Akira M. Murakami

Artificial intelligence assistance for searching skeletal fractures on radiographs improved the sensitivity and specificity of readers and shortened their reading time. Background Missed fractures are a common cause of diagnostic discrepancy between initial radiographic interpretation and the final read by board-certified radiologists. Purpose To assess the effect...

Purpose: Describe the frequency and severity of knee ligament sprains diagnosed by MRI in athletes participating at the 2016 Summer Olympic Games, their association with certain sports and assess correlations with additional knee structural injury. Patients and Methods: All knee MRIs performed in the Olympic Village and polyclinics during the 2016 Olympics were retrospectively, blindly reviewed for ligament sprains and associated knee injuries. In addition to the absence or presence of these abnormalities, athletes were stratified by age, gender and sport. Results: 11,274 athletes participated in the 2016 Olympic Games: 113 athletes received at least one knee MRI with some having bilateral or repeat MRI on the same knee. Anterior cruciate and medial collateral ligament (ACL/MCL) sprains were most common, accounting for 32 of the 43 sprains (74.4%). Wrestling (10), hockey (7), athletics (7), and judo (5) accounted for over half of ligament sprains. ACL sprains showed a significant positive correlation with medial, lateral meniscal tears and bone contusions. The positive correlation between posterior cruciate ligament (PCL) sprains with MCL/lateral collateral ligament sprain, and popliteus tendon tear was statistically significant with 50% of total PCL sprains occurring in hockey. When athletes were stratified by gender, ligament sprains had a similar occurrence and distribution between men and women. Conclusion: Knee ligament sprains, at the Rio 2016 Games, were most common in wrestling, hockey, athletics and judo with ACL and MCL sprains most frequent. Meniscal tears and bone contusions occurred often with ACL sprains. PCL sprains tended to be multi-ligamentous injuries. Sustained ligament sprains had similar occurrence between genders, while men had a peak incidence of sprains at a younger age and women at an older age.

An increased clinical awareness of adverse joint events after intraarticular corticosteroid injections has led to potential imaging findings and patient characteristics that may assist in identifyi... Osteoarthritis (OA) of the hip and knee is among the most common joint disorders. Intra-articular corticosteroid (IACS) injections are frequently performed to treat OA and other joint-related pain ...

To use Magnetic Resonance Imaging (MRI) to characterize the severity, location, prevalence, and demographics of shoulder injuries in athletes at the Rio de Janeiro 2016 Summer Olympic Games. This was a retrospective analysis of all routine shoulder MRIs obtained from the Olympic Village Polyclinic during the Rio 2016 Summer Olympics. Imaging was performed on 1.5 T and 3 T MRI, and interpretation was centrally performed by a board-certified musculoskeletal radiologist. Images were assessed for tendon, muscle, bone, bursal, joint capsule, labral, and chondral abnormality. A total of 11,274 athletes participated in the Games, of which 55 (5%) were referred for a routine shoulder MRI. Fifty-three (96%) had at least two abnormal findings. Seven (13%) had evidence of an acute or chronic anterior shoulder dislocation. Forty-nine (89%) had a rotator cuff partial tear and / or tendinosis. Subacromial / subdeltoid bursitis was present in 29 (40%). Thirty (55%) had a tear of the superior labrum anterior posterior (SLAP). Our study demonstrated a high prevalence of both acute and chronic shoulder injuries in the Olympic athletes receiving shoulder MRI. The high rates of bursal, rotator cuff, and labral pathology found in these patients implies that some degree of glenohumeral instability and impingement is occurring, likely due to fatigue and overuse of the dynamic stabilizers. Future studies are needed to better evaluate sport-specific trends of injury.

Injuries to the labrum, joint capsule (in particular the inferior glenohumeral ligament), cartilage, and glenoid periosteum are associated with anterior shoulder instability. The goal of this review is to provide common radiographic images and findings in patients with anterior shoulder instability. Furthermore, we will demonstrate the best methods for measuring anterior glenoid bone loss.

Patient characteristics, surgical characteristics, duration of hospitalization, radiographic results, complications, and functional outcomes between adults forty years of age or older who had undergone primary surgery for spinal deformity and those who had undergone revision surgery for spinal deformity. Methods: We retrospectively reviewed the cases of 167 consecutive patients forty years of age or older who had undergone surgery for spinal deformity performed by the senior author (K.M.K.) from January 2005 through June 2009 and who were followed for a minimum of two years. We divided the patients into two groups: primary surgery (fifty-nine patients) and revision surgery (108 patients). We compared the patient characteristics (number of levels arthrodesed, type of procedure, estimated blood loss, and total operative time), duration of hospitalization, radiographic results (preoperative, six-week postoperative, and most recent follow-up Cobb angle measurements for thoracic and lumbar curves, thoracic kyphosis, and lumbar lordosis), major and minor complications, and functional outcome scores (Scoliosis Research Society-22 Patient Questionnaire and Oswestry Disability Index). Results: The groups were comparable with regard to most parameters. However, the revision group had more patients with sagittal plane imbalance and more frequently required pedicle subtraction osteotomies (p < 0.01). Patients in the primary group required more correction in the coronal plane than did patients in the revision group, whereas patients in the revision group required more correction in the sagittal plane. We found no significant difference between the two groups in the rate of major complications or in the Scoliosis Research Society-22 Patient Questionnaire functional outcome scores. There were significant improvements in many functional outcome scores in both groups between the preoperative and early (six-week) postoperative periods and between the early postoperative period and the time of final follow-up. Conclusions: Revision surgery for spinal deformity in adults, although technically challenging and considered to present a higher risk than primary surgery, was shown to have a complication rate and outcomes that were comparable with those of primary spinal deformity surgery in adults. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence....