Michael Zlatkin - Academia.edu (original) (raw)

Papers by Michael Zlatkin

American Journal of Roentgenology, Jul 1, 1991

The components of the intervertebral disk serve two purposes. The hydrophilic matrix is contained... more The components of the intervertebral disk serve two purposes. The hydrophilic matrix is contained by circumferential rings of fibrocartilage (outer anulus) and Sharpey's fibers. The gellike hydrophilic matrix acts as a cushion between the vertebral body endplates by providing an even distribution of axial and rotational compressive forces. The construction and integrity of the intervertebral disk are assessed

Radiologic Clinics of North America, Mar 1, 2013

The shoulder is inherently unstable and subject to injury. The labrum is one component of the sho... more The shoulder is inherently unstable and subject to injury. The labrum is one component of the shoulder mechanism that functions in preserving joint stability; it is also often a part of the pathologic lesions associated with instability, and isolated tears of the labrum associated with shoulder pain and dysfunction. Tears of the labrum are generally classified as anterior, posterior, inferior, and superior. The location and severity of the tear generally dictates clinical management, which may range from medical management to arthroscopic debridement and labral repair. In the more severe cases, a shoulder stabilization procedure may be needed.

Radiologic Clinics of North America, Mar 1, 1990

After reading this article, the radiologist should be able to discuss MR imaging technique for im... more After reading this article, the radiologist should be able to discuss MR imaging technique for imaging the shoulder, the appearance of the shoulder on MR imaging, and common pathology of the painful shoulder.

Magnetic Resonance Imaging Clinics of North America, May 1, 2004

Imaging of the wrist with MR imaging can be difficult because of the small size of this joint, it... more Imaging of the wrist with MR imaging can be difficult because of the small size of this joint, its complex anatomy, and its sometimes poorly understood pathologic lesions. A recent study by Hobby and coworkers [1] of 98 patients revealed that MR imaging of the wrist influences clinicians' diagnoses and management plans in most patients. This article summarizes the current diagnostic criteria that can be useful in interpreting abnormalities of the wrist ligaments and triangular fibrocartilage complex (TFCC) of the wrist in this difficult topic in joint MR imaging. Anatomy Ligamentous anatomy The carpal ligaments may be classified as either extrinsic or intrinsic. The extrinsic ligaments link the carpal bones to the radius and ulna. The intrinsic or intercarpal ligaments connect the individual carpal bones.

PubMed, Jun 1, 1992

Magnetic resonance (MR) imaging has developed rapidly as a diagnostic tool in the evaluation of t... more Magnetic resonance (MR) imaging has developed rapidly as a diagnostic tool in the evaluation of the wrist. In this article, the authors review simple high-resolution technique and appropriate surface coils to aid in wrist evaluation. Evaluation of the wrist is facilitated by an understanding of the anatomy of the carpal ligaments, the triangular fibrocartilage, and the carpal tunnel, and the anatomic features of the distal radioulnar joint. Triangular fibrocartilage tears, which represent an important cause of ulnar wrist pain, are well evaluated on MR. These appear as a linear band of increased signal on the short repetition time/echo time (TR/TE), proton density weighted spin echo, or gradient echo images. True tears should be differentiated from degenerative changes, which do not demonstrate increase in signal on T2 or T2* weighted images. With good technique, accuracies approaching 90% have been reported. MR is also useful in evaluating injuries of the interosseous ligaments and volar and dorsal radiocarpal ligaments and distal radioulnar joint instability. MR also has a role in evaluating the carpal tunnel syndrome. This is especially true with patients for whom symptoms suggest the diagnosis of carpal tunnel syndrome but for whom few objective findings exist. Findings suggestive of carpal tunnel syndrome include diffuse swelling of the median nerve, flattening of the median nerve at the level of the hamate, and increased signal of the median nerve on the long TR/TE images. MR is also indicated in avascular necrosis of the carpal bones and occult carpal fractures. MR is useful in evaluating bone tumors, particularly with regard to their extent. With the advent of more rapid scanning techniques, kinematic studies are feasible. For these, fast gradient echo techniques are employed and serial images are acquired during radial and ulnar deviation. These images may be helpful in observing integrity of intercarpal ligaments and evaluating dynamic instability. With proper attention to technique, and an understanding of wrist pathophysiology, MR is a valuable diagnostic tool.

