David J Wilson

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Verified

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• MBBS BSc MFSEM FRCP FRCR
• Member of Congregation at University of Oxford

Vertebroplasty is commonly used to treat painful, osteoporotic vertebral compression fractures. In this multicenter trial, we randomly assigned 131 patients who had one to three painful osteoporotic vertebral compression fractures to undergo either vertebroplasty or a simulated procedure without cement (control group). The primary outcomes were sco...

Objective To compare the outcome of nerve root injection guided by ultrasound/MRI fusion with radiofrequency needle tracking (eTRAX © ) and the same procedure undertaken by fluoroscopic guidance. Methods This is a retrospective audit of anonymised clinical records from before and after a change in the imaging technique used to perform nerve root b...

Objectives To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton’s neuroma) and provide clinical indications. Methods We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who revi...

Objectives Interventional procedures around the knee are widely adopted for treating different musculoskeletal conditions. A panel of experts from the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the existing literature to assess the evidence on image-guided musculoskeletal interve...

Objectives Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musc...

Objectives Image-guided musculoskeletal interventional procedures around the hip are widely used in daily clinical practice. The need for clarity concerning the actual added value of imaging guidance and types of medications to be offered led the Ultrasound and the Interventional Subcommittees of the European Society of Musculoskeletal Radiology (E...

Conventional radiographs and CT are primary investigations in spinal trauma. However MRI is the primary technique in the assessment of degenerative and inflammatory disorders. There are occasions when conventional radiographs, CT and bone scintigraphy assist in the diagnosis of degenerative and inflammatory disorders. A detailed understanding of an...

Background Although image-guided interventional procedures of the elbow and wrist are routinely performed, there is poor evidence in the literature concerning such treatments. Our aim was to perform a Delphi-based consensus on published evidence on image-guided interventional procedures around the elbow and wrist and provide clinical indications on...

Objectives: Ankle injuries are very common. In clinical practice the Ottawa foot and ankle rules are used to determine which patients should undergo conventional radiographic examination. Those who do not merit radiographic examination and those with no identifiable fracture on radiographs are managed as having a soft tissue injury. However, not a...

Background Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb bas...

Background Image-guided interventional procedures around the shoulder are commonly performed in clinical practice, although evidence regarding their effectiveness is scarce. We report the results of a Delphi method review of evidence on literature published on image-guided interventional procedures around the shoulder with a list of clinical indica...

Radiology has not been spared in recent economic crises with a substantial reduction in the turnover of imaging equipment. These problems are exacerbated by increasing demand for healthcare across Europe. Therefore, using existing radiological services while rigorously following evidence-based guidelines might improve patient care. Thus, diagnostic...

Osteoporosis is common throughout the world. Complications include fragility fractures. In this paper I will describe the condition as it relates to athletes young and old. It will be seen that osteoporosis may result from poorly managed sporting activities at the same time it may be ameliorated by exercise in those susceptible to the disorder. I w...

Objectives: To update the 2012 European Society of Musculoskeletal Radiology (ESSR) clinical consensus guidelines for musculoskeletal ultrasound referral in Europe. Methods: Twenty-one musculoskeletal imaging experts from the ESSR participated in a consensus study based on a Delphic process. Two independent (non-voting) authors facilitated the p...

Background Low back pain is common and relates to a variety of overlapping pathologies. Imaging of the spine has a high priority in the assessment of patients with low back pain. However, studies have shown that clinicians vary widely in how frequently they obtain imaging tests for assessment of low back pain. Technical advances in the field of lum...

Background: Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian C-spine Rule (CCR)....

Background: Sprained ankles are common, and when there are no signs or evidence of a fracture conventional management is conservative. At present, there are no clinical markers to identify those that may develop persisting instability and disability that would require rehabilitation or surgery. Objective: To investigate the nature and extent of...

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Objectives: To assess the prevalence of injury of the talonavicular ligament (TNL) in ankle sprains, its anatomy and the stability of the talonavicular joint (TNJ) before and after dividing the TNL in a cadaver. Methods: During a prospective study of 100 patients to assess the outcome of ankle injuries we noted high incidence of TNL injuries: we...

