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  1. Article ; Online: ESR essentials: MRI of the knee-practice recommendations by ESSR.

    Parkar, Anagha P / Adriaensen, Miraude E A P M

    European radiology

    2024  

    Abstract: Many studies and systematic reviews have been published about MRI of the knee and its structures, discussing detailed anatomy, imaging findings, and correlations between imaging and clinical findings. This paper includes evidence-based recommendations ... ...

    Abstract Many studies and systematic reviews have been published about MRI of the knee and its structures, discussing detailed anatomy, imaging findings, and correlations between imaging and clinical findings. This paper includes evidence-based recommendations for a general radiologist regarding choice of imaging sequences and reporting basic MRI examinations of the knee. We recommend using clinicians' terminology when it is applicable to the imaging findings, for example, when reporting meniscal, ligament and tendon, or cartilage pathology. The intent is to standardise reporting language and to make reports less equivocal. The aim of the paper is to improve the usefulness of the MRI report by understanding the strengths and limitations of the MRI exam with regard to clinical correlation. We hope the implementation of these recommendations into radiological practice will increase diagnostic accuracy and consistency by avoiding pitfalls and reducing overcalling of pathology on MRI of the knee. CLINICAL RELEVANCE STATEMENT: The recommendations presented here are meant to aid general radiologists in planning and assessing studies to evaluate acute and chronic knee findings by advocating the use of unequivocal terminology and discussing the strengths and limitations of MRI examination of the knee. KEY POINTS: • On MRI, the knee should be examined and assessed in three orthogonal imaging planes. • The basic general protocol must yield T2-weighted fluid-sensitive and T1-weighted images. • The radiological assessment should include evaluation of ligamentous structures, cartilage, bony structures and bone marrow, soft tissues, bursae, alignment, and incidental findings.
    Language English
    Publishing date 2024-03-27
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-024-10706-7
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  2. Article ; Online: Scientific papers on musculoskeletal radiology presented at ECR 2020.

    Parkar, Anagha P

    European radiology

    2020  Volume 30, Issue 10, Page(s) 5315–5316

    MeSH term(s) Congresses as Topic ; Diagnostic Imaging/methods ; Europe ; Humans ; Musculoskeletal Diseases/diagnostic imaging ; Radiology
    Language English
    Publishing date 2020-05-16
    Publishing country Germany
    Document type Editorial
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-020-06940-4
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  3. Article ; Online: Self-assessment of range of motion in patients undergoing surgery for a unilateral shoulder condition.

    Solheim, Eirik / Rosenlund, Maja / Ulsaker, Karen Gjørwad / Parkar, Anagha P

    Acta orthopaedica et traumatologica turcica

    2023  

    Abstract: Objective: This study aimed to investigate the agreement of patient-assessed and researcher/physician-assessed measurements of the difference in range of motion between the unaffected and affected shoulders in 55 patients undergoing arthroscopic surgery ...

    Abstract Objective: This study aimed to investigate the agreement of patient-assessed and researcher/physician-assessed measurements of the difference in range of motion between the unaffected and affected shoulders in 55 patients undergoing arthroscopic surgery for a unilateral shoulder condition.
    Methods: The investigation included 55 patients (17 women and 38 men; median age=53 years; range=26-74) with a symptomatic unilateral shoulder condition and a surgically treatable diagnosis. Images of a model/researcher performing active shoulder abduction, flexion, external rotation, and internal rotation were created. Each image was paired with a degree diagram or a level system (for internal rotation) on the back for the patient to accurately self-evaluate and record. Each patient was instructed to attentively examine the figures and perform the movements with the same posture as depicted. On the day of surgery, prior to the procedure, 2 independent researchers who were not involved in the patient's care used a standard goniometer to assess the same active movements that the patient had previously self-assessed. For agreement analyses, the intraclass correlation coefficient and Bland-Altman plots were calculated for continuous data (abduction, flexion, and external rotation), and Cohen's weighted kappa was calculated for ordinal categorical data (internal rotation).
    Results: The intraclass correlation coefficient for abduction, flexion, and external rotation was 0.93 (excellent) 95% CI (0.87, 0.96), 0.89 (good) 95% CI (0.81, 0.94), and 0.72 (moderate) 95% CI (0.52, 0.84), respectively. Cohen's kappa for internal rotation (measured as reaching levels on the back) was 0.63 (moderate).
    Conclusion: We believe that patient-assessed measurements of abduction (intraclass correlation coefficient 0.93) and flexion (intraclass correlation coefficient 0.89) can be used as a valid substitute (for measurements by a clinician or researcher). Patient-assessed measurements for external rotation (intraclass correlation coefficient 0.72) and internal rotation (kappa 0.63) are in moderate agreement and should be used more cautiously as substitutes.
    Level of evidence: Level II, Diagnostic Study.
    Language English
    Publishing date 2023-09-27
    Publishing country Turkey
    Document type Journal Article
    ISSN 2589-1294
    ISSN (online) 2589-1294
    DOI 10.5152/j.aott.2023.22166
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  4. Article ; Online: Klinikken er ikke industri.

