Ghost Sign Research Articles

Ghost Sign on Diffusion-Weighted Imaging Generated Apparent Diffusion Coefficient Map: Additional MRI Diagnostic Marker for Extremity Osteomyelitis

Objective The aim of this study was to determine the sensitivity and specificity and inter-reader reliability of previously known “ghost sign” and “penumbra sign” on T1-weighted (T1W) imaging and “ghost sign” on apparent diffusion coefficient (ADC) map in osteomyelitis (OM) of the extremities. Materials and Methods In this cross-sectional retrospective study, two fellowship-trained musculoskeletal readers blinded to final diagnosis of OM versus no OM were asked to report the penumbra sign and ghost sign on T1W images and ghost sign on ADC map, as well as diagnosis of OM. Cohen's kappa was used. Diagnostic performance measures including sensitivity, specificity, and accuracy were calculated. Results A sample of 178 magnetic resonance imaging (MRI) scans of pathology-proven cases were included in this study, with 41 being positive for OM and 137 being negative for OM. There was a fair inter-reader agreement for imaging signs, and moderate agreement of 0.60 for OM. The sensitivities of the penumbra sign on T1W imaging, ghost sign on T1W imaging, and ghost sign on ADC map for OM are 3.7, 9.8, and 19.5%, respectively, while their respective specificities are 98.9, 97.8, and 94.5%, respectively. All three imaging signs showed a similar (good) accuracy of 76 to 78%. Conclusion The ghost sign on ADC can be used as an additional marker for OM and is a similarly highly specific but a more sensitive sign for OM than the conventionally used penumbra sign and ghost sign on T1W imaging. Key Points

The Usefulness of Posterior Shiny Corner Lesions in the Early Diagnosis of Medial Meniscus Posterior Root Tears.

Posterior shiny corner lesions (PSCLs) have been reported to be useful for the early diagnosis of medial meniscus posterior root tears (MMPRTs) in surgical patients. However, the usefulness of PSCLs in outpatients, particularly regarding the optimal timing of magnetic resonance imaging (MRI) examinations after injury, remains unknown. We hypothesized that PSCLs would normally be observed in patients with MMPRTs within one month of injury. This study included 144 patients with knee pain who visited our hospital between January 2021 and May 2023. MRI findings within and after one month were examined. Fisher's exact test was performed for PSCLs, cleft signs, ghost signs, radial tear signs, bone cysts, and medial meniscus extrusion (MME), which are findings used for the diagnosis of MMPRTs. Time-dependent receiver operating characteristic (ROC) curve analysis was performed for each MRI finding. A binomial logistic regression analysis was performed for age, sex, PSCL, ghost sign, and MME. PSCLs were observed on 82.6% of the MRI scans within one month, but the positivity rate decreased after one month. After one month, a high percentage of patients had cleft signs and ghost signs. The results of a time-dependent ROC curve analysis showed that the PSCL had better diagnostic ability than the cleft sign, ghost sign, radial tear sign, and MME at a relatively early stage. Additionally, the area under the curve (AUC) of PSCL peaks around 35 days and then declines, reaching 0.8 or less around 40 days. On the other hand, the AUC of the cleft sign and ghost sign began to increase around 30 days after injury, and it exceeded 0.8 after approximately 100 days. The results of the binomial logistic regression analysis revealed significant PSCLs and ghost signs. Independent associations between the PSCL, or ghost sign, and the MMPRT were demonstrated. This study suggests that PSCLs have a superior diagnostic capability for MMPRT during the early stages of injury compared with other MRI findings in outpatients. In particular, PSCLs have a high positivity rate within one month after injury and a high diagnostic capacity up to 40 days after injury.

The "ghost sign": focal paleness as a novel marker of an inverted colonic diverticulum.

The "ghost sign": focal paleness as a novel marker of an inverted colonic diverticulum.

Evaluation of the All-Inside Technique for the Repair of Lateral Meniscus Root Tears at 1 Year After ACL Reconstruction.

