Tendon and Peritendinous Infections

In this month’s Radsource MRI Web Clinic, Dr. Mark Awh discusses a group of tendon-related abnormalities in which MRI is useful for both diagnosis and for guiding rapid treatment.

Lipomatosis of Nerve

In the first Radsource MRI Web Clinic of 2024, Dr. Leon Toye discusses a characteristic abnormality affecting peripheral nerves, in which the MRI findings may be pathognomonic.

Brachialis Muscle and Tendon Injury

In this month’s Radsource MRI Web Clinic, Dr. Violet Nikac examines an under-recognized cause of elbow pain, in which MRI is often key to the diagnosis.

Meniscal Posterior Root Tears

Dr. Elizabeth Carpenter discusses an important category of meniscal pathology in which MRI is critical for both diagnosis and treatment determination.

Muscle Herniation

Dr. Derek Stensby discusses an interesting muscle abnormality that is well characterized with MRI.

Spinal Cord Cavernous Malformation

Dr. Katharine Tansavatdi discusses the MRI appearance, differential diagnosis, and management of a characteristic spinal cord lesion.

Anterolateral Ligament Tear

Dr. Leon Toye discusses anatomy and pathology relevant to a lesser-known knee structure frequently injured in association with ACL tears.

Shoulder Cysts

Dr. Phillip Tirman discusses the MR appearance of a subset of shoulder abnormalities with varied clinical presentations.

Dorsal Arachnoid Webs

Dr. Malisa Lester discusses the imaging and clinical features of an intraspinal abnormality in which the MR diagnosis may be challenging.

Pisotriquetral Joint Pathology

Dr. Benjamin Eyer discusses the utility of MRI in the evaluation of an under-appreciated cause of wrist pain.

Chronic Recurrent Multifocal Osteomyelitis

A 10 year-old female presents with a several-week history of atraumatic pain and swelling in the right clavicular region. A frontal radiograph with 15-degree cephalic angulation (1a) and a fat-suppressed coronal proton density-weighted image (1b) are provided. What are the findings? What are your diagnostic considerations?

Scapular Winging

An 18-year-old was involved in a motor vehicle accident 8 weeks prior. He reports pain and weakness with deformity of the scapula. MRI was performed to assess for muscle tear or other injury. Initial radiograph frontal radiograph (1a) performed 4 weeks prior to the MRI. Coronal T2 fat-suppressed image provided (1b).

Developmental Talocalcaneal Coalitions and Associated Conditions

A 37-year-old man presented with left ankle pain that began while serving in the military. The pain is aggravated by prolonged standing and walking, and it prevents him from running. An anteroposterior (AP) radiograph (1A), coronal CT image (1B), and coronal oblique (1C), and sagittal (1D) T2-weighted fat-suppressed (T2 FS) magnetic resonance (MR) images are provided.

Hammer, Mallet, and Claw Toe Deformities of the Lesser Toes

A 50-year-old female presents with pain and swelling for 3 weeks. MRI was performed because of clinical suspicion for osteomyelitis. Sagittal proton density-weighted, sagittal STIR, and post-gadolinium sagittal T1-weighted with fat suppression images through the 4th toe are provided (Figure 1). What are the findings? What is your diagnosis?

Pathology of the Popliteus Tendon

An 84-year-old male presents with lateral knee pain and swelling. Coronal (1A), axial (1B, 1D), and sagittal (1C) fat-suppressed proton-density-weighted images of the knee are provided.

Wrist Ganglion Cysts

A 22 year-old woman first noted a painless lump on the dorsum of her wrist a few months ago. It aches when the wrist is extended and weightbearing, such as when doing a “plank” during yoga. On exam, the mass feels firm and partly mobile. Axial T1-weighted (1a) and fat-suppressed PD-weighted (1b), coronal fat-suppressed PD-weighted (1c), and sagittal T2-weighted (1d) images are shown.

Nora’s Lesion

A 31-year-old male presents with a history of trauma two years ago and a one year history of an enlarging, mildly painful mass at the left long finger. T1-weighted (1A) and fat-suppressed proton density-weighted (1B) coronal images, a fat-suppressed proton density-weighted axial (1C) image, and an AP radiograph (1D) are provided. What are the findings? What is your diagnosis?

