomographic
(CT) techniques
are preferred,
espccially in injured
patients
(7-9). Studies
have suggested
use of magnetic
resonance
(MR) imaging
in the evaluation
of disorders
of the stennoclaviculan
joint (10,11). The purpose
of our study
was to evaluate
the use of MR imagstructures,
ing
in examination
stemnoclavicular
ing ligaments.
ANATOMIC
of structures
joint
and
in the
surround-
Figure
1.
Anterior
aspect
of the sternoclavicular
joint.
The right
sternoclavicular
joint
is cut in the coronal
plane.
1 = intraarticular
disk, 2 = interclavicular
ligament,
3 = antenor sternoclavicular
ligament,
4 = costoclavicular
ligament,
posterior
fibers,
5 = first
costal
cartilage,
6 = costoclavicular
ligament
(anterior
fibers),
7 = second
costal
cartilage,
8 = manubriosternal
joint,
9 = second
sternocostal
joint.
(Adapted,
with
permission,
from reference
12.)
lined
cavities
cavities
cavity
cral
cavity.
stemnoclaviculam
joint
throdial
saddle
joint
bounded
bulbous
medial
end
of the
the concave
saddle-shaped
notch
of the manubrium
the
cartilaginous
part
is a dian-
by the
clavicle,
claviculam
stemni, and
of the
first
rib
(Fig 1). The articulan
surface
of the
clavicle
is covered
by fibrocantilage
which
covers
the
of the sternum.
Owin size between
the two articulan
surfaces,
the stability
of the stennoclavicular
joint depends
primarily
on surrounding
ligaments.
The fibrocartilaginous
disk is flat and nearly
between
clavicle
dividing
intraarticular
circular.
It lies
the articulan
surfaces
of the
and the manubrium
sterni,
the joint into two synovium-
1). The
two
the
the
joint
inferomedial
supemolat-
intraanticulan
disk
the junction
between
the first costal cartilage
and the stemnum and inserts
on the postcmosuperior surface
of the medial
edge of the
originates
CONSIDERATIONS
(Fig
differ
in size:
is smaller
than
clavicle
The
thicker
than
that
articulam
surface
ing to a discrepancy
RSNA,
W.
Joint:
spite
MATERIALS
#{149}
Klaus
#{149}
The
from
(Fig
1). In the
anterior
and
posterior
aspects
the disk is attached
to the fibrous
capsule.
The anterior
and posterior
sternoclaviculam
ligaments
reinforce
the fibrous
joint
stemnoclavicular
capsule
(12).
ligament
to be the strongest
stemnoclavicular
The anterior
is presumed
ligament
joint
(13).
of the
It is at-
tached
to the anterosuperiom
aspect
of
the medial
epiphysis
of the clavicle,
to
which
it is mediocaudal,
and inserts
on the ventral
surface
on the upper
part of the manubrium
stemni.
The posterior
stemnoclavicular
ligament attaches
to the posterior
surface
Abbreviation:
FOV
=
field
of view.
193
b.
a.
Figure
matrix,
cartilage
2. Coronal
sections
through
the sternoclavicular
joint of an 80-year-old
man. (a) TI-weighted
spin-echo
MR image (500/20, 256 x 192
14-cm FOV, two signals acquired).
(b) Corresponding
anatomic
slice. C = clavicle,
M = manubnium
sterni,
R = first rib, I = articular
of clavicle,
2 = articular
cartilage
of manubrium,
3 = intraarticular
disk, 4 = capsule,
5 = interclavicular
ligament
(fibers).
of the medial
is less distinct
noclavicular
sternoclavicular
caudal
aspect
of the clavicle
but
than
the anterior
sterligament.
The posterior
ligament
is medio-
to the clavicle;
the insertion
is
on the dorsal
surface
of the superior
aspect
of the manubrium.