    Parkar, Anagha P / Fischer-Bredenbeck, Cornelia / Rykkel, Linda

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2022  Volume 142, Issue 14

    Title translation Clinical practice is not a production line
    MeSH term(s) Ambulatory Care Facilities ; Drug Industry ; Humans
    Language Norwegian
    Publishing date 2022-10-10
    Publishing country Norway
    Document type Journal Article ; Comment
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.22.0590
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A young woman with persistent nausea, vomiting and hiccups.

    Wergeland, Stig / Parkar, Anagha P / Maric, Snezana / Torkildsen, Øivind

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2021  Volume 141, Issue 2021-14

    Abstract: Background: Neuromyelitis optica is an inflammatory syndrome of the central nervous system, associated with anti-aquaporin-4 IgG antibodies. It is associated with severe neurological symptoms and risk of permanent neurological disability. The diagnosis ... ...

    Title translation En ung kvinne med langvarig kvalme, oppkast og hikke.
    Abstract Background: Neuromyelitis optica is an inflammatory syndrome of the central nervous system, associated with anti-aquaporin-4 IgG antibodies. It is associated with severe neurological symptoms and risk of permanent neurological disability. The diagnosis can be established on the basis of clinical core characteristics of neuromyelitis optica, together with serological testing for anti-aquaporin-4 IgG antibodies and magnetic resonance imaging of the central nervous system.
    Case presentation: We describe the case of a young woman presenting with obstipation, persistent nausea, vomiting and hiccups. The initial diagnostic workup confirmed obstipation, but did not find any underlying gastrointestinal pathology that could explain her persistent symptoms. Her condition deteriorated, she was unable to eat or drink without inducing vomiting, and eventually she received parenteral nutrition. Further diagnostic workup included magnetic resonance imaging of the brain, which revealed a T2-hyperintense lesion in the medulla oblongata, more specifically in the area postrema. Neurological and neuroradiological assessment led to a tentative clinical diagnosis of neuromyelitis optica spectrum disorder with a well-described, but rare, presentation: the area postrema syndrome. The diagnosis was confirmed by serological testing for anti-aquaporin-4 IgG antibodies. She was successfully treated with methylprednisolone with complete remission of symptoms. Patients with neuromyelitis optica spectrum disorders frequently experience relapses of the disease if untreated, and she was therefore treated with rituximab to prevent future relapses.
    Interpretation: This case is a reminder that common gastrointestinal symptoms may be caused by diseases of the central nervous system.
    MeSH term(s) Female ; Hiccup/etiology ; Humans ; Nausea/etiology ; Vomiting/etiology
    Language Norwegian
    Publishing date 2021-10-11
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.21.0071
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  6. Article ; Online: Correction: Pulmonary embolism in a patient with Klinefelter's syndrome.

    Leidland, Magnus / Undheim, Britt / Parkar, Anagha P / Giil, Lasse Melvær

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2021  Volume 141, Issue 5

    Title translation Rettelse: Lungeembolisme hos en pasient med Klinefelters syndrom.
    Language Norwegian
    Publishing date 2021-03-04
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.21.0146
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  7. Article ; Online: Pulmonary embolism in a patient with Klinefelter's syndrome.