Pediatric Elbow Dislocation

A 15-year-old boy presents with elbow pain, limited range of motion and ulnar neuropraxia after a recent wrestling injury. An AP radiograph (1a), coronal STIR (1b) and (1c) fat-suppressed T2-and (1d) T1-weighted axial images are provided.

Pigmented Villonodular Synovitis

A 21 year-old female complains of pain, swelling, and stiffness in the knee anteriorly, status post MVA 4 months ago. (1A,1B,1C) Sagittal STIR, T1-weighted, and gradient echo sequences are provided.

Congenital and Acquired Hypertrophic Peripheral Neuropathies

A 55-year-old female presents with constant lower back pain and extremity numbness. Sagittal and parasagittal T2-weighted images (1a-b) of the lumbar spine and axial T2-weighted images at the L4-5 (1c) and S1 levels (1d) are provided. 

Facet Synovitis

A 69-year-old female presents with low back pain, bilateral buttock, and posterior right thigh pain, aggravated when moving from seated to standing position. The patient denies radicular type symptoms. On exam, the patient demonstrates increased pain with hyperextension and lateral movements in hyperextension. There is point tenderness over the paraspinal lower lumbar levels greater on the left. Sagittal STIR (1a and 1b) and axial T2-weighted (1c) and T1-weighted (1d) images are provided.

Serous Atrophy

A 22-year-old female runner presents with worsening right foot pain with running and prolonged weight-bearing. Sagittal T1-weighted (1a) and STIR (1b), axial T1-weighted (1c) and fat-suppressed T2-weighted (1d), as well as coronal T2 Dixon Fat (1e) and T2 Dixon Water (1f) images are provided. What are the findings? What is your diagnosis?

Myxopapillary Ependymoma

A 35-year-old woman presents with low back and right leg pain that began during pregnancy four years previously. Sagittal T1- and T2-weighted (1a and 1b), T1-weighted post-gadolinium (1c), axial T2-weighted (1d) and T1-weighted post-gadolinium axial images (1e) are provided.

Tissue Delamination

A 66 year-old man presents with persistent right shoulder pain, accompanied by painful clicking. (1A,B) T2-weighted fat-suppressed coronal MR images of the right shoulder are provided. What are the findings? What is your diagnosis?

Vaccine-related Shoulder Injury

A 64-year-old male complains of shoulder pain and limited range of motion for six weeks after an influenza vaccination. Fat-suppressed T2-weighted coronal (1A) and proton density-weighted axial (1B) images of the left shoulder are provided.

Proximal Tibiofibular Joint Instability

A 21-year-old male with lateral knee pain radiating into the calf status-post soccer injury. Rule out lateral meniscus tear. Sequential axial (1A), coronal (1B), and sagittal (1C) fat-suppressed proton density-weighted images are provided through the proximal tibiofibular joint.

Off-track Shoulder Lesions

A 36 year-old female with a history of shoulder instability and prior surgery presents after suffering a recurrent dislocation. (1A) T1-weighted coronal, and (1B,C) fat-suppressed proton density-weighted axial and sagittal images are provided.

Developmental Dysplasia of the Hip

×        Clinical History: A 30 year-old female presents with chronic hip pain to evaluate for femoroacetabular impingement. Coronal (1A) and axial oblique (1B) fat-suppressed proton density-weighted images are provided.  What are the findings? ...

Bucket-handle Tear of the Meniscus

A 25 year-old male presents with medial knee pain after recent injury. Three contiguous sagittal fat-suppressed proton density-weighted images are provided. What are the findings? What MRI sign is demonstrated? What is your diagnosis?

Dural Ectasia

An 18 year-old male undergoes MRI for low back pain. Sagittal T2-weighted (1a), sagittal T1-weighted (1b), and axial T1-weighted (1c) and axial T2-weighted (1d) images at the level of S1 are provided.

Sinus Tarsi Syndrome

A 28 year old female presents to an orthopaedic surgeon with lateral left ankle pain, tenderness to palpation, and a sensation of instability.  She reports left ankle injury 3 weeks ago.