The presence of a lateral meniscus root tear (LMRT) in patients with an anterior cruciate ligament (ACL) tear makes the knee more unstable and increases the risk of osteoarthritis and osteonecrosis. An all-inside suture repair technique without bone tunnels has been proposed to treat LMRT. To compare the 1-year postoperative findings between patients who underwent ACL reconstruction combined with LMRT repair (LMRT group) and patients who underwent isolated ACL reconstruction (control group). Cohort study; Level of evidence, 3. The LMRT group consisted of 19 patients, and the control group consisted of 56 patients. In this study, the authors compared the postoperative magnetic resonance imaging (MRI) findings (meniscal extrusion, ghost sign, and hyperintensity in the tibial plateau beneath the LMRT), functional outcomes (International Knee Documentation Committee [IKDC], Lysholm, and Tegner scores), and reoperation rate between groups. The primary endpoint was analyzed by comparing, in the LMRT group, the 1-sided 97.5% confidence interval (CI) of the mean lateral meniscal extrusion at 1 year to the limit of noninferiority (fixed at 0.51). To take into account imbalanced baseline characteristics between groups, adjusted mean meniscal extrusion (with 1-sided 97.5% CI) was assessed using a linear regression model. The mean follow-up was 12.2 months (range, 7.7-14.7 months) in the control group and 11.5 months (range, 7.1-13.0 months) in the LMRT group (P = .06). For meniscal extrusion, the LMRT group was noninferior to the control group. The mean meniscal extrusion was 2.19 mm (97.5% CI, -infinity to 2.68 mm) in the LMRT group and 2.03 mm (97.5% CI,-infinity to 2.27 mm) in the control group, indicating that the upper boundary of the 1-sided 97.5% CI in the LMRT group was less than the noninferiority threshold of 2.78 (ie, 2.27 mm + 0.51 mm = 2.78 mm). There was a statistically significant difference in the IKDC score between the LMRT and control groups (77.2 ± 8.1 vs 80.3 ± 7.3, respectively; P = .04). There was no between-group difference in the other MRI parameters, the Lysholm and Tegner scores, or the reoperation rate. There was no significant difference in extrusion on MRI or clinical outcomes at 1-year follow-up in patients who underwent ACL reconstruction with all-inside LMRT repair compared with patients who did not have an LMRT.

Hidden Meniscus Problems: Ramp Lesion and Posterior Meniscus Medial Root Tear

Ramp lesion (RL) is a peripheral tear affecting the posterior horn of the medial meniscus in the setting of ACL tears. Posterior meniscus medial root tear (PMMRT) is defined as an avulsion of the attachment, or a complete radial tear within 1 cm of the posterior tibial attachments of the meniscus. Both are not uncommonly found. The prevalence of RL existing in conjunction with ACL tears ranges from 9 to 42%. On the other hand, PMMRT contributes up to 10 to 21% of all meniscus tears. Both RL and PMMRT have significant consequences. RT increases anterior tibia translation and internal rotation after ACL reconstruction which may increase graft failure. PMMRT may accelerate the progress of medial knee osteoarthritis. Unfortunately, both conditions are frequently overlooked from physical examination, MRI reading, and arthroscopy procedures, due to the low sensitivity, unfamiliarity, and hidden location of the lesions. Posteromedial tibia edema finding on MRI images in a complete ACL tear in young patients increases the risks of RL. Ghost sign and medial femorotibial edema found on MRI may indicate PMMRT. RL and PMMRT may not be identifiable from the standard arthroscopic view. The trochlear view may be needed for RL and MCL trephination is almost always needed for PMMRT. The stability of both lesions should be assessed by meniscus probing, and repair is the gold standard for unstable lesions. RL can be repaired with sutures from the anterior or posterior. PMMRT is usually repaired using the transtibial pull-out suture technique.

Controversial Treatment Choice to Manage Lateral Meniscus Posterior Root Tear: A Case Report

