Mark Kransdorf - Academia.edu (original) (raw)

Papers by Mark Kransdorf

Skeletal Radiology

In 2019, Skeletal Radiology published a total of 253 articles including 111 scientific articles, ... more In 2019, Skeletal Radiology published a total of 253 articles including 111 scientific articles, 36 review articles, 51 case reports, 16 Test-Yourself cases, 15 technical reports, as well as multiple browser notes, meeting abstracts, and meeting summaries. As we have done previously, in this review, we will highlight those articles that stimulated the most interest from our readers, as measured by their downloads, and those that stimulated other researchers and authors, as measured by their citations. The manuscripts highlighted herein were chosen from this list.

Journal of the American College of Radiology

Shoulder pain is one of the most common reasons for musculoskeletal-related physician visits. Ima... more Shoulder pain is one of the most common reasons for musculoskeletal-related physician visits. Imaging plays an important role in identifying the specific cause of atraumatic shoulder pain. This review is divided into two parts. The first part provides a general discussion of various imaging modalities (radiographs, arthrography, nuclear medicine, ultrasound, CT, and MRI) and their usefulness in evaluating atraumatic shoulder pain. The second part focuses on the most appropriate imaging algorithms for specific shoulder conditions including: rotator cuff disorders, labral tear/instability, bursitis, adhesive capsulitis, biceps tendon abnormalities, postoperative rotator cuff tears, and neurogenic pain. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

AJR. American journal of roentgenology, 2018

The purpose of this article is to assist radiologists in developing an organized, systematic appr... more The purpose of this article is to assist radiologists in developing an organized, systematic approach to imaging interpretation in the care of patients who have been surgically treated for sarcoma. Postoperative imaging interpretation of sarcoma can be complex and requires an organized, systematic approach that includes review of the patient's clinical and surgical history and pretreatment images to gain context for differentiating recurrence from time-dependent posttreatment changes.

Journal of the American College of Radiology : JACR, 2018

Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic... more Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic. This pain may be the result of either fracture (the clavicle, scapula, or proximal humerus) or soft-tissue injury (most commonly of the rotator cuff, acromioclavicular ligaments, or labroligamentous complex). Imaging assessment of traumatic shoulder pain begins with conventional radiography and, depending on physical examination findings, will require MRI or MR arthrography for assessment of soft-tissue injuries and CT for delineation of fracture planes. Ultrasound excels in assessment of rotator cuff injuries but has limited usefulness for assessment of the deep soft-tissues. CT angiography and conventional arteriography are helpful for assessment of vascular injury, and bone scintigraphy can be used in assessment of complex regional pain syndrome after traumatic shoulder injury. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clin...

Journal of the American College of Radiology : JACR, 2018

Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, rega... more Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, regardless of the suspected diagnosis. When radiographs are normal or equivocal, advanced imaging with MRI (without or without intravenous contrast or following arthrography), CT (usually without contrast), and ultrasound each has a role in establishing a diagnosis. Furthermore, these examinations may contribute to staging disease, treatment planning, and prognostication, even when radiographs are diagnostic of a specific condition. Which examination or examinations are best depends on the specific location of pain and the clinically suspected conditions. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-e...

Skeletal radiology, Jan 22, 2017

Journal of the American College of Radiology : JACR, 2017

Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the U... more Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revi...

Topics in Magnetic Resonance Imaging

Journal of the American College of Radiology : JACR, 2017

Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue... more Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. MRI with contrast is the examination of choice for the evaluation of suspected osteomyelitis, and MRI, CT, and ultrasound can all be useful in the diagnosis of soft tissue infection. CT or a labeled leukocyte scan and sulfur colloid marrow scan combination are alternative options if MRI is contraindicated or extensive artifact from metal is present. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision i...

Journal of the American College of Radiology : JACR, 2017

Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR... more Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where e...

The Journal of arthroplasty, Jul 10, 2017

A standing anteroposterior (AP) radiograph is commonly used to evaluate coronal alignment followi... more A standing anteroposterior (AP) radiograph is commonly used to evaluate coronal alignment following total knee arthroplasty (TKA). The impact of coronal alignment on TKA outcomes is controversial, perhaps due to variability in imaging and/or measurement technique. We sought to quantify the effect of image rotation and tibial slope on coronal alignment. Using a standard extramedullary tibial alignment guide, 3 cadaver legs were cut to accept a tibial tray at 0°, 3°, and 7° of slope. A computed tomography scan of the entire tibia was obtained for each specimen to confirm neutral coronal alignment. Images were then obtained at progressive 10° intervals of internal and external rotation up to 40° maximum in each direction. Images were then randomized and 5 blinded TKA surgeons were asked to determine coronal alignment. Continuous data values were transformed to categorical data (neutral [0], valgus [L], and varus [R]). Each 10° interval of external rotation of a 7° sloped tibial cut (or...