Midtarsal (Chopart) Joint Sprain

A 30 year-old male presents with pain in the midfoot following a twisting injury to the ankle. A lateral radiograph of the foot is provided [Figure 1A] with sagittal fat-suppressed T2-weighted [Figure 1B, 1C and 1D], and axial fat-suppressed proton-density weighted [Figure 1E] MR images provided.

Non-degenerative Disease of the Peripheral Nerves

A 30 year-old male who was involved in a high-speed motor vehicle accident 10 months prior. Axial T2-weighted (1A) and T1-weighted (1B) images are provided. What are the findings? What is your diagnosis?

Myxoid Soft-Tissue Neoplasms

A 57-year-old female patient presents for MR imaging with a history of mass at the lateral aspect of her shoulder for 1.5 years, evaluate for lipoma.

Knee Bursae

A 73 year-old male complains of a gradually enlarging “knot” on the anterior knee for 8 years. He previously worked laying tile. Sagittal T1-weighted (1A), sagittal fat-suppressed proton density-weighted (1B), and axial fat-suppressed proton density-weighted (1C) images are shown.

Scapholunate Instability – An Update

A 41-year-old right-handed man presents with 3 years of radial-sided right wrist pain. No specific injury, but he began having severe wrist pain while training for the marines. He was initially treated with rest, which resulted in improved symptoms. The symptoms were aggravated while working out….

The Postoperative Meniscus

An 18 year-old male with a history of a posterior horn medial meniscus peripheral longitudinal tear treated with meniscal repair at age 16 presents for MR imaging.  The patient had a recent new injury with increased pain. 

Dupuytren’s Disease

In this month’s Radsource MRI Web Clinic, Dr. David Rubin discusses the role of MRI in the evaluation of a characteristic entity that affects the fingers.

Adhesive Capsulitis of the Shoulder

A 48 year-old female presents with right shoulder stiffness and pain for 3 months with no known injury and no relief with ice, rest, and NSAIDs. Coronal fat-suppressed T2-weighted (1A and 1C), sagittal T2-weighted (1B), and coronal T1-weighted (1D) images are provided.

Collateral Ligament Injuries of the Fingers

A 16 year-old male presents for MRI of the hand following a wrestling injury with pain at the metacarpal-phalangeal joint (MPJ) of the small finger. Consecutive (1A) fat-suppressed T2-weighted images of the small finger MPJ from dorsal to palmar and a (1B) single fat-suppressed proton density-weighted axial image are provided.

Elastofibroma Dorsi

A 79 year-old female noticed a painless mass along the inferior scapula, present for several months. Axial T1-weighted (1a), coronal T2-weighted (1b), sagittal T1-weighted (1c), and fat-suppressed sagittal T2-weighted (1d) images are provided.

Gynecological Findings Encountered on Musculoskeletal MRI

A 35 year-old female runner with bilateral hip pain presents for MRI of the pelvis. Sagittal and coronal T2-weighted (1a,b), axial intermediate-weighted with fat suppression (1c), and coronal post-gadolinium T1-weighted with fat suppression (1d) images of the pelvis are provided.

Pediatric Hip Disorders

A 6-year-old boy presents to the orthopaedic surgeon with a one-week history of right groin pain with no known trauma or injury.  Coronal T1 and fat-suppressed T2-weighted MR images (1A, 1B) through the right hip were performed, with x-ray correlate also provided (1C). 

Chondrolysis of the Glenohumeral Joint

A 48 year-old female presents with right shoulder pain and limited range of motion for 5 months and no known injury. (1A) Fat-suppressed T2-weighted coronal and (1B) fat-suppressed proton density-weighted axial images are provided.

Subchondral Fractures

A 59 year-old female with no history of prior surgery presents with medial knee pain for 1 month. (1a,c) Coronal and (1b) sagittal fat suppressed proton density weighted MR images are submitted for review.

Posteromedial Rotatory Instability of the Elbow

A 41-year-old man presented with left elbow pain after slipping on a wet floor and falling onto the left arm 1 week prior. Pain involved both the anterior and posterior aspects of the elbow, influenced by how the arm was moved from one position to another.