Introduction: Meniscus root tears are defined as radial tears within 1 cm of the meniscus insertion, or avulsions at the insertion of the meniscus. Based on tear morphology, there are 2 classification system for both medial and lateral posterior root tears. Lateral meniscus posterior root tear (LMPRT) is usually traumatic in nature and has been reported to occur in 7-10% of patients with anterior cruciate ligament (ACL) injury. The most commonly utilized treatments for LMPRT include non-operative treatment, partial meniscectomy, or repair. However, studies evaluating the clinical success of partial meniscectomy for LMPRT are contradictory. Case Report: A 18 years old man came to the orthopaedic clinic with complaints of pain in the right knee, after 2 months excessive physical training to join the police academy. Physical examination of the right knee showed positive results on McMurray and Thesaly’s test. According the combination of the cleft, truncated triangle, and ghost signs on the patient’s MRI examination which showed there was a lateral meniscus posterior root tear of the right knee without ACL injury. Meniscus repair was performed for this patient at the beginning, but apparently the meniscus can not be repositioned. Therefore, we decided that Arthroscopy Partial Meniscectomy (APM) was the best option for this patient. Conclusion: Even though APM long term outcomes is still controversial, when repair is not possible, APM is preferred to get short term benefits after the surgery, such as shorter recovery time and less revision surgery rates.

Ghost signs at the mall: structuring semiotics and (formerly) branded retail space

ABSTRACT Research from both managerial branding and social semiotics has acknowledged the construction of space for retail establishments, while the experiential turn in brand practice has resulted in the more deliberate use of space to build identifiable characteristics across outlets. As a “retail apocalypse” has been sweeping across the U.S., forcing numerous chains and malls to close, these outlets often leave a host of brand-identifying materials behind after their closing. As the materials were once used to define the space and communicate a brand identity, they continue to do so in the afterlife of stores, forcing future tenants and the surrounding community to deal with the remains from the former capitalistic enterprises. Using a reflexive, visual ethnography, this paper shows how the materials used for brand purposes outlast establishments and pose obstacles for new tenants by casting a shadow and structuring new tenants as subordinate or lesser than the original outlets. The increased use of branded spaces coupled with the extensive closure of retail outlets has made this a pressing concern as communities need to deal with the trash departing retails have left behind.

Generalized black holes in 3D Kerr-Schild double copy

The double copy of the Coulomb solution in three dimensions is a nonvacuum solution that can be obtained through different matter couplings. It is the static black hole solution of Einstein-Maxwell theory or general relativity minimally coupled to a free scalar field (with one ghost sign in the action in both cases). We consider generalizations of these matter couplings by paying particular attention to the regularity of the static black solution on the gravity side and the corresponding single copy electric field in the gauge theory. We show that (i) Einstein-Born-Infeld theory yields a singular double copy, which admits stable orbits for certain choices of parameters, with a regular single copy electric field, and (ii) black hole solutions constructed by Bueno et al. [Phys. Rev. D 104, L021501 (2021).] by coupling to the scalar field exemplify mostly regular double copies with regular single copy electric fields and also admit stable orbits. Additionally, we use these solutions to investigate the connection between horizons on the gravity side and electric fields on the gauge theory side, which was previously observed in four dimensions.

Kerr-Schild double copy of the Coulomb solution in three dimensions

While the Kerr-Schild double copy of the Coulomb solution in dimensions higher than three is the Schwarzschild black hole, it is known that it should be a non-vacuum solution in three dimensions. We show that the static black hole solution of Einstein-Maxwell theory (with one ghost sign in the action) is the double copy with the correct Newtonian limit, which provides an improvement over the previous construction with a free scalar field that does not vanish at infinity. By considering a negative cosmological constant, we also study the charged Ba\~nados-Teitelboim-Zanelli black hole and find that the single copy gauge field is the Coulomb solution modified by a term which describes an electric field linearly increasing with the radial coordinate, which is the usual behaviour of the Schwarzschild-AdS black hole in higher dimensions when written around a flat background metric.

SIGNS OF GHOST APPEARANCE IN SHORT STORIES IN BATAVIAASCH NIEUWSBLAD (1936-1939): SEMIOTIC ANALISYS

In 2018-2019 the production of the Indonesian ghost story is much in demand and favored, even in 2020 the ghost content on YouTube is still lively and salable in the Indonesian market. The existence of ghosts cannot be separated from the daily lives of Indonesians.The author is interested in exploring further how the signs of the emergence of a ghostly figure believed by the people in the colonial era. This study uses a descriptive qualitative method with an approach using the analysis of language semiotics from the perspective of Charles Sanders Peirce's semiotics theory. 5 ghost stories published by the Bataviaasch Nieuwsblad newspaper in 1936-1939 were used as corpus. You can see ghost signs that appear using the senses of sight, hearing, touch and smell. No sign was found that uses the sense of taste as a receptor. However, it does not rule out the sense of taste as a receptor to appear in other short stories. There is only one short story that shows that something that is seen by a character is really a ghost that is "’ n griezelige nacht "Bataviaasch Nieuwsblad Wednesday edition, October 14, 1936.

