AIIMS-MAMC-PGI IMAGING SERIES: DIAGNOSTIC RADIOLOGY Musculoskeletal and Breast Imaging
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AIIMS-MAMC-PGI IMAGING SERIES: DIAGNOSTIC RADIOLOGY Musculoskeletal and Breast Imaging
Fourth Edition
Editors Manavjit Singh Sandhu MD FICR
Professor and Head Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research Chandigarh, India
Arun Kumar Gupta MD FAMS
Professor and Head Department of Radiodiagnosis All India Institute of Medical Sciences New Delhi, India
Anju Garg MD
Director-Professor and Head Department of Radiodiagnosis Maulana Azad Medical College New Delhi, India
Associate Editors
Mahesh Prakash MD MAMS FIACM FICR
Professor Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research Chandigarh, India
Anindita Sinha MD MAMS
Additional Professor Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research Chandigarh, India
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Diagnostic Radiology: Musculoskeletal and Breast Imaging
First Edition: 1998
Second Edition: 2005
Reprint Edition: 2011 Third Edition: 2012
Fourth Edition: 2021
9789390020553
Printed at
- Ajay Kumar MD Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Akshay Saxena MD DNB FICR Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Alpana Manchanda MD Director-Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Anindita Sinha MD MAMS
- Additional Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Anjali Prakash DMRD DNB MNAMS
- Director-Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Anju Garg MD
- Director-Professor and Head
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Ankur Goyal MD DNB MNAMS
- Associate Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Arun Kumar Gupta MD FAMS
- Professor and Head
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Ashu Seith Bhalla MD MAMS FICR
- Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Atin Kumar MD DNB MNAMS FICR
- Professor
- Department of Radiodiagnosis
- (Trauma Center Division)
- All India Institute of Medical Sciences
- New Delhi, India
- Chirag Kamal Ahuja MD DM
- Associate Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Deep Narayan Srivastava
- MD MBA FAMS FICR
- Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Devasenathipathy Kandasamy
- MD DNB FRCR
- Additional Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Ekta Dhamija MD
- Associate Professor
- Department of Radiodiagnosis
- (BRA IRCH Division)
- All India Institute of Medical Sciences
- New Delhi, India
- Gaurav Shanker Pradhan
- MBBS DMRD DNB
- Director-Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Gita Devi MD DNB
- Assistant Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Harish Bhujade
- MD Fellowship (Interventional Radiology)
- Assistant Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Jyoti Kumar MD DNB MNAMS FICR
- Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Kushaljit Singh Sodhi
- MD PhD MAMS FICR
- Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Madhavi Tripathi
- MD DNB (Nuclear Medicine)
- Additional Professor
- Department of Nuclear
- Medicine and PET
- All India Institute of Medical Sciences
- New Delhi, India
- Madhusudhan KS MD MAMS FRCR
- Additional Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Mahesh Prakash MD MAMS FIACM FICR
- Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Manavjit Singh Sandhu MD FICR
- Professor and Head
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Mandeep Kang MD MAMS FICR
- Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Manisha Jana MD DNB FRCR
- Additional Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Manphool Singhal MD DNB MAMS
- Additional Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Mukesh Kumar Yadav
- (MD Radiodiagnosis)
- Formerly Associate Professor
- PGIMER, Chandigarh
- Associate Professor
- Department of Radiodiagnosis
- All India Institute of Medical
- Sciences (IRCH)
- New Delhi, India
- Nidhi Prabhakar MD DNB
- Senior Research Associate
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Paramjeet Singh MD
- Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Priyanka Naranje MD DNB MNAMS
- Associate Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Radhika Batra MD DNB
- Assistant Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Raju Sharma MD MAMS FICR
- Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Rakesh Kumar DRM DNB PhD
- Professor and Head
- Diagnostic Nuclear Medicine Division
- Department of Nuclear Medicine and PET
- All India Institute of Medical Sciences
- New Delhi, India
- Rashmi Dixit MD
- Director-Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Sameer Vyas MD DM
- Additional Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Sapna Singh MD DNB MNAMS
- Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Shamim Ahmed Shamim
- MD (Nuclear Medicine)
- Associate Professor
- Department of Nuclear Medicine
- All India Institute of Medical Sciences
- New Delhi, India
- Shivanand Gamanagatti
- MD MAMS FICR
- Professor
- Department of Radiodiagnosis
- (Trauma Center Division)
- All India Institute of Medical Sciences
- New Delhi, India
- Smita Manchanda MD DNB
- Associate Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Smriti Hari MD MAMS
- Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Surabhi Vyas MD DNB MNAMS
- Additional Professor
- Department of Radiodiagnosis
- All India Institute of Medical Sciences
- New Delhi, India
- Swati Gupta MD DNB FRCR
- Assistant Professor
- Department of Radiodiagnosis
- Maulana Azad Medical College
- New Delhi, India
- Tulika Singh MD
- Additional Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Ujjwal Gorsi (MD Radiodiagnosis)
- Associate Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Uma Debi MD
- Associate Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Veenu Singla MD
- Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
- Vikas Bhatia MD DM
- Assistant Professor
- Department of Radiodiagnosis
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh, India
The scope and use of various imaging modalities in musculoskeletal radiology and breast imaging has increased manifold since the publication of the third edition of this book. While radiographs remain the cornerstone of diagnosis of musculoskeletal lesions, this edition also highlights the basics and advances in cross-sectional imaging with special emphasis and coverage of imaging with MRI.