RadioGraphics, 2016

■ Describe the objectives of musculoskeletal tumor imaging. ■ Identify the appropriate MR imaging... more ■ Describe the objectives of musculoskeletal tumor imaging. ■ Identify the appropriate MR imaging sequences for assessment of musculoskeletal masses to meet the objectives of tumor imaging. ■ Discuss the optimal uses of CT and US in evaluation of musculoskeletal masses.

Radiologic Clinics of North America, 2016

Primary lymphoma of bone and soft tissue is rare and almost invariably of B-cell origin. Osseous ... more Primary lymphoma of bone and soft tissue is rare and almost invariably of B-cell origin. Osseous lymphoma usually reveals aggressive bone destruction and associated soft tissue extension. Soft tissue involvement is optimally depicted by MR imaging. Cortical destruction allowing communication between the intraosseous and soft tissue components may be subtle with small striations of extension. Lymphoma of the deep soft tissues usually reveals long cones of intramuscular or intermuscular tumor again best depicted by MR imaging. Cutaneous or subcutaneous lymphoma demonstrates multiple nodules and plaquelike thickening.

International journal of surgery case reports, Jan 25, 2016

Hemophilic pseudotumor is a rare but well documented complication seen in approximately 1-2% of p... more Hemophilic pseudotumor is a rare but well documented complication seen in approximately 1-2% of patients with hemophilia. The incidence continues to decrease, likely because of increasingly sophisticated techniques in managing factor deficiency. We present a case of hemophilic pseudotumor in a patient without hemophilia, an exceptionally rare entity, and outline a hybrid approach to treatment. The patient presented with a left sided iliopsoas mass and associated radiculopathy, with a history of a poorly characterized bleeding diathesis and Noonan's syndrome. He had no history of trauma and was not being treated with anti-coagulation. Of note, factors VIII, IX and XI were normal. An open biopsy was consistent with hemophilic pseudotumor. The patient underwent a hybrid procedure of preoperative embolization of the left internal iliac and left deep circumflex arteries followed by surgical debridement and resection, with an excellent outcome. Hemophilic pseudotumor is rarely seen in...

Skeletal Radiology, Feb 1, 1988

This study reviews 16 cases of chondroblastoma of the patella which constitute nearly 6% of a lar... more This study reviews 16 cases of chondroblastoma of the patella which constitute nearly 6% of a large group of chondroblastomas scattered throughout the skeleton. Both radiologic and histologic appearances of chondroblastomas of the patella are indistinguishable from those of chondroblastomas arising in other sites. A reasonable differential diagnosis, including chondromalacia patella, is discussed together with important therapeutic considerations.

American Journal of Roentgenology, 2016

Lodwick's well-established grading system of lytic bone lesions has been widely u... more Lodwick's well-established grading system of lytic bone lesions has been widely used in predicting growth rate for lytic bone lesions. We applied a Modified Lodwick-Madewell Grading System as an alternative means to categorize lytic bone tumors into those with low, moderate, and high risks of malignancy. A retrospective review of the radiographs of 183 bone lesions was performed. Cases were selected to include a broad range of benign and malignant tumors. Readers applied our Modified Lodwick-Madewell Grading System, and consensus was reached in all cases. This modified system consists of grade I, which is composed of grades IA and IB as listed in the Lodwick system; grade II, which is grade IC in the Lodwick system; and grade III, which is composed of IIIA (changing margination), IIB (moth-eaten and permeative patterns), and IIIC (radiographically occult). Grading was correlated with the final diagnosis. Of the 183 tumors, 81 were classified as grade I, 54 as grade II, and 48 as grade III. When correlating grade with pathology, we found that 76 of 81 (94%) grade I lesions were benign and 39 of 48 grade III lesions (81%) were malignant. A nearly equal number of grade II lesions proved to be benign (29/54; 54%) and malignant (28/54; 53%). By expanding Lodwick's grading system to include two additional patterns of disease described by Madewell and colleagues (changing margination and radiographically occult) and by reclassifying them into three distinct grades, we propose a modified system-the Modified Lodwick-Madewell Grading System. Application of this system shows correlation of tumor grade with tumor biologic activity and with risk of malignancy: Grade I lesions are usually benign, grade II lesions carry moderate risk of malignancy, and grade III lesions possess a high likelihood of malignancy.