A posterior shiny-corner lesion of the tibia is observed in the early phase after medial meniscus posterior root tear.

Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee, and pullout repair is recommended to prevent subsequent osteoarthritis. Diagnosing MMPRTis sometimes difficult, especially in the case of an incomplete tear. A posterior shiny-corner lesion (PSCL) is reported to be useful for diagnosis, although the association between MMPRT and PSCL is unknown. This study aimed to investigate the properties of PSCL, such as the location, volume, and duration from injury to the time of MRI (duration). We hypothesized that PSCL is observed in the early phase after the MMPRT onset. T2-weighted fat-suppression magnetic resonance imaging (MRI) was obtained from 55 patients with MMPRT preoperatively. The prevalence of the PSCL; giraffe neck, cleft, and ghost signs; severe MM extrusion (> 3mm); and the PSCL volume were evaluated. The PSCL lesion elliptical volume (mm3) was calculated by measuring the anteroposterior, transverse, and craniocaudal dimensions. PSCL was observed in 34 (62%) cases. The mean volume of the PSCL was 102.0mm3. A significantly shorter duration was observed in the PSCL-positive group (5.6weeks) than that in the PSCL-negative group (40.9weeks, P < 0.01), although no significant correlation was observed between the PSCL volume and duration. The sensitivity for the MMPRT was 90.5% when the cut-off duration value was 3weeks and 81.8% when the cut-off value was 8weeks. MRI examination may detect PSCL if it is performed early following MMPRT onset. Detecting PSCL may be useful in diagnosing MMPRT with high sensitivity.

Lateral Meniscus Posterior Root Injury: MRI Findings in Children With Anterior Cruciate Ligament Tear.

BACKGROUND. Undiagnosed and unrepaired root tears are increasingly recognized as a preventable cause of accelerated osteoarthritis. Preoperative MRI findings of lateral meniscus posterior root tears in children with concomitant anterior cruciate ligament (ACL) injury are not well described. OBJECTIVE. The purpose of this study was to investigate the performance of preoperative MRI for identifying concomitant lateral meniscus posterior root injuries in pediatric patients with ACL tears with arthroscopy as the reference standard. METHODS. Consecutively registered children who underwent MRI within 90 days before arthroscopic primary ACL reconstruction between March 2017 and December 2019 were included. Two radiologists assessed MRI examinations for direct signs involving the root proper and for findings associated with lateral meniscus posterior root tears. Kappa coefficients for MRI findings were computed. Findings in patients with root tears and intact roots were compared by independent-samples t test, Mann-Whitney U test, chi-square test, Fisher exact test, and multivariable logistic regression analysis. RESULTS. At arthroscopy, 39 children (18 boys, 21 girls; mean age, 15.2 ± 1.4 years) had lateral meniscus posterior root tears; 51 (22 boys, 29 girls; mean age, 15.7 ± 1.8 years) had intact roots. Kappa coefficients ranged from 0.65 to 0.92, aside from tears involving the entheseal segment (κ = 0.55) or popliteomeniscal fascicles (κ = 0.45). MRI findings that were predictors of arthroscopically diagnosed root tear (p < .05) were lateral meniscus root tear in any segment (odds ratio [OR], 16.8; 95% CI, 5.6-50.1), degeneration in any segment (OR, 3.9; 95% CI, 1.6-9.6), coronal cleft sign (OR, 5.7; 95% CI, 2.0-16.7), sagittal ghost sign (OR, 4.8; 95% CI, 1.2-19.1), and axial radial defect sign (OR, 7.1; 95% CI, 2.4-20.5). Tear involving any segment of the root proper had the highest PPV, 82%, with 79% NPV. The coronal cleft, sagittal ghost, and axial radial defect signs had specificities of 88%, 94%, and 88% but sensitivities of 44%, 23%, and 49%. The only significant independent predictor on preoperative MRI was root tear in any segment (OR, 15.8; 95% CI, 2.7-137.5; p = .003). CONCLUSION. Among MRI findings evaluated for preoperative diagnosis of lateral meniscus posterior root tear, tear involving any segment of the root proper had the strongest performance; associated findings had high specificity but low sensitivity. CLINICAL IMPACT. Accurate identification of lateral meniscus posterior root tears on preoperative MRI can aid in operative planning and reduce treatment delay.