American Journal of Roentgenology, Jun 1, 1985

Soft-tissue chondromas are benign, relatively rare lesions. The clinicopathologic and radiologic ... more Soft-tissue chondromas are benign, relatively rare lesions. The clinicopathologic and radiologic features in six cases are presented and the literature is reviewed. Five of six cases had calcifications. Peripheral curvilinear calcification was seen in two cases, multiple nnglike areas characteristic of cartilage in one, and discrete

Journal of Bone and Joint Surgery, American Volume, 1991

The sensitivity, specificity, and predictive value of magnetic resonance imaging in the diagnosis... more The sensitivity, specificity, and predictive value of magnetic resonance imaging in the diagnosis of lesions of the rotator cuff, glenohumeral capsule, and glenoid labrum were evaluated in ninety-one patients and fifteen asymptomatic volunteers. Magnetic resonance imaging demonstrated 100 per cent sensitivity and 95 per cent specificity in the diagnosis of complete tears, and it consistently predicted the size of the tear of the rotator cuff. There was a definite correlation between atrophy of the supraspinatus muscle and the size of a complete, chronic tear of the rotator cuff. The sensitivity and specificity of magnetic resonance imaging in the differentiation of tendinitis from degeneration of the cuff were 82 and 85 per cent, and in the differentiation of a normal tendon from one affected by tendinitis with signs of impingement the sensitivity and specificity were 93 and 87 per cent. The formation of spurs around the acromion and acromiocalvicular joint correlated highly with increased age of the patient and with chronic disease of the rotator cuff. The sensitivity and specificity of magnetic resonance imaging in the diagnosis of labral tears associated with glenohumeral instability were 88 and 93 per cent. The study showed that high-resolution magnetic-resonance imaging is an excellent non-invasive tool in the diagnosis of lesions of the rotator cuff and glenohumeral instability.

Radiologic Clinics of North America, Nov 1, 1987

Magnetic resonance proton imaging (MRI) of tumors provides excellent anatomic detail by defining ... more Magnetic resonance proton imaging (MRI) of tumors provides excellent anatomic detail by defining the size, location and shape of the tumor in relationship to surrounding organs, muscle compartments, fascial planes, bone and neurovascular structures. The signal intensity on MRI depends on the biophysical properties of tissues such as proton density and the intrinsic relaxation times of the protons being imaged (T1 and T2 values). Variations in these parameters provide excellent contrast between normal and pathological tissue even when there is no difference in x-ray absorption. MRI permits the identification of necrosis, edema, hemorrhage, cystic degeneration and fibrosis providing more useful information relating to tumor staging as compared with other imaging techniques. These capabilities may lead to improved surgical management of soft tissue masses (1). Recent studies (2–5) indicate that MRI is superior to computerized tomography in the assessment of soft tissue masses.

Clinical topics in infectious disease, 1988

The radiologist is often called upon to make an early diagnosis of skeletal infection if there is... more The radiologist is often called upon to make an early diagnosis of skeletal infection if there is clinical suspicion of such a process. Early diagnosis is essential to the institution of proper medical management. Methods useful in the diagnosis of skeletal infection include conventional radiography, magnification radiography, and skeletal scintigraphy. Computed tomography and magnetic resonance imaging have also recently been found useful in the evaluation of musculoskeletal infection.

Magnetic Resonance Imaging Clinics of North America, Feb 1, 1999

Technical advances in MR imaging of sports-related bone and joint derangement have improved our a... more Technical advances in MR imaging of sports-related bone and joint derangement have improved our ability to evaluate these problems. This article discusses current utilization of MR imaging, advances in local coils, pulse sequences and parameters, and reviews current aspects and indications for MR arthrography.

Spine, Jan 12, 2015

Study Design. Cross-sectional studyObjective. The purpose of this study was to determine the prev... more Study Design. Cross-sectional studyObjective. The purpose of this study was to determine the prevalence and distribution of abnormal findings on cervical spine magnetic resonance image (MRI).Summary of Background Data. Neurological symptoms and abnormal findings on MRI are keys to diagnose the spinal diseases. To determine the significance of MRI abnormalities, we must take into account the 1) frequency and 2) spectrum of structural abnormalities, which may be asymptomatic. However, no large-scale study has documented abnormal findings of the cervical spine on MRI in asymptomatic subjects.Methods. MRIs were analyzed for the anteroposterior spinal cord diameter, disc bulging diameter, and axial cross-sectional area of the spinal cord in 1,211 healthy volunteers. The age of healthy volunteers prospectively enrolled in this study ranged from 20 to 70, with approximately 100 individuals per decade, per gender. These data were used to determine the spectrum and degree of disc bulging, sp...