Brachial Plexopathy

In this month’s Radsource MRI Web Clinic, Dr. Ashwin Prabhu examines the utility of MRI in the evaluation of a complex entity that causes upper extremity symptoms.

Parsonage-Turner Syndrome

In this month’s Radsource MRI Web Clinic, Dr. Thomas Hash discusses an entity that has variable clinical presentations in which MRI can provide critical guidance for patient care.

Myositis Ossificans

An 18 year-old basketball player presents with anterior thigh pain and swelling 4 weeks after being struck in the thigh during a game. (1A) T1-weighted coronal, (1B) fat-suppressed proton density-weighted axial, (1C) fat-suppressed T2-weighted coronal, (1D) post-contrast fat-suppressed T1-weighted axial MR images, and (1E) a lateral radiograph of the thigh are provided.

Arthrofibrosis of the Knee

In this month’s Radsource MRI Web Clinic, Dr. Michael Stadnick discusses the varied appearance of a frequently encountered complication of knee surgery.

Guyon’s Canal

A 43-year-old male presents with numbness and tingling along the ring and small finger for 6 weeks with decreased grip strength?  Axial fat-suppressed T2-weighted (1A,B) and coronal fat-suppressed T2 (1C) and T1 weighted (1D) images are provided.

Intravertebral Cleft Sign

A 78 year-old male presents with low back pain radiating into the mid back for 3 months due to 4 falls. Sagittal T2-weighted (1a), sagittal T1-weighted (1b), sagittal STIR (1c) image and lateral radiograph (1d) obtained around the time of presentation for pain are provided.

Synovial Plicae of the Knee

In this month’s Radsource MRI Web Clinic, Dr. Leland Tsao provides an in-depth review of a group of anatomical structures in the knee that variably result in significant clinical symptoms.

Plantar Vein Thrombosis

In this month’s Radsource MRI Web Clinic, Dr. Stephen Quinn discusses a cause of foot pain and swelling that is likely underdiagnosed.

Salter-Harris Fractures

In this month’s Radsource MRI Web Clinic, Dr. Martha Norris reviews a group of childhood osseous injuries in which the risk of growth disturbance can be assessed with MRI.

Persistent Median Artery

A 35 year-old male patient presents with index finger ischemia and volar wrist pain. Fat-suppressed proton density-weighted axial (1a-c) and sagittal T2-weighted (1d) images through the wrist near the level of the carpal tunnel are provided.

Compartment Syndrome of the Leg

A 32 year-old male presents with right lateral leg pain and swelling. Symptoms began while running a half marathon two weeks ago. (1A) Axial T1-weighted and (1B,C) fat suppressed T2-weighted images are provided.

Flexor Carpi Radialis Tendinopathy

A 51-year-old male with chronic wrist pain felt a sudden pop and acute pain exacerbation while lifting a heavy object.  Axial and coronal fat-suppressed proton density-weighted and two sagittal T2-weighted MR images are provided. 

Scheuermann’s Disease

A 14 year-old male complains of back pain during exercise. A sagittal T2-weighted view of the thoracic spine is provided.

Meniscal Tear Patterns in ACL disruption

A 16 year-old female presents after twisting her knee while playing basketball 7 days prior.  Cropped fat-suppressed proton density-weighted coronal (1A) and sagittal (1B) images are provided. 

Pathology of the Teres Minor

A professional football player presents with posterior shoulder pain following a fall onto the anterior shoulder during a game. T2-weighted sagittal (1A), fat-suppressed proton density-weighted axial (1B,C) and fat-suppressed T2-weighted coronal images (1D) are provided.

Extensor Pollicis Longus Rupture

A 43 year-old male presents with pain for 3 days after injury. He is experiencing forearm cramping and is unable to extend his thumb.

Baastrup’s Disease

An 84 year-old female presents with low back pain, right leg pain, hip pain, numbness and weakness.

Atypical Femur Fractures

A 62 year-old female with a history of arthritis has had vague left thigh pain for several months. An MRI was performed to evaluate the musculature and femur.