Cost-effective technique for medial meniscus posterior root tear repair

Purpose This study aimed at determining the effectiveness of medial meniscus posterior root repair by transosseous pull-out sutures, relying on readily available tools. Patients and methods Thirty-four patients, aged between 18 and 49 years old of both sexes, with isolated post-traumatic meniscal root tear, operated between September 2013 and September 2015, were prospectively evaluated clinically in terms of Lysholm and Tegner scoring systems. Successful repair was measured by improvement of gap sign, ghost sign, and meniscal extrusion. Results The study group had 18 females and 16 males, mean age was 40.8±6.9 years, mean BMI was 30.5±4.9 kg/m2. The mean follow-up duration was 24.5 months. Lysholm and Tegner scores improved significantly (P=0.000). Complete healing occurred in 20 cases (P=0.000), and partial healing in 10 cases (P=0.000), failure occurred in four cases. Both absolute and relative meniscal extrusion decreased by −1.2±1.5 mm (P=0.01) and −0.12±0.15 (P=0.007), respectively. Conclusions Meniscal root repair by transosseous pull-out suture is a cost-effective and reproducible technique that yields good structural and functional results. This was objectively confirmed both functionally and radiologically in 88% of cases fixed by this technique.

Obesity is a risk factor for osteoarthritis progression and spontaneous osteoporosis is a risk for the development of spontaneous osteonecrosis in patients with medial meniscus posterior root tear

BackgroundObesity is a representative risk factor for osteoarthritis (OA). The relationship between osteoporosis and executed osteonecrosis has been reported. The primary aim of this study was to determine the influence of obesity and osteoporosis on disease progression in patients with medial meniscus posterior root tear (MMPRT). MethodsWe included 41 knees with MMPRT in this study. MMPRT was diagnosed based on the presence of both a meniscus ghost sign and a vertical linear defect on MRI. OA progression and development of osteonecrosis were evaluated using plain radiographs obtained at the initial visit and the final follow-up. The follow-up period for all knees was 30 ± 8 (mean ± standard deviation) months. Patients’ physical attributes were assessed at initial visits; these attributes included body mass index (BMI) and the clinical risk for osteoporotic fracture, as determined by the World Health Organization fracture risk assessment tool (FRAX). Patients with a BMI ≥25 kg/m2 were classified in the obesity group and those with a BMI <25 kg/m2 in the control group. Patients with a FRAX score of ≥10% were classified in the high FRAX group and those with a FRAX score of <10% in the low FRAX group. ResultsOA progression evaluated by Kellgren–Lawrence grading scale was observed in 75% patients in the obesity group (1 grade in 38%, 2 grades in 31%, and 3 grades in 6%) and 58% in the control group (1 grade in 58%). Patients in the obesity group showed significantly greater OA progression. Spontaneous osteonecrosis was observed in no knees at the initial visit and six knees at the final follow-up. All six lesions were observed in the high FRAX group, which was statistically significant. ConclusionsOA progression and development of osteonecrosis were the two representative deterioration patterns in patients with MMPRT. High BMI was related with OA progression, and FRAX score of ≥10% with the development of osteonecrosis.