Skeletal Radiology

In 2019, Skeletal Radiology published a total of 253 articles including 111 scientific articles, ... more In 2019, Skeletal Radiology published a total of 253 articles including 111 scientific articles, 36 review articles, 51 case reports, 16 Test-Yourself cases, 15 technical reports, as well as multiple browser notes, meeting abstracts, and meeting summaries. As we have done previously, in this review, we will highlight those articles that stimulated the most interest from our readers, as measured by their downloads, and those that stimulated other researchers and authors, as measured by their citations. The manuscripts highlighted herein were chosen from this list.

Journal of the American College of Radiology

Shoulder pain is one of the most common reasons for musculoskeletal-related physician visits. Ima... more Shoulder pain is one of the most common reasons for musculoskeletal-related physician visits. Imaging plays an important role in identifying the specific cause of atraumatic shoulder pain. This review is divided into two parts. The first part provides a general discussion of various imaging modalities (radiographs, arthrography, nuclear medicine, ultrasound, CT, and MRI) and their usefulness in evaluating atraumatic shoulder pain. The second part focuses on the most appropriate imaging algorithms for specific shoulder conditions including: rotator cuff disorders, labral tear/instability, bursitis, adhesive capsulitis, biceps tendon abnormalities, postoperative rotator cuff tears, and neurogenic pain. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

AJR. American journal of roentgenology, 2018

The purpose of this article is to assist radiologists in developing an organized, systematic appr... more The purpose of this article is to assist radiologists in developing an organized, systematic approach to imaging interpretation in the care of patients who have been surgically treated for sarcoma. Postoperative imaging interpretation of sarcoma can be complex and requires an organized, systematic approach that includes review of the patient's clinical and surgical history and pretreatment images to gain context for differentiating recurrence from time-dependent posttreatment changes.

Journal of the American College of Radiology : JACR, 2018

Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic... more Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic. This pain may be the result of either fracture (the clavicle, scapula, or proximal humerus) or soft-tissue injury (most commonly of the rotator cuff, acromioclavicular ligaments, or labroligamentous complex). Imaging assessment of traumatic shoulder pain begins with conventional radiography and, depending on physical examination findings, will require MRI or MR arthrography for assessment of soft-tissue injuries and CT for delineation of fracture planes. Ultrasound excels in assessment of rotator cuff injuries but has limited usefulness for assessment of the deep soft-tissues. CT angiography and conventional arteriography are helpful for assessment of vascular injury, and bone scintigraphy can be used in assessment of complex regional pain syndrome after traumatic shoulder injury. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clin...

Journal of the American College of Radiology : JACR, 2018

Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, rega... more Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, regardless of the suspected diagnosis. When radiographs are normal or equivocal, advanced imaging with MRI (without or without intravenous contrast or following arthrography), CT (usually without contrast), and ultrasound each has a role in establishing a diagnosis. Furthermore, these examinations may contribute to staging disease, treatment planning, and prognostication, even when radiographs are diagnostic of a specific condition. Which examination or examinations are best depends on the specific location of pain and the clinically suspected conditions. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-e...

Skeletal radiology, Jan 22, 2017

Journal of the American College of Radiology : JACR, 2017

Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the U... more Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revi...

Topics in Magnetic Resonance Imaging

Journal of the American College of Radiology : JACR, 2017

Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue... more Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. MRI with contrast is the examination of choice for the evaluation of suspected osteomyelitis, and MRI, CT, and ultrasound can all be useful in the diagnosis of soft tissue infection. CT or a labeled leukocyte scan and sulfur colloid marrow scan combination are alternative options if MRI is contraindicated or extensive artifact from metal is present. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision i...

Journal of the American College of Radiology : JACR, 2017

Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR... more Chronic hip pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic hip pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where e...

The Journal of arthroplasty, Jul 10, 2017

A standing anteroposterior (AP) radiograph is commonly used to evaluate coronal alignment followi... more A standing anteroposterior (AP) radiograph is commonly used to evaluate coronal alignment following total knee arthroplasty (TKA). The impact of coronal alignment on TKA outcomes is controversial, perhaps due to variability in imaging and/or measurement technique. We sought to quantify the effect of image rotation and tibial slope on coronal alignment. Using a standard extramedullary tibial alignment guide, 3 cadaver legs were cut to accept a tibial tray at 0°, 3°, and 7° of slope. A computed tomography scan of the entire tibia was obtained for each specimen to confirm neutral coronal alignment. Images were then obtained at progressive 10° intervals of internal and external rotation up to 40° maximum in each direction. Images were then randomized and 5 blinded TKA surgeons were asked to determine coronal alignment. Continuous data values were transformed to categorical data (neutral [0], valgus [L], and varus [R]). Each 10° interval of external rotation of a 7° sloped tibial cut (or...