Topics in Magnetic Resonance Imaging, Jun 1, 1989

Radiologic Clinics of North America

In this article, the numerous proven applications of diagnostic ultrasound to the assessment of d... more In this article, the numerous proven applications of diagnostic ultrasound to the assessment of disease processes affecting the popliteal fossa and lower extremities have been discussed. Popliteal cysts and aneurysms, hematomas, cellulitis, abscesses, soft tissue neoplasms, and other space-occupying fluid collections are readily identified using this technique. In addition, post-traumatic and inflammatory disorders affecting tendons, synovial thickening and effusion, derangement of articular cartilage, meniscal tears, and alterations in soft tissue thickness as well as foreign bodies are amenable to detection by sonography. With future technologic improvements in transducer design and computerized image reconstruction, diagnostic capabilities of this method in the lower extremities should continue to expand.

Skeletal Radiology, 2006

s of the Society of Skeletal Radiology 29th Annual Meeting, Tucson, Arizona, 4-8 March 2006 7:00 ... more s of the Society of Skeletal Radiology 29th Annual Meeting, Tucson, Arizona, 4-8 March 2006 7:00 a.m. – 8:00 a.m. Continental Breakfast 8:00 a.m. – 9:00 a.m. SSR Business Meeting 7:00 p.m. – 4:00 p.m. Registration 7:00 a.m. – 4:00 p.m. Exhibit Hall Open 9:00 A.M. – 10:00 A.M. SCIENTIFIC SESSION I: MISCELLANEOUS TOPICS Moderator: Catherine Roberts, MD 9:00 a.m. – 9:20 a.m. PRELIMINARY MRI FINDINGS IN THE CERVICAL SPINE AFTER

American Journal of Roentgenology, 1996

American Journal of Roentgenology, 2010

The purpose of this study was to assess the diagnostic correlation between indirect MR arthrograp... more The purpose of this study was to assess the diagnostic correlation between indirect MR arthrography, conventional MRI, and arthroscopy in acetabular labral and cartilage lesions of the hip. Fourteen patients who underwent conventional and indirect MR arthrography with arthroscopic correlation were studied over the course of 18 months. MR studies were performed on a 1.5-T magnet. Sequences consisted of unilateral sagittal turbo spin-echo proton density fat-suppressed, axial turbo spin-echo T2 fat-saturated, and coronal turbo spin-echo proton density fat-saturated images. Whole-pelvis coronal T1 and STIR sequences were also performed. Patients received IV gadolinium contrast material and exercised for 15 minutes. Gadolinium-enhanced fat-saturated T1 sequences were obtained in three planes. Arthroscopy was performed by two orthopedic surgeons who specialize in treating hip disorders. Cases were then retrospectively reviewed by two experienced musculoskeletal radiologists who were blinded to the arthroscopic findings. Cases were examined for acetabular labral tears and chondral lesions. Extraarticular findings of femoral acetabular impingement were recorded. Unenhanced and gadolinium-enhanced images of the labrum were compared for differences and changes in diagnosis. Comparison was made between the arthroscopic and MR findings for analysis of the results. Of the 13 labral tears found at arthroscopy, 85% were detected by conventional MRI, whereas 100% were identified via indirect MR arthrography. Seventy percent of the labral tears identified on conventional MRI were better delineated by indirect MR arthrography. Identification of chondral abnormalities was not improved via indirect MR arthrography over conventional MRI. IV contrast-enhanced indirect MR arthrography appears to be an effective means of hip evaluation for labral tears. It does not appear to improve detection of cartilage abnormalities when compared with conventional MRI.

American Journal of Roentgenology, 2007

The purpose of this report is to describe the clinical and imaging findings of chondrolysis of th... more The purpose of this report is to describe the clinical and imaging findings of chondrolysis of the glenohumeral joint. In the appropriate clinical setting, both radiographs and MR images of the shoulder can be used to establish the diagnosis of chondrolysis of the glenohumeral joint.