No dynamic extrusion in medial meniscus root lesions - an ultrasound study

Aims and Objectives: Extrusion of the medial meniscus in MRI is an indirect radiological sign for a meniscus root tear. However, a recent study has shown that ultrasound-detectable dynamic extrusion is considered physiological in healthy volunteers. The aim of our study was to analyze the dynamic meniscal extrusion in patients with proven root injury in ultrasound. Our hypothesis was that dynamic extrusion is reduced in patients with root injury of the medial meniscus compared to healthy volunteers. Materials and Methods: Inclusion criteria for this prospective study were MRI signs for a root lesion of the medial meniscus (ghost sign, extrusion &gt; 3 mm). An age matched group of healthy volunteers served as control. Exclusion criterion was osteoarthritis &gt; II° of the medial compartment according to Kellgren &amp; Lawrence. The extrusion of the medial meniscus (MME) of the affected knee was measured by ultrasound (US) in supine position and under full weight bearing. Results: 25 patients with a medial root lesion were included in the study. The evaluation of the ultrasound results revealed a significant decreased dynamic medial displacement of the meniscus in patients with root injury. In the supine position, the mean medial meniscus extrusion was 3.60 mm (± 1.00 mm). In the standing position, the mean medial meniscus extrusion increased to 3.72 mm (± 0.96 mm). The mean delta-extrusion was 0.11 mm (± 0.17 mm). This difference was statistically not significant. In 14 patients, no dynamic extrusion was detectable at all. All patients belonging to the medial root tear group had a significant varus deformity (mechanical axis hits the tibial joint line more than 15 mm medially form the center). In the control group, the mean medial meniscus extrusion was 1.34 mm (± 0.37 mm) in supine position and 2.20 mm (± 0.34 mm) under full weight bearing. The mean delta-extrusion was 0.85 mm (± 0.30 mm). The difference in mean delta-extrusion between the root tear and control group was statistically significant. Conclusion: Ultrasonography is a diagnostic tool to detect the dynamic extrusion of the medial meniscus. Lack of dynamic extrusion (“dead meniscus sign”) may serve as an indicator for medial root injury.

Meniscal Root Tears

Meniscus root tears are a specific type of meniscal injury that have gained attention over the past 5 years and have been reported to account for 10% to 21% of all meniscal tears, affecting nearly 100,000 patients annually. Meniscal root tears either are defined as an avulsion of the insertion of the meniscus attachment or complete radial tears that are located within 1 cm of the meniscus insertion. Biomechanical studies have demonstrated that meniscal root injuries interrupt the continuity of the circumferential fibers, and hence lead to failure of the normal meniscal function to convert axial loads into transverse hoop stresses. The most common presenting symptoms in meniscal root tears are posterior knee pain and joint line tenderness, especially with deep squatting.Another common symptom is a popping sound heard while participating in light activities such as ascending stairs or squatting. Magnetic resonance imaging signs of medial meniscus root tears include: (1) medial meniscal extrusion of ≥3 mm in a coronal section; (2) high signal indicating a disruption of the posterior meniscal root region in an axial view; and (3) a “ghost sign,” which is the absence of an identifiable meniscus in the sagittal plane, or increased signal replacing the normally dark meniscal tissue signal at the posterior root attachment. Active patients, regardless of age, should be referred early and considered for a meniscal root repair. Indications for a meniscal root repair include acute, traumatic root tears in patients with nearly normal or normal cartilage and chronic symptomatic root tears in young or middle-aged patients without significant preexisting osteoarthritis.Meniscal root repair has been demonstrated to have high satisfaction rates and superior outcomes to arthroscopic meniscectomy for root tears. To restore the function of the meniscus after medial meniscus root tears, a transosseous meniscal root repair technique is most commonly used. The advantage of this technique is the ability to reduce and fix the meniscal root to the broad anatomic footprint to maximize its healing potential. In addition, the transtibial tunnels may contribute to the release of biological factors that can enhance the healing of the meniscal root repair.

A giraffe neck sign of the medial meniscus: A characteristic finding of the medial meniscus posterior root tear on magnetic resonance imaging.

The posterior root ligament of the medial meniscus (MM) has a critical role in regulating the MM movement. An accurate diagnosis of the MM posterior root tear (MMPRT) using magnetic resonance imaging (MRI) is important for preventing sequential osteoarthritis following the MMPRT. However, diagnosis of the MMPRT is relatively difficult even after using several characteristic MRI findings. The aim of this study was to identify a useful meniscal body sign of the MMPRT for improving diagnostic MRI reading. Eighty-five patients who underwent surgical treatments for the MMPRT (39 knees) and other types of MM tears (49 knees) were included. The presence of characteristic MRI findings such as cleft sign, ghost sign, radial tear sign, medial extrusion sign, and new meniscal body shape-oriented "giraffe neck sign" was evaluated in 120 MRI examinations. Giraffe neck signs were observed in 81.7% of the MMPRTs and in 3.3% of other MM tears. Cleft, ghost, and radial tear signs were highly positive in the MMPRTs compared with other MM tears. Medial extrusion signs were frequently observed in both groups. Coexistence rates of any 2 MRI signs, except for medial extrusion sign, were 91.7% in the MMPRT group and 5% in other MM tears. This study demonstrated that a new characteristic MRI finding "giraffe neck sign" was observed in 81.7% of the MMPRT. Our results suggest that the combination of giraffe neck, cleft, ghost, and radial tear signs may be important for an accurate diagnostic MRI reading of the MMPRT.