Osteomyelitis

A 16 year-old male presents with pain for 2-3 weeks following a soccer injury.  An MRI was performed for suspected cartilage injury.

Pseudomeningocele

35 year-old obese female was status post a recent microdiscectomy at L4-5 with resolution of radicular symptoms. Three days post-operatively she developed headaches and episodic recurrent left radicular symptoms.

The Calcaneofibular Ligament

A 49 year-old male suffered an ankle inversion injury requiring reduction 2-3 weeks prior to imaging and presents with continued pain and swelling. MRI was performed to evaluation for ankle subtalar joint dislocation.

Common Peroneal Nerve Abnormalities

A 17-year-old male presents with foot drop 4 months following surgery for an ACL tear and a posterolateral corner injury. Axial fat-suppressed proton density-weighted (1a), axial fat-suppressed T2-weighted (1b,c) and coronal fat-suppressed T2-weighted (1d) images are provided.

Klippel Feil Syndrome

A 60 year-old woman presented to her physician complaining of upper and lower extremity pain. A (1a) T2-weighted sagittal MR image and (1b) sagittal and (1c) coronal cervical spine CT images are provided.

Acromioclavicular Trauma in the Skeletally Immature Patient

An 11 year-old boy presents with shoulder pain after a fall from a tree. T1-weighted (1a) and T2-weighted (1b) coronal oblique fat-suppressed images, and a fat-suppressed T2-weighted (1c) axial image through the left shoulder are provided.

Atypical Scan Angles in Musculoskeletal MRI

In the March 2017 Radsource MRI Web Clinic, Drs. Leon Toye and Nabeel Anwar discuss the utility of non-orthogonal imaging planes in the evaluation of the musculoskeletal system.

Costal Cartilage Injuries

A 26 year-old football player presents with severe anterior chest pain following a tackling injury. MRI of the sternum was performed. A (1A) fat-suppressed T2-weighted coronal image and (1B,C) fat-suppressed proton density-weighted axial images are provided.

Achilles Tendon Pathology

In the 1st MRI Web Clinic of 2017, Dr. Michael Stadnick revisits a site of tendon pathology that is a common source of morbidity in adult patients.

Chondroid Lesions

In this month’s Radsource MRI Web Clinic, Dr. Pamela Burdett discusses the evaluation and management of one of the most commonly encountered osseous lesions in musculoskeletal MR.

Foreign Body Imaging with MRI

In this month’s Radsource MRI Web Clinic, Drs. Leon Toye and Anthony Onofrio discuss an entity that may present diagnostic challenges in a variety of musculoskeletal locations.

Traumatic Neuroma

A 45 year old man fell through a plate glass window 6 months ago, lacerating the right wrist with subsequent diminished sensation in the right thumb, index and middle fingers. He now presents to the orthopaedist with an enlarging painful mass in the wrist at the site of injury.

Stress Fractures in the Foot and Ankle

A 17 year-old female presents with three months of anterior ankle pain. (1a) Axial T1-weighted and (1b) coronal proton-density weighted fat-suppressed images are provided.

The Thumb Carpometacarpal Joint

A 21 year-old male crashed his all-terrain vehicle 10 days ago and radiographs revealed dorsoradial dislocation of the thumb CMC joint. Coronal STIR images of the wrist/thumb are provided.

Deep Venous Thrombosis

A 62 year-old female complains of progressive knee pain that worsens with exercise.

Acromial Apophysiolysis

A 16 year-old female presents with shoulder pain and stiffness for 2 months. The pain started when she increased her softball activities and overhead weightlifting.

Ankylosing Spondylitis

A 16 year-old male presented to his physician complaining of low back pain and stiffness and bilateral hip pain for 2 years.

Iliopsoas Tendinopathy

A 77 year-old female presents with left groin pain with prominent hip flexion weakness for a month, with no known injury.

Sternoclavicular Joint Pathology

A 31 year-old female presents with anterior pectoralis muscle hardening and swelling with extreme pain. She has a history of multiple episodes of MRSA infection over the previous 9 years.