The first edition of Musculoskeletal and Breast Imaging was published in 1998; the second edition in 2005; followed by the third edition in 2012.
The present edition has incorporated 4 new chapters in the musculoskeletal subsections and 2 new chapters in the breast subsection. The content has been divided into 7 different subsections, beginning with current concepts and interventions. The first section deals with all imaging modalities in musculoskeletal imaging. There is an updated section on MR imaging, including new additions of imaging of wrist and ankle; peripheral nerve imaging and imaging of prosthetic joints. All chapters have been thoroughly revised.
The second part of the book contains updated chapters on Breast imaging and interventions and includes two new chapters on Male Breast Imaging and Advances in Breast Imaging.
We hope this edition will serve as a concise yet comprehensive guide for students and practitioners of radiodiagnosis as well as a ready reckoner to clinicians in understanding the basics as well as current advances in imaging and interventions.
The editors take this opportunity to thank the faculty of the three institutions who have put their collective experience and effort in this book. We would also like to express our appreciation to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director–Content Strategy), Ms Nedup Denka Bhutia (Development Editor) and the other staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their professionalism and dedication towards publication of this book.
Manavjit Singh Sandhu
Arun Kumar Gupta
Anju Garg
Preface to the First Edition
There has been a significant increase in the awareness as well as in the actual incidence of detection of disorders related to the musculoskeletal system and the breast over the years. At the same time, a continuous revolution, occurring in the field of imaging over these years, has given a new insight in the proper diagnosis, management and follow-up of these disorders. With the availability of a large number of imaging techniques today, including conventional radiology, computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (USG), interventional procedures and radioisotope studies, each having its own merits and limitations, it has become essential on the part of the present day radiologist to be able to advise and use the most cost-effective methodology in a given clinical situation. Such a need assumes even a greater importance in the limited resources situation of a developing country. It is necessary for a radiologist of today to learn the basic aspects and the role of various imaging modalities in a given clinical situation for taking the fullest advantage of these modalities. The need for a closer cooperation and understanding of each other's role between the radiologist and a clinician had never been felt greater before.
The present book on Musculoskeletal and Breast Imaging, the fifth in the series of AIIMS-MAMC-PGI imaging courses, is a further attempt in this direction. The book has been broadly divided into two sections, i.e., the musculoskeletal disorders and the breast disorders, each section dealing at length with the relevant imaging techniques and their interpretations in various disease processes. There are 19 chapters, dealing with all important aspects of these systems.
The multimodality imaging approach to bone, soft tissue and joint diseases is presented while retaining the major emphasis on conventional radiological findings. There are separate sections devoted to imaging modalities for infections and inflammations, metabolic bone disorders and tumors. The text is intended to assist in the interpretation of imaging studies of patients with these disorders and in suggesting the appropriate imaging technique to the clinicians involved in their care.
The role of mammography in early diagnosis of breast cancer and in helping in breast conservation need not be overemphasized. The section on breast imaging deals in detail with the role of screening mammography, its relevance as it pertains to our country, the current status of various other imaging modalities and future directions in the imaging of breast. The purpose of this book is to provide the reader with essential information in all important aspects of the subspecialty of musculoskeletal and breast imaging, and we hope that it serves as a compliment to the AIIMS-MAMC-PGI course, through its concise, comprehensive and current survey on the subject.
We are grateful to all our faculty staff and other eminent teachers for contributing their experiences through their excellent write-ups in all these volumes providing a balanced view on the modern day practice of Radiology in various clinical situations. We also thank the series publishers M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, Shri Jitendar P Vij (Chairman and Managing Director) and other staff, for timely publication of all these volumes in an excellent form. But for their active and persistent involvement, such a gigantic task would not have been a reality. We do sincerely hope that all these volumes, including the present one published under the AIIMS-MAMC-PGI imaging course series, shall be able to fulfill the desired aims and shall continue to guide the readers in their daily office practice of radiology. Readers response shall always remain the ultimate guiding spirit in this direction.
Manorama Berry
Veena Chowdhury
Sudha Suri
Sima Mukhopadhyay