The interclavicular
ligament
is a
tough
band
of fibers
that connects
the
clavicles
in the superior
and
medial
aspects
(Fig I). The costoclavicular
ligament
is attached
to the undersurface of the medial
clavicle
and to the
superior
rim of the first rib and costal
cartilage
(Fig 1). Two
different
fasciculi
exist within
this ligament:
an
anterior
fasciculus,
which
is directed
craniolaterally,
and a posterior
fasciculus,
which
is oriented
in the craniomedial
direction
(12).
Several
muscles
have
origins
or insertions
on the medial
end of the
clavicle.
The origin
of part of the stemnocleidomastoid
muscle
is on the medial half of the superior
surface
of the
clavicle.
The insertion
of some
fibers
of the pectoralis
major
muscle
is on
the medial
anterior
surface
of the
clavicle.
The origin
of part of the sternohyoid
muscle
is dorsal
to the attachment
of the costoclavicular
liga-
ment
on the
inferior
surface
of the
clavicle.
The subclavius
muscle,
which
connects
the first rib and the clavicle,
is attached
by a thick
tendon
to the
first costal
cartilage
anterior
to the
costoclavicular
ligament.
Laterally,
it
is attached
to the undersurface
of the
middle
third
of the clavicle.
MATERIALS
Fourteen
fresh
from
seven
human
and
four
women
AND
sternoclavicular
cadavers
64-94
years
#{149}
Radiology
MR
unit
(Signa;
GE
Medical
Systems,
pulse
sequences
with
repetition
times
of
500 msec
and 2,000
msec
and
echo
times
of 20 msec
and 80 msec
(repetition
time
msec/echo
time msec = 500/20
and
2,000/
20, 80). The field of view
(FOV)
was 14 cm
in all examinations.
The data-acquisition
matrix
was 256 x 192 for the TI-weighted
images
and 256 x 128 for the T2-weighted
and
proton-density-weighted
images.
A
section
thickness
of 3 mm was used
with
a
1-mm
intersection
gap.
Two
signals
were
acquired.
Imaging
transaxial,
sagittal,
in an oblique
plane
the clavicle.
After
completion
was
and
arthrography
noclavicular
performed
of four
(eight
was
joints
joints).
performed
coronal
in the
planes
and
along
the long
of MR
imaging,
axis of
A 2-mmol
on the
specimens
solution
pentetate
dimeglumine
(I mL
ist [Scheming,
Berlin,
Germanyl
250 mL of saline
solution)
was
into the joints
with
a 23-gauge
stem-
of gadoof Magnevdiluted
in
injected
needle
un-
der fluoroscopic
guidance.
Images
of these
four specimens
were
obtained
with TIweighted
and
fat-suppressed
TI-weighted
spin-echo
sequences.
After
imaging,
the
specimens
were
planes.
photographed
pearance.
subjective
AS.).
Each
slice
was
for correlation
Correlation
impressions
joints
(three
men
of age at the
were
with
a
sity.
Calcified
peared
sity
examined
with
MR
was based
on
of the authors
and
apthe
U.B.,
RESULTS
The anatomy
of the stemnoclavicular
joint
was demonstrated
best with
weighted
spin-echo
MR images.
Ti-
intraarticulan
as areas
on
disks
of lower
Ti-weighted
ap-
signal
images,
intenand
were easier
to visualize
fled disks. At macroscopic
than
of the
calcification
sliced
specimens,
they
noncalciinspection
of the intnaanticular
disk appeared
localized
white
areas within
the
Calcification
was present
in four
as
disk.
of
specimens.
Differentiation
nous intraarticulan
lam surface
was
of the fibrocartilagidisk from the articueasier
on T2-wcighted
and proton-density-weighted
images
than on Ti-weighted
images.
On T2weighted
images,
the intmaarticular
disk appeared
as an area of low signal
intensity
surrounded
by
areas
of high
signal
intensity,
which
represented
the joint space and articulan
cartilage.