Advertising and Public Memory: Social, Cultural and Historical Perspectives on Ghost Signs

Advertising and Public Memory: Social, Cultural and Historical Perspectives on Ghost Signs

Evaluation, Treatment, and Outcomes of Meniscal Root Tears: A Critical Analysis Review.

Meniscal root tears or avulsions compromise the biomechanical function of the menisci to a greater extent than simple meniscal tears do. As such, if left untreated, root injuries render the menisci incapable of properly distributing axial load and resisting rotation and translation. The clinical diagnosis of meniscal root abnormalities may be difficult as the signs and symptoms typically associated with meniscal body injuries, such as mechanical locking and catching, may not be present in patients with root injury and there may not be a history of an acute traumatic event. Treating practitioners need to have a high suspicion for meniscal root abnormalities in patients presenting with joint line tenderness and pain with deep flexion activities. Magnetic resonance imaging (MRI) signs indicative of meniscal root abnormality include a radial tear of the meniscal root (on axial imaging), a vertical linear defect in the meniscal root (truncation sign on coronal imaging), meniscal extrusion >3 mm outside the peripheral margin of the joint (on coronal imaging), and increased signal within the meniscal root (ghost sign on sagittal sequences). Two main approaches for meniscal root repair have evolved. One approach involves the use of a transtibial pullout technique, and the other involves the use of a suture anchor repair. The goal of both approaches is to restore an anatomical attachment of the meniscal root to bone that is capable of converting axial weight-bearing loads into hoop stresses. In a recent systematic review of meniscal root repairs, healing (partial and complete) was reported to have occurred in 96% of cases, with all studies demonstrating improvements in terms of subjective and functional scores at a mean of 30.2 months postoperatively.

The potential role of citizen conservation in re-shaping approaches to murals in an urban context

Public visual spaces, populated by a blend of community murals, unauthorised street art, and historic painted mercantile signs, are often the mark of an urban environment that is both progressive and eclectic. Changes in the aesthetic and cultural value of these urban mural forms have led to an increase in the appreciation and, in some instances, promotion of their artistic merit and cultural significance as examples of public art. However, examining the significance of these works, with a view to implementing a conservation approach is problematic. This is due to a number of practical and theoretical considerations that are primarily a result of the ephemeral existence of urban murals outside conventional exhibition spaces, and issues associated with their often fragmented ownership and uncertain authorship. Consequently, larger thinking on the interpretation, conservation assessment, and advocacy for the conservation of urban murals are required. Key to defining and implementing such strategies is contextualising the public visual spaces that these murals occupy and, as part of this, the local and wider communities’ perception of these murals as culturally significant objects as well as fostering awareness and understanding of appropriate measures aimed at their conservation. This paper examines the role of citizen science, or crowd-sourcing, of local community members in establishing a conservation dialogue and generating conservation- relevant data on urban murals. It looks specifically at a project involving a collection of in situ historic painted mercantile signs — also known as ghost signs — in the City of Port Phillip, Melbourne, Australia. The project fostered the establishment of an informed and open dialogue between conservation specialists and participants from the local community on the significance of local ghost signs whilst transferring knowledge on conservation processes and assessment methods. Working directly with community members, a programme was designed in which conservation and community knowledge of these urban art forms, could be collected and exchanged across digital platforms. This enabled researchers to examine how citizen science can be utilised as a research tool as well as a means to advocate for the conservation of collections of urban murals. It created the opportunity to consider the role of non-specialists and shared authorities in the collection and collation of conservation- relevant data and how information generated from what we call citizen conservation projects, can inform the way in which conservators evaluate and prioritize the conservation of urban cultural heritage. The data gathered and interpreted proved to be the most effective means of ‘conserving’ these often ephemeral forms of cultural material.