Intraosseous Pneumatocyst

A 50 year-old man was involved in a motor vehicle accident with complaints of shoulder and neck pain.

Primary Synovial Chondromatosis

A 51-year-old male presents with slowly progressive swelling, loss of range of motion and intermittent locking of the right knee.

Trochlear Dysplasia

A 15-year-old female presents with knee pain following a sports injury nine days prior.

Subcoracoid Bursa

A 35 year-old female presents with shoulder pain after injuring her shoulder lifting a gate.

The Owl’s Eyes Sign

A 52 year-old male presents to his orthopaedic surgeon complaining of chronic bilateral hand numbness and tingling.

Distal Biceps Tendon Rupture Elbow

A 56 year-old male presents with swelling and ecchymosis in the antecubital fossa following a “pop” and acute onset of pain while lifting a heavy weight one week earlier.

Common Intraosseous Cysts

A 61 year-old male presents with posterior left shoulder pain and limited range of motion for six months. No known injury. An axial fat-suppressed proton density image at the level of the lower glenoid is provided. What are the findings? What is your diagnosis?

Proximal Iliotibial Band Syndrome

Clinical History: A 53 year-old female complains of progressive pain around the area of the iliac crest with no history of trauma. A T2-weighted fat suppression image in the coronal plane of the pelvis is provided.

Osteochondral Injury of the Elbow

Clinical History: An 11 year-old female gymnast presents with right elbow pain and popping with flexion. A coronal inversion recovery image is provided.

Chiari I Malformation

A 36 year-old female presents with neck pain and headaches. A sagittal T1-weighted image of the brain is provided (A). What is the finding? What is your diagnosis?

Accessory Anterior Inferior Tibiofibular (Bassett’s) Ligament

A 16 year-old female presents with chronic anterolateral ankle pain and a history of injury one year prior. Oblique axial proton density-weighted (1A) and coronal (1B) and sagittal (1C) T2-weighted fat-suppressed images are provided. What are the findings? What is your diagnosis?

Ankle Extensor Tendon Pathology

Clinical History: A 62 year-old woman fell while descending the steps from her front porch. She presents to the orthopaedist 3 weeks later, reporting weakness of the left foot and a palpable mass over the anterior left ankle. MRI of the ankle was obtained with axial...

Sesamoid Bones: Normal and Abnormal

Clinical History: A 20-year-old female college tennis player presents with a long-standing history of intermittent, fluctuating pain at the plantar aspect of the first metatarsophalangeal joint, increasing over the past 3-4 months. A marker was placed over the region...

MRI of Rectus Femoris / Quadriceps Injury

Clinical History: A 16 year-old female track athlete presents with a 6 week history of a thigh mass and pain. Axial proton density fat-suppressed (1a) and sagittal T2-weighted fat-suppressed (1b) images are provided. What are the findings? What is your diagnosis?...

Accessory Muscles of the Hand and Wrist

Clinical history: A 29 year-old female presents with increasing swelling of the volar 1st web space for several years. She has numbness in the thumb and pain with gripping. Proton density-weighted (1a) and STIR (1b) axial images and T1-weighted sagittal (1c) and...

Pathology of the Long Head of the Biceps Tendon

Clinical History: A 68 year-old male presents with a 2 month history of pain and limited range of motion. Coronal oblique T2-weighted fat-suppressed (1a,1b), axial proton density-weighted fat-suppressed (1c), and sagittal oblique T2-weighted FSE (1d) images are...

Lipoma and Liposarcoma

Clinical History: A 65 year-old male presents with right flank pain and sensation of a mass. (1a,1b) T1-weighted sagittal and coronal images and a (1c) STIR coronal image are provided. What are the findings? What is your diagnosis? Findings [figure...

Bertolotti’s Syndrome

Clinical History: A 66 year-old male presents to his doctor's office with a longstanding history of low back and leg pain. On physical exam he demonstrates a left L5 radiculopathy. The patient is referred for an MRI of the lumbar spine. (1a,b) T2-weighted coronal and...

Acetabular Labral Tear

Clinical History: A 15 year-old female runner with a history of pain and possible stress fracture. (1a) Coronal T2-weighted with fat saturation and (1b) Axial proton density-weighted with fat saturation images of the right hip are provided. What are the findings? What...

