The broad goal of this research is to apply advanced imaging techniques to develop, in a patient-specific manner, a quantitative understanding of how the joints function, and of how they are affected by soft-tissue injuries and by their surgical treatment. The central hypothesis is that this understanding will lead to reliable, early and improved diagnostic and therapeutic procedures for joint ailments involving soft-tissue injuries. The focus of this proposal is on the ankle joint and its ligament injuries.
The Specific Aims are: (1) to investigate ankle flexibility characteristics associated with specific ligament injuries; (2) to determine relative internal bone movements at the ankle and subtalar joints associated with ligament injuries; (3) to develop stress radiography and stress slice MRI that are optimum to show bone displacements associated with specific ligament injuries; and (4) to objectively assess the stabilization achieved by surgical reconstruction techniques for treating ligament damage. To fulfill Aim 1, a special mechanical device will be built and flexibility data will be gathered from normal injured, and post-surgical joints. To fulfill Aim 2, methods of MRI imaging under stress, image segmentation, 3-D reconstruction, and 3-D analysis will be developed. The resulting injury-specific internal displacement data will be utilized to devise simple, cost-effective methods, such as stress radiography and stress slice MRI, that best show the effect of injury (Aim 3). Such data will be used to objectively assess surgical reconstruction techniques based on pre- and post-operative scans and measurements (Aim 4). The expected outcomes of this research are twofold: (1) simple, cost-effective and high specificity methods of diagnosing ankle ligament injuries; and (2) new knowledge about the exact displacements occurring at the ankle and subtalar joints as a result of ligament injuries or their surgical repair.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Research Project (R01)
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Orthopedics and Musculoskeletal Study Section (ORTH)
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Panagis, James S
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University of Pennsylvania
Schools of Medicine
United States
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Liu, Jiamin; Udupa, Jayaram K; Saha, Punam K et al. (2008) Rigid model-based 3D segmentation of the bones of joints in MR and CT images for motion analysis. Med Phys 35:3637-49
Imhauser, Carl W; Siegler, Sorin; Udupa, Jayaram K et al. (2008) Subject-specific models of the hindfoot reveal a relationship between morphology and passive mechanical properties. J Biomech 41:1341-9
Udupa, Jayaram K; Leblanc, Vicki R; Zhuge, Ying et al. (2006) A framework for evaluating image segmentation algorithms. Comput Med Imaging Graph 30:75-87
Siegler, S; Udupa, J K; Ringleb, S I et al. (2005) Mechanics of the ankle and subtalar joints revealed through a 3D quasi-static stress MRI technique. J Biomech 38:567-78
Liu, Jianguo; Udupa, Jayaram K; Odhner, Dewey et al. (2005) A system for brain tumor volume estimation via MR imaging and fuzzy connectedness. Comput Med Imaging Graph 29:21-34
Ringleb, S I; Udupa, J K; Siegler, S et al. (2005) The effect of ankle ligament damage and surgical reconstructions on the mechanics of the ankle and subtalar joints revealed by three-dimensional stress MRI. J Orthop Res 23:743-9
Saha, Punam K; Udupa, Jayaram K; Falcao, Alexandre X et al. (2004) Iso-shaping rigid bodies for estimating their motion from image sequences. IEEE Trans Med Imaging 23:63-72
Lei, Tianhu; Udupa, Jayaram K; Odhner, Dewey et al. (2003) 3DVIEWNIX-AVS: a software package for the separate visualization of arteries and veins in CE-MRA images. Comput Med Imaging Graph 27:351-62
Nyul, Laszlo G; Udupa, Jayaram K; Saha, Punam K (2003) Incorporating a measure of local scale in voxel-based 3-D image registration. IEEE Trans Med Imaging 22:228-37
Woodburn, James; Udupa, Jayaram K; Hirsch, Bruce E et al. (2002) The geometric architecture of the subtalar and midtarsal joints in rheumatoid arthritis based on magnetic resonance imaging. Arthritis Rheum 46:3168-77

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