On proton-density-weighted
images,
the
deep-frozen
for 24 hours
(Forma
BioFreezer;
Forma
Scientific,
Marietta,
Ohio).
Then,
each
specimen
was cut with
a band
saw into
3-mm
slices
along
one of the im-
aging
These
images
depicted
all ligaments
and soft tissue around
the stemnoclavicular
joint. The fibrous
capsule,
postenor
sternoclaviculan
ligament,
and
anterior
stemnoclavicular
ligament
were of low signal intensity
in all imaging
sequences
and imaging
planes.
On Ti-weighted
images,
the intnaarticulan
disk was depicted
as an area
of low to intermediate
signal
inten-
seven
MR
METHODS
time
of death;
mean
age, 84 years)
examined.
Images
were
obtained
194
1.5-T
Milwaukee,
Wis)
with
a circular
5-inch
(12.7 cm) receive
surface
coil. The specimens
were
placed
anterior
surface
down
on the coil, which
was centered
on the
superior
sternal
notch.
Imaging
parameters
included
spin-echo
intmaamticular
disk
appeared
as an
area of low signal
intensity,
but the
anticular
cartilage
and joint space
were not delineated
as well as they
were on T2-weightcd
images.
Although
an increase
in signal
intensity
of the intraarficular
disk on T2-weighted
and proton-density-weighted
images
suggested
abnormality
type of abnormality
was
of the
alterations
intensity
disk,
the
confirmed
only
with MR arthnography.
No definite
altemations in intradiskal
signal intensity
were found on Ti-weighted
images.
Five of 14 stemnoclaviculan
joints showed
in signal
consistent
January
1996
a.
b.
c.
d.
e.
f.
Figure
3.
Coronal
sections
through
the sternoclavicular
joint
of a 92-year-old
woman.
(a) Ti-weighted
spin-echo
MR image
(500/20,
256 x 192
matrix,
14-cm
FOV,
two signals
acquired).
(b) T2-weighted
spin-echo
MR image
(2,000/80,
256 x 128 matrix,
14-cm
FOV,
two signals
acquired).
Small
amounts
of synovial
fluid allow
delineation
of disk perforation
on the left side and possible
perforation
on the right.
(c) Ti-weighted
spin-echo
MR arthrogram
(500/20,
256 x i92 matrix,
14-cm
FOV,
two signals
acquired)
of the left sternoclavicular
joint shows
disk perforation.
(d) Corresponding
anatomic
slice. (e) Ti-weighted
spin-echo
MR arthrogram
(500/20,
256 x 192 matrix,
14-cm
FOV,
two signals
acquired)
of
right
sternoclavicular
joint shows
no disk perforation.
(f) Corresponding
anatomic
slice. C = clavicle,
M = manubrium
sterni,
R = first rib, 3
intraarticular
disk, 4 = capsule,
6 = costoclavicular
ligament,
7 = subclavius
muscle,
insertion
of tendon
at first rib, 8 = sternocleidomastoid
muscle,
9 = anterior
sternoclavicular
ligament.
perforation
of the disk.
The presence
of four perforations
was confirmed
with
MR arthrography.
with
Coronal
Plane
Imaging
Volume
the coronal
imaging
2, 3) was best suited
for
the articular
surfaces
of the
of the clavicle
and
the main
plane
(Figs
displaying
medial
end
198
Number
#{149}
1
nubrium.
The coronal
imaging
plane
also was best for delineating
the entire intraarticular
disk and for demonstrating
perforations.
The disk usually
was thicker
in its periphery,
especially
the posterosupenior
part.
The origin
of the disk near
the junction
between
the first costal
cartilage
and
the sternum
and the insertion
of the disk on
the medial
edge
of the posterosupe-
surface
onstrated.
nor
In the
of the
medial
clavicle
aspect,
were
the
joint
=
dem-
cap-
sule could
not be differentiated
from
the fibers
of the interclaviculan
ligament.