Rowing and sculling are increasingly popular sports with active participation from the early teens to the 90s for both genders. An understanding of the mechanisms of injuries with their imaging appearances occurring while training for competitive and recreation of rowing is important to coaches, radiologists, and sports medicine professionals. This...

This is the protocol for a review and there is no abstract. The objectives are as follows: This review aims to determine the diagnostic accuracy of the NEXUS criteria and the Canadian C-spine rule in a pediatric population evaluated for CSI following blunt trauma.

Injuries of the foot are less common than those to the ankle. Stress or insufficiency fractures are a particular feature and are best excluded using MR with water-sensitive fat-suppressed sequences. Foot deformity may lead to metatarsalgia and Morton’s neuroma. These lesions will be detected and can be partially treated using ultrasound. Both ultra...

Ankle sprains are common, but fortunately, the symptoms often resolve spontaneously. Many clinicians use the Ottawa rules to determine who should undergo radiographic examination to detect fracture. However, radiographs alone may overlook occult and sometimes highly significant fractures. In problem cases especially where there is persisting pain o...

Percutaneous vertebroplasty (PVP) is a minimally invasive surgical procedure in which bone cement is injected into a fractured vertebra. Percutaneous balloon kyphoplasty (BKP) is a variation of this approach, in which an inflatable balloon tamp is placed in the collapsed vertebra prior to cement injection. To systematically evaluate and appraise th...

Objectives: Coblation to create a cavity in the affected vertebral body was performed for complex fractures and/or when there was a posterior wall defect. This permitted a low-pressure injection and potentially reduces the risk of extravasation of cement into the spinal canal. Methods: Prospective audit for outcome measures and complications all...

Ultrasound elastography (EUS) is a method to assess the mechanical properties of tissue, by applying stress and detecting tissue displacement using ultrasound. There are several EUS techniques used in clinical practice; strain (compression) EUS is the most common technique that allows real-time visualisation of the elastographic map on the screen....

Ultrasound is a powerful screening examination for athletes with upper limb injuries. It is very effective in demonstrating injuries to muscle, tendon, ligament, and nerves. The technique is particularly useful in excluding joint effusion and in detecting soft tissue foreign bodies. Dynamic ultrasound examination is especially useful in detecting s...

To develop clinical guidelines for musculoskeletal ultrasound (MSKUS) referral in Europe. Sixteen musculoskeletal radiologists from seven European countries participated in a consensus-based interactive process (Delphi method) using consecutive questionnaires and consensus procedure meetings at several European radiology meetings. The evaluation of...

Most patients with symptoms related to the carpal tunnel have idiopathic median nerve compression. Imaging has little role in the care of most cases because steroid injection, therapeutic ultrasound, and surgery have established roles. However, cases with atypical presentation, mass lesions, synovitis, or failed carpal tunnel surgery will benefit f...

Keywords Hodgkins disease.Osteoartropathy.Radiographs.CTThere is periosteal reaction along the shaft of the longbones of the hand and foot, leading to the diagnosis ofhypertrophic osteoarthropathy (HPOA), associated withintrathoracic Hodgkin’s disease.DiscussionHypertrophic osteoarthropathy in children is rare and istypically considered to be a sig...

On the basis of current evidence, cannot be recommended as the first line treatment

Recent publications compared treatment of vertebral fractures reporting improvement in the majority but with no significant difference between the local anaesthetic and vertebroplasty groups. Potential explanations include placebo response or therapeutic response to the "control procedure". We investigated whether preliminary facet joint injection...

Ultrasound does not use radiation and does not need sedation, and so is the best way of imaging children when practical. Ultrasound has superb line pair resolution and therefore can look at the soft tissues in great detail and assess tendon muscle and ligament injury. Ultrasound has a long learning curve and the operator must be familiar with child...

PURPOSE To assess the subsequent fracture rate at 12 months in patients from the INVEST randomized trial of vertebroplasty for osteoporotic spinal fractures. METHOD AND MATERIALS In this preliminary analysis we reviewed available radiographs from 12 month follow-up visits of patients randomly assigned to undergo either vertebroplasty or a control...