    Leidland, Magnus / Undheim, Britt / Parkar, Anagha P / Giil, Lasse Melvær

    Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke

    2021  Volume 141, Issue 2

    Abstract: Background: Dyspnoea and syncope are common causes of admission to hospitals. Pulmonary embolism is often a differential diagnosis, and by examining the clinical history the clinician searches for known predisposing factors. This case report highlights ... ...

    Title translation Lungeembolisme hos en pasient med Klinefelters syndrom.
    Abstract Background: Dyspnoea and syncope are common causes of admission to hospitals. Pulmonary embolism is often a differential diagnosis, and by examining the clinical history the clinician searches for known predisposing factors. This case report highlights the importance of Klinefelter's syndrome as a predisposing factor for venous thromboembolism. The syndrome is caused by an extra X chromosome in men, among whom the prevalence is estimated to be 1:500-1:1000. Probably only 25 % of men with the syndrome are diagnosed.
    Case presentation: A man in his forties was admitted to hospital due to dyspnoea and syncope. CT showed submassive pulmonary embolism. The course illustrates the challenges of pulmonary embolism and its association with Klinefelter's syndrome.
    Interpretation: Several studies have shown an increased incidence of venous thromboembolism in patients with Klinefelter's syndrome. Klinefelter's patients have a higher pre-test likelihood of venous thromboembolism than other patients, similar to patients with hereditary thrombophilia. Klinefelter's syndrome is a persistent risk factor for recurrent thromboembolism. Thus, Klinefelter's syndrome impacts both the diagnosis and treatment of thromboembolic disease.
    MeSH term(s) Humans ; Klinefelter Syndrome/complications ; Klinefelter Syndrome/diagnosis ; Male ; Pulmonary Embolism/complications ; Pulmonary Embolism/diagnosis ; Thrombophilia/complications ; Thrombophilia/diagnosis ; Thrombophilia/genetics
    Language Norwegian
    Publishing date 2021-01-21
    Publishing country Norway
    Document type Case Reports ; Journal Article
    ZDB-ID 603504-8
    ISSN 0807-7096 ; 0029-2001
    ISSN (online) 0807-7096
    ISSN 0029-2001
    DOI 10.4045/tidsskr.20.0523
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  8. Article ; Online: Incidence and Prognostic Significance of the Segond Fracture in Patients Undergoing Anterior Cruciate Ligament Reconstruction.

    Slagstad, Irene / Parkar, Anagha P / Strand, Torbjørn / Inderhaug, Eivind

    The American journal of sports medicine

    2020  Volume 48, Issue 5, Page(s) 1063–1068

    Abstract: Background: The Segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament (ACL) tear. It is currently unclear if the Segond fracture needs treatment or if it heals spontaneously and if it ... ...

    Abstract Background: The Segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament (ACL) tear. It is currently unclear if the Segond fracture needs treatment or if it heals spontaneously and if it is associated with an increased risk of failure after ACL reconstruction.
    Purpose: To identify the incidence and spontaneous healing rate of Segond fractures in a consecutive cohort of patients undergoing ACL reconstruction and to examine the predictive value of the Segond fracture on the risk of undergoing revision surgery.
    Study design: Cohort study; Level of evidence, 3.
    Methods: A retrospective review of a cohort undergoing isolated ACL reconstruction between 2002 and 2016 was performed. Radiographs from the time of injury and preoperative radiographs were evaluated for Segond fractures and healed Segond fractures. Descriptive data were extracted from an internal quality database. Statistical analyses were performed to investigate risk of revision surgery and to compare across subgroups of patients.
    Results: A total of 1364 patients were included in the study. The incidence of Segond fractures was 7.4%. In addition, 10.4% of patients displayed signs of healed Segond fractures. In total, 15.2% of patients had either 1 or both findings. The overall healing response of the fracture was 35.6%. Those with Segond fractures were older (
    Conclusion: The incidence of conventional Segond fractures in patients with ACL injury was found to be in accordance with former studies. Accounting for the high incidence of healed Segond fractures, a much higher incidence (15%) was seen. Although the spontaneous healing rate from initial radiographs to preoperative imaging was only 36%, the presence of Segond fractures did not represent a higher risk of undergoing revision surgery.
    MeSH term(s) Adolescent ; Adult ; Anterior Cruciate Ligament Injuries/epidemiology ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Reconstruction ; Cohort Studies ; Female ; Humans ; Incidence ; Knee Injuries/epidemiology ; Knee Injuries/surgery ; Male ; Prognosis ; Retrospective Studies ; Tibial Fractures/diagnostic imaging ; Tibial Fractures/epidemiology ; Tibial Fractures/surgery ; Young Adult
    Language English
    Publishing date 2020-03-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/0363546520905557
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  9. Article: Differential Diagnosis of Cavitary Lung Lesions.