At its lateral
attachment
at the
undersurface
of the clavicle,
the joint
capsule
was not well demonstrated.
MR arthrography
helped
delineate
the extent
of the capsule.
Radiology
195
#{149}
Figure
4.
Sagittal
noclavicular
joint
sections
through
(a) Ti-weighted
spin-echo
(500/20, 256 x 192 matrix,
signals
cavities
woman.
MR arthrogram
14-cm
acquired)
demonstrates
and attachment
of the
joint
capsule.
slice.
A subchondral
the ster-
in a 64-year-old
FOV,
two
both joint
disk to the
(b) Corresponding
anatomic
cyst communicates
with
the joint space. C = clavicle,
M = manubrium
sterni,
R = first rib, 3 = intraarticular
disk,
4 = capsule,
9 = anterior
sternoclavicular
ligament,
10 = posterior
sternoclavicular
ligament,
ii = pectoralis
muscle.
Anterior
surface
faces the right.
The
anterior
clavicular
demonstrated
and
posterior
sterno-
ligaments
were
not well
in the coronal
plane.
The costoclavicular
ligament
delineated,
but differentiation
tween
anterior
and posterior
was
not
possible.
toclavicular
the subclavius
Anterior
ligament,
muscle
was
first
the insertion
costal
cartilage.
tion
face
of the
of the
also
was
to the
cos-
the tendon
was evident,
of the
The
muscle
middle
was well
beportions
muscle
lateral
of
as
on the
inser-
on the undensurthird of the clavicle
delineated.
Sagittal
Plane
Use of the sagittal
imaging
plane
(Figs 4,5) allowed
the best delineation
of the antcnoposterior
thickness
of the
costoclavicular
ligament.
The two fasciculi
of this
ligament
and
the
bursa
between
the fasciculi
were not differentiated,
however.
Sagittal
images
also showed
the position
of the subclavius
muscle,
which
was
under
the
clavicle
and anterior
to the costoclavicular
ligament.
The extent
of the
anterior
and posterior
stemnoclaviculam ligaments
was defined,
and the
attachment
of the
intraarticular
anterior
and
posterior
capsule
was
seen.
disk
to the joint
Although
the
disk
and the two joint
on images
in this
cavities
were seen
plane,
diagnosis
of
disk
perforations
was
with
routine
Transaxial
Use
not
Plane
of the
transaxial
imaging
(Fig 6) allowed
depiction
nor and posterior
parts
capsule
possible
MR imaging.
and
the
anterior
plane
of the anteof the joint
and
poste-
nor stemnoclavicular
ligaments.
Single
images
viewed
in this plane,
however, did not demonstrate
optimally
the position
of the clavicles
in relation
to the manubnium.
The anterior
and
posterior
ticular
disk
attachments
to the
joint
depicted.
Delineation
of the intraarticular
sible.
196
Use
of the
#{149}
Radiology
of the intraarcapsule
were
of perforations
disk was not pos-
transaxial
plane
also
a.
Figure
5.
Sagittal
sections
through
woman.
(a) Ti-weighted
spin-echo
nals acquired).
(b) Corresponding
ligament,
7 = subclavius
muscle,
b.
area of the interclavicular
ligament
in a 64-year-old
MR image
(500/20,
256 x 192 matrix,
14-cm
anatomic
slice. C = clavicle,
R = first rib, 6
11 = pectoralis
muscle.
Anterior
surface
faces
FOV,
=
two
sig-
costoclavicular
the
right.
January
1996
a.
b.
Figure
6.
Transaxial
sections
through
the sternoclavicular
joint of an 86-year-old
woman.
(a) Ti-weighted
spin-echo
MR image
(500/20,
256 x
192 matrix,
14-cm
FOV,
two signals
acquired).