To investigate the feasibility and reproducibility of real-time freehand ultrasound elastography (RTE) of the normal Achilles tendon and to describe its elastographic appearances. Fifty normal Achilles tendons were prospectively examined using RTE performed by tissue compression using the hand-held transducer. The information was colour-coded (red=...

Diagnostic and therapeutic imaging of children poses particular challenges. First it is vital to limit the radiation dose. The younger the child, the more radiosensitive the bone marrow and the greater the potential harm. In addition children have to be persuaded to cooperate to obtain adequate imaging studies and particular radiographic skills are...

The objective was to evaluate the findings and diagnostic accuracy of ultrasound in antero-lateral ankle impingement (ALI) with clinical and arthroscopic correlation. Seventeen elite footballers with chronic ankle pain were referred for ultrasound with a clinical diagnosis of ALI (n = 8) or a control condition (n = 9; lateral mechanical instability...

This article will discuss the aspects of sports medicine where ultrasound imaging has advantages when compared to MRI looking at the strengths and weaknesses of ultrasound in the context of diagnosis and management. It will also assess the use of ultrasound in therapy including guided injections and current thoughts on novel forms of treatment. We...

Ultrasound and MRI now provide us with tools to assess and quantify the nature of tendon and ligament disease around the ankle. They are playing an increasing role in prognosis, management and treatment for those patients with ankle injuries.

ination. Blood tests should be routinely obtained, including a full blood count, erythrocyte sedimentation rate (ESR) and/or C-reactive protein and blood cultures. Imaging should begin with a plain AP radiograph of the pelvis, with frog leg views in children at risk of SUFE, followed by an ultrasound examination. The plain radiograph is obtained to...

The sport of rowing has gained considerable momentum in recent years. It appeals to many age groups and is an endurance activity with no sudden accelerations or ballistic impact forces. It is associated with several injuries that are so typical that they are easily recognized by the enthusiast and in many cases do not require imaging. These include...

Ultrasound examination is often the most effective and sometimes the only practical means of examining children with soft tissue, tendon and joint diseases. This review will cover the important application of diagnostic ultrasound in children musculoskeletal disorders. We will consider topics where ultrasound is the only sensible means of examinati...

Ultrasound examination is often the most effective and sometimes the only practical means of examining children with soft tissue, tendon and joint diseases. This review will cover the important application of diagnostic ultrasound in children musculoskeletal disorders. We will consider topics where ultrasound is the only sensible means of examinati...

Radiopharmaceutical agents are used for a variety of diagnostic purposes; their application to musculoskeletal imaging provides a powerful diagnostic tool for the detection and analysis of abnormal bone metabolism.

Ultrasound is the investigation of choice for imaging soft tissue disease, offering resolution significantly greater than CT or MRI. It is low cost and readily accessible allowing dynamic imaging which is particularly useful for assessing musculoskeletal abnormalities. It also allows real-time image-guided interventional. procedures including biops...

There has long been interest in the use of imaging to assess the carpal tunnel in patients with suspected median nerve compression. I was first drawn to this subject in the early 1980s by an article on the use of computed tomography (CT) in this context. 1 Around the same time we were starting to use ultrasound in the musculoskeletal system and it...

In comparison to adults, the skeleton of the neonate has a higher ratio of cartilage to bone, making it well suited to examination by ultrasound. Cartilage can be easily distinguished from soft tissue, thus offering a substantial advantage over the plain radiograph. Furthermore, using ultrasound as the primary investigation avoids exposure to ionis...

Soft tissue infection may be acute or chronic and may be introduced by the haematogenous route, or by inoculation, including surgical infection, or spread from other areas. The spectrum of infecting organism differs in primary infection, in immunodeficiency or when foreign bodies, including prostheses, are present. Bacterial infections are usually...

Osteocartilaginous metaplasia is known to occur rarely in melanomas, particularly in subungual melanomas. We present a case of a calcified subungual soft tissue tumour in which biopsy of the lesion showed malignant round and spindle-shaped tumour cells, many of which were associated with the formation of cartilage and osteoid-like material. Subsequ...