    Parkar, Anagha P / Kandiah, Panchakulasingam

    Journal of the Belgian Society of Radiology

    2016  Volume 100, Issue 1, Page(s) 100

    Abstract: Many different diseases present as cavitary pulmonary nodules. The spectrum of diseases ranges from acute to chronic infections, chronic systemic diseases, and malignancies. To decide on the most likely or correct diagnosis may be challenging. Knowledge ... ...

    Abstract Many different diseases present as cavitary pulmonary nodules. The spectrum of diseases ranges from acute to chronic infections, chronic systemic diseases, and malignancies. To decide on the most likely or correct diagnosis may be challenging. Knowledge of common and uncommon radiological findings in correlation with relevant clinical history and findings is necessary to make the right diagnosis and recommend the correct follow-up or step forward. The aim of this pictorial review is to present a brief overview of CT findings of common cavitary lung diseases seen in adult patients.
    Language English
    Publishing date 2016-11-19
    Publishing country England
    Document type Journal Article
    ISSN 2514-8281
    ISSN 2514-8281
    DOI 10.5334/jbr-btr.1202
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  10. Article ; Online: The Effect of Posterior Tibial Slope on the Risk of Revision Surgery After Anterior Cruciate Ligament Reconstruction.

    Dæhlin, Lene / Inderhaug, Eivind / Strand, Torbjørn / Parkar, Anagha P / Solheim, Eirik

    The American journal of sports medicine

    2021  Volume 50, Issue 1, Page(s) 103–110

    Abstract: Background: A significant proportion of patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) later experience graft failure. Some studies suggest an association between a steep posterior tibial slope (PTS) and graft failure.: ... ...

    Abstract Background: A significant proportion of patients undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) later experience graft failure. Some studies suggest an association between a steep posterior tibial slope (PTS) and graft failure.
    Purpose: To examine the PTS in a large cohort of patients about to undergo ACLR and to determine whether a steep PTS is associated with later revision surgery.
    Study design: Case-control study; Level of evidence, 3.
    Methods: A retrospective review of a cohort undergoing isolated ACLR between 2002 and 2012 (with 8-19 years of follow-up) was conducted. Preoperative sagittal radiographs of knees in full extension were used for measurements of the PTS. There were 2 independent examiners who performed repeated measurements to assess the reliability of the method. Statistical analyses were performed to compare the PTS in the groups with and without later revision surgery.
    Results: A total of 728 patients, with a mean age of 28 years at the time of surgery, were included. Overall, 10% (n = 76) underwent revision surgery during the observation period. The group of injured knees had a significantly steeper PTS compared with the group of uninjured knees (9.5° vs 8.7°, respectively;
    Conclusion: The current study did not find any association between a steep PTS measured on lateral knee radiographs and revision ACL surgery. However, a steeper PTS was seen in the group of injured knees compared with the group of uninjured (contralateral) knees. Independent of the PTS, younger patients, those with a shorter time from injury to surgery, and those with a smaller graft size were found to undergo revision surgery more often.
    MeSH term(s) Adolescent ; Adult ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Reconstruction ; Case-Control Studies ; Humans ; Knee Joint/surgery ; Reoperation ; Reproducibility of Results ; Retrospective Studies ; Tibia/diagnostic imaging ; Tibia/surgery ; Young Adult
    Language English
    Publishing date 2021-11-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/03635465211054100
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