(b) Corresponding
anatomic
slice. C = clavicle,
VB = brachiocephalic
vein,
VT! = inferior
thyroid
vein,
1 = articular
cartilage
of the clavicle,
3 = intraarticular
disk, 5 = interclavicular
ligament,
8 = sternocleidomastoid
muscle,
9 = anterior
stemnoclavicular
ligament,
1(1 = posterior
sternoclavicular
ligament,
12 = sternothyroid
muscle.
Anterior
surface
faces the top.
a.
Figure
b.
7.
Oblique
sections
parallel
192 matrix,
14-cm
FOV,
two signals
the clavicle,
2 = articular
cartilage
posterior
sternoclavicular
ligament.
allowed
demonstration
to the long axis of the clavicle
acquired).
(b) Corresponding
of manubrium,
.3 = intraarticular
of the costo-
clavicular
and the intcnclavicular
ligaments.
The close
relation
between
the
stemnoclavicular
joint
and the great
vessels
and trachea
was shown.
Oblique
Transaxial
Use of the
(Fig 7) allowed
the
relation
clavicle
Plane
oblique
the
transaxial
plane
best assessment
of
of the
to the
medial
manubrium.
end
of the
The
extent
and course
of the anterior
and postenor stemnoclavicular
ligaments
were
depicted
in great detail.
The posterosuperior
ticulan
clavicle
attachment
of the intraardisk to the medial
end of the
also was well demonstrated.
tients
with
seronegative
thropathics
(3), rheumatoid
(16), and hyperpamathyroidism
The
stennoclaviculam
Several
clavicular
clavicle
tion
diseases
involve
the
joint.
It can be a site
for infection,
users
(1,4,5,14,15).
lam joint
also may
Volume
198
especially
in drug
The sternoclavicube affected
in pa-
Number
#{149}
sternoof loca-
1
spondyloararthritis
(17,18).
joints
are a typi-
cal site of involvement
in the SAPHO
syndrome
(synovitis,
acne,
pustulosis,
hyperostosis,
osteitis),
which
cornprises
chronic
recurrent
multifocal
osteomyclitis
(CRMO),
osteitis
condensans
of the clavicle,
sternocostoclavicular
hypenostosis,
and various
forms
of pustulotic
amthro-osteitis
(2,9,1 1,19-21
). Degenerative
changes
in the stennoclavicular
joint
affect
the
clavicle
and the fibmocartilaginous
disk
(22). Perforations
of the disk and
chondrocalcinosis
with
deposition
of
calcium
pymophosphate
dihydrate
are
common
DISCUSSION
in a 67-year-old
woman.
(a) Ti-weighted
spin-echo
MR image
(500/20,
256 x
anatomic
slice. C = clavicle,
M = manubrium
sterni, I = articular
cartilage
of
disk,
7 = subclavius
muscle,
9 = anterior
sternoclavicular
ligament,
10 =
(22,23).
Dislocation
of the
(6,7) is associated
with inju-
nies to the
noclaviculam
anterior
and
ligaments.
posterior
stemWith
addi-
tional
superior
displacement
clavicle,
the costoclavicular
also is disrupted.
Radiognaphs
of the
of the
ligament
stemnoclavicular
joints
often
are
inadequate.
projections
include
oblique,
and lateral
these
projections
the
stemnoclaviculam
Special
Standard
postemoanteniom,
views,
although
often
do
joint
radiographic
not
display
adequately.
projections
of
the stemnoclavicular
joint have been
described
(24-26),
but they arc used
primarily
to demonstrate
dislocations
of the joint. For better
visualization
of
the joint surfaces
and subtle
intmaosseous
phy
changes,
or CT
has
conventional
been
used
To our
knowledge,
imaging
in the
the
diagnosis
tomogra(14,15,20).
role
of MR
of stennocla-
vicular
joint diseases
has not been
defined,
although
a few descriptions
of the use of MR imaging
in the asscssmcnt
vicular
Our
relation
slices,
of disorders
of the
stennocla-
joint do exist (10,11,21).
results,
derived
from close conof MR images
and anatomic
suggest
that
the
anatomy
of the
stennoclaviculan
joint and the sunrounding
tissues
can be demonstrated
in detail.
All the ligaments
around
Radiology
the
#{149}
197
stemnoclaviculan
joint
eated
with conventional
sequences.
The
can be delinMR imaging
anterior
and
posterior
stennoclaviculan
joints can be partially
demonstrated
on coronal
images,
can
be well demonstrated
on transaxial
and sagittal
images,
and can be best
demonstrated
on oblique
images,
which
parallel
the long axis of the
clavicle.
The intenclavicular
ligament
can be evaluated
best on coronal
images, although
it also can be seen on
transaxial
and sagittal
images.
The
coronal
and sagittal
planes
appear
most favorable
for imaging
the costoclavicular
ligament.
The intraarticular
disk is best demonstrated
in its entirety
in the coronal
plane.
This disk is difficult
to diffementiate from the fibrocantilaginous
anticulan
surfaces
on Ti-weighted
images unless
it is calcified.
Although
it
is well
demonstrated
MR images
with
proton-density-weighted
sequences,
the
on
demonstrated
and
imaging
is best
delineated
perforations
these
limited
198
studies
by respiratory
of the
Radiology
#{149}
are
likely
motion
of supporting
the joint and
may prove
assessment
joint
to the
(27,28).
is.
16.
1.
Karten
I.
Septic
rheumatoid
17.
parathyroidism.
326.
18.
Med
1969;
19.
3.
4.
Kahn
MF, Chamot
6.
7.
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1993;
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Reginato
AJ.
Syphilitic
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379-398.
Nettles
JL, Linscheid
R. Stemnoclavicular
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J Trauma 1968; 8:158-164.
Cope
R. Dislocations
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Radiol
1993;
22:233-238.
Hatfield
MK, Gross BH, Glazer
GM, et al.
tomography
its articulations.
Skeletal
197-203.
Greenspan
A, Gerscovich
of the sternum
Radiol
1984;
E, Szabo
and
11:
RM,
et
al. Condensing
osteitis of the clavicle: a
rare but frequently
misdiagnosed
condi10.
1 1.
12.
tion. AJR 1991; 156:1011-1015.
Shanley
DJ, Vassallo
CJ, Buckner
AB.
Sternoclavicular
pyarthrosis
demonstrated
on bone scan: correlation
with CT and
MRI. Clin NucI Med 1991; 16:786-787.
Vierboom
MAC, SteinbergJDJ,
Mooyaart
EL, et al.
Condensing
osteitis
of the
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resonance
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as an
adjunct
method
for differential
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PC, Warwick
R, eds.
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of injuries
clavicular
5.
intraanticulan
disk in four of five stemnoclavicular
joints
in which
perforations were present.
Although
this is a
high prevalence
of perforation,
it is
known
that this type of lesion
is cornmon in elderly
people
(22). The clinical relevance
of this finding
is unclean
and probably
is unimportant.
MR amthrography
also allows
evaluation
of
the boundaries
of the joint capsule.
These
results
arc promising
with
regard
to the potential
of MR imaging
in assessment
of traumatic
and nontraumatic
disorders
about
the sternoclavicular
joint. The images
were obtamed
in cadavers,
however,
so
motion
artifacts
were eliminated.
In
patients,
around
cpiphysis
Rheumatol
with MR anthrography
combined
with Ti-weighted
on Ti-weighted
fat-saturated
imaging.
MR amthrography
assessment
conventional
T2-wcightcd
disk
although
fasten imaging
sequences
and developments
in gating
techniques
should
make MR imaging
of
the stemnoclavicular
joint feasible.
The
ability
of MR imaging
to allow direct
20.
21.
22.
23.
Chigira
M, Shimizu
T.
Computed
tomographic
appearances
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hyperostosis.
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JM, Landry
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MR imaging
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EurJ
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projection
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view.
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epiphysis.
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D, Hoffer
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January
1996