• Ultrasound is an important tool in the detection and management of developmental dysplasia of the hip. • Universal screening for developmental dysplasia of the hip by ultrasound may be wise but there is currently insufficient evidence to clearly recommend this a national policy. • A painful hip in childhood is a clinical emergency. • Ultrasound i...

This article assessed anesthetists' ability to identify correctly a marked lumbar interspace in 100 patients undergoing spinal magnetic resonance imaging scans. Using ink, the first anesthetist marked an interspace on the lower spine and attempted to identify its level with the patient in the sitting position. The second anesthetist attempted to id...

We report our experience with the first 1000 patients with non-traumatic low back pain (LBP) without radiculopathy undergoing limited sequence magnetic resonance imaging (MRI) instead of plain radiography. Between January 1996 and December 1998, 1042 patients with low back pain unresponsive to conservative treatment were examined using a limited MR...

Ultrasound of the shoulder is a powerful and accurate method for the examination of the rotator cuff, biceps mechanism and the synovium. This article describes the anatomy, standard examination technique, indications, pitfalls and potential errors. It lists suggested imaging algorithms for a range of shoulder pathology.

To assess the impact and cost effectiveness of a system of radiological review of accident and emergency (A&E) plain films. Review documentation was studied retrospectively over a 1-year period. Six hundred and eighty-four actual or suspected errors in the initial radiological interpretation by A&E staff were highlighted by radiologists in training...

Anaesthetists' ability to identify correctly a marked lumbar interspace was assessed in 100 patients undergoing spinal magnetic resonance imaging scans. Using ink, one anaesthetist marked an interspace on the lower spine and attempted to identify its level with the patient in the sitting position. A second anaesthetist attempted to identify the lev...

To determine whether it was possible using magnetic resonance imaging (MRI) to define the pattern of muscle recruitment in a specific sport (rowing) and to see whether there were differences in this pattern between athletes of different experience. It has been shown that during vigorous exercise the water content of muscle increases transiently. Th...

Diagnostic ultrasound is an invaluable technique in the management of a variety of skeletal disorders. Technical innovations such as colour-flow Doppler, 3-D surface reconstruction and ultrasound contrast agents have introduced new areas of practice and the quality of the images has continued to improve. These developments have led to better unders...

To compare the outcome of hip therapy with the response to local anaesthetic into the hip. A retrospective hip arthrographic study of 60 patients complaining of hip pain was performed. The average age of the patients was 58 +/- 20 years with ratio of men to women of 11:19. Thirty-eight of these patients underwent local anaesthetic intracapsular inj...

Fourteen cases of peripheral nerve tumour which had been examined by MRI were reviewed. T1-weighted images showed the tumours to be of intermediate signal and T2-weighted images showed a high signal with some heterogeneity. These appearances are not specific to peripheral nerve tumours, although the diagnosis may be suggested if the lesion arises f...

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Ultrasound has become a routine investigation in the investigation of the painful hip in children. It has been recommended that all effusions demonstrated by sonography be drained. Based on the experience of 800 hip aspirations, the authors describe an approach to the demonstration and aspiration of hip effusions with some of the pitfalls that resu...

Suprascapular nerve block is used with increasing frequency by anaesthetists and rheumatologists in the management of shoulder pain from a variety of disorders. In the classical technique, the needle is introduced into the supraspinous fossa perpendicular to the blade of the scapula and then is moved to enter the scapular notch, with the risk of pn...

We made a prospective study of 58 patients with suspected internal derangement of the knee. They were examined by magnetic resonance imaging using 3-D gradient echo intermediate-weighted studies before having an arthroscopy. The preoperative clinical assessment was found to have a diagnostic sensitivity of 77% and a specificity of 43%, compared wit...

We made a prospective study of 58 patients with suspected internal derangement of the knee. They were examined by magnetic resonance imaging using 3-D gradient echo intermediate-weighted studies before having an arthroscopy. The preoperative clinical assessment was found to have a diagnostic sensitivity of 77% and a specificity of 43%, compared wit...