RadioGraphics, 2016

■ Describe the objectives of musculoskeletal tumor imaging. ■ Identify the appropriate MR imaging... more ■ Describe the objectives of musculoskeletal tumor imaging. ■ Identify the appropriate MR imaging sequences for assessment of musculoskeletal masses to meet the objectives of tumor imaging. ■ Discuss the optimal uses of CT and US in evaluation of musculoskeletal masses.

Radiologic Clinics of North America, 2016

Primary lymphoma of bone and soft tissue is rare and almost invariably of B-cell origin. Osseous ... more Primary lymphoma of bone and soft tissue is rare and almost invariably of B-cell origin. Osseous lymphoma usually reveals aggressive bone destruction and associated soft tissue extension. Soft tissue involvement is optimally depicted by MR imaging. Cortical destruction allowing communication between the intraosseous and soft tissue components may be subtle with small striations of extension. Lymphoma of the deep soft tissues usually reveals long cones of intramuscular or intermuscular tumor again best depicted by MR imaging. Cutaneous or subcutaneous lymphoma demonstrates multiple nodules and plaquelike thickening.

International journal of surgery case reports, Jan 25, 2016

Hemophilic pseudotumor is a rare but well documented complication seen in approximately 1-2% of p... more Hemophilic pseudotumor is a rare but well documented complication seen in approximately 1-2% of patients with hemophilia. The incidence continues to decrease, likely because of increasingly sophisticated techniques in managing factor deficiency. We present a case of hemophilic pseudotumor in a patient without hemophilia, an exceptionally rare entity, and outline a hybrid approach to treatment. The patient presented with a left sided iliopsoas mass and associated radiculopathy, with a history of a poorly characterized bleeding diathesis and Noonan's syndrome. He had no history of trauma and was not being treated with anti-coagulation. Of note, factors VIII, IX and XI were normal. An open biopsy was consistent with hemophilic pseudotumor. The patient underwent a hybrid procedure of preoperative embolization of the left internal iliac and left deep circumflex arteries followed by surgical debridement and resection, with an excellent outcome. Hemophilic pseudotumor is rarely seen in...

Skeletal Radiology, Feb 1, 1988

This study reviews 16 cases of chondroblastoma of the patella which constitute nearly 6% of a lar... more This study reviews 16 cases of chondroblastoma of the patella which constitute nearly 6% of a large group of chondroblastomas scattered throughout the skeleton. Both radiologic and histologic appearances of chondroblastomas of the patella are indistinguishable from those of chondroblastomas arising in other sites. A reasonable differential diagnosis, including chondromalacia patella, is discussed together with important therapeutic considerations.

American Journal of Roentgenology, 2016

Lodwick's well-established grading system of lytic bone lesions has been widely u... more Lodwick's well-established grading system of lytic bone lesions has been widely used in predicting growth rate for lytic bone lesions. We applied a Modified Lodwick-Madewell Grading System as an alternative means to categorize lytic bone tumors into those with low, moderate, and high risks of malignancy. A retrospective review of the radiographs of 183 bone lesions was performed. Cases were selected to include a broad range of benign and malignant tumors. Readers applied our Modified Lodwick-Madewell Grading System, and consensus was reached in all cases. This modified system consists of grade I, which is composed of grades IA and IB as listed in the Lodwick system; grade II, which is grade IC in the Lodwick system; and grade III, which is composed of IIIA (changing margination), IIB (moth-eaten and permeative patterns), and IIIC (radiographically occult). Grading was correlated with the final diagnosis. Of the 183 tumors, 81 were classified as grade I, 54 as grade II, and 48 as grade III. When correlating grade with pathology, we found that 76 of 81 (94%) grade I lesions were benign and 39 of 48 grade III lesions (81%) were malignant. A nearly equal number of grade II lesions proved to be benign (29/54; 54%) and malignant (28/54; 53%). By expanding Lodwick's grading system to include two additional patterns of disease described by Madewell and colleagues (changing margination and radiographically occult) and by reclassifying them into three distinct grades, we propose a modified system-the Modified Lodwick-Madewell Grading System. Application of this system shows correlation of tumor grade with tumor biologic activity and with risk of malignancy: Grade I lesions are usually benign, grade II lesions carry moderate risk of malignancy, and grade III lesions possess a high likelihood of malignancy.