Bipartite Medial Cuneiform

Clinical History: A 32 year old male patient presented with pain in the tarsal region and burning in the dorsal foot, after a twisting injury. (1a) Sagittal T1, (1b) sagittal fat saturated fast spin echo (FSE) T2, and (1c) coronal fat saturated proton density (PD)...

Proximal Gastrocnemius Tendon Pathology

Clinical history: A 58 year old woman presents for MRI with right knee and leg pain and swelling medially for 3 weeks, without a specific injury. Sagittal proton density images with fat saturation at the medial aspect of the knee (1a,1b) are provided. What are the...

MRI of the Diabetic Foot

Clinical History: A 60 year-old female presents with foot and ankle pain with swelling for 3 months. No history of trauma. Axial proton density fat-suppressed and sagittal T2-weighted fat-suppressed images are provided. What are the findings? What is the diagnosis?...

Articular Osteochondroses of the Lower Extremity

Clinical History: A 9 year old boy presents for imaging with a 4 week history of medial and lateral ankle pain and progressive swelling. (1a) A single sagittal T1-weighted image through the right foot is provided. What are the findings? What is the diagnosis? [figure...

Palmar Bursae and Flexor Tendon Sheaths of the Wrist and Hand

Clinical History: A 55-year-old man developed slowly progressive swelling of the right hand and wrist over the previous several months. Fat-suppressed T2-weighted axial image just proximal to the wrist (1a) and fat-suppressed T1-weighted post-contrast axial images at...

Lipoma Arborescens

Clinical History: A 78 year-old male complains of a distal thigh mass for six months. MRI of the distal thigh was performed. Corresponding (1a) sagittal fat-suppressed proton density (PD FS) and (1b) T1-weighted images are presented. What are the findings? What is...

Transient Lateral Patellar Dislocation

Clinical History: A 23 year-old female presents with medial knee pain following a twisting injury. (1a) A single fat-suppressed proton density-weighted coronal image is provided. What is the diagnosis?   Findings   Diagnosis...

Intraarticular Osteoid Osteoma

Clinical History: A 29 year-old female complains of progressive knee pain and stiffness without a history of trauma. A radiograph (not shown) demonstrated no abnormality. T1-weighted (1a) and proton density fat suppressed (1b) sagittal images of the knee are provided....

Rotator Cuff Pitfalls

Clinical History: An orthopaedic surgeon requests an over-read of a pre-operative MRI that was presumed to be false positive, as no rotator cuff tear was found at surgery. The patient is a 54 year-old male who experienced shoulder pain following a pulling injury....

Deltoid Ligament Injuries

Clinical History: A 27 year-old male presents with severe ankle pain two weeks following an inversion injury of the ankle. Proton density-weighted fat-suppressed coronal (A) and T2-weighted FSE (B) axial images are provided. The syndesmotic ligaments between the tibia...

Internal Derangement of the Temporomandibular Joint

Clinical History: A 45 year-old female presents with a history of chronic ear pain and headaches. She recently experienced an episode of locking of her jaw. Oblique sagittal proton density-weighted images were obtained through the right temporomandibular joint in both...

Ischiofemoral Impingement Syndrome

Clinical history: A 38 year old female presents with a 10 month history of right hip and groin pain. Axial and sagittal fat-saturated proton density images are provided. What are the findings? What is your diagnosis?   Findings ...

Tendon Intersection Syndromes

Case 1 A 43 year old female presents with radial side forearm pain after working in her garden for several days. MRI was obtained with axial fat-suppressed fast spin-echo T2-weighted (1a) and coronal inversion recovery-weighted (1b) images.  ...

Discitis

Clinical history: A 91 year-old woman complains of low back pain. A routine lumbar spine MR with (1a) T1-weighted sagittal and (1b,1c) T2-weighted sagittal and axial images was performed. What are the findings? What is your diagnosis?   Findings...

Carpal Instability

Clinical History: A 45 year-old woman with a history of arthritis presents with progressive wrist pain. Fat-suppressed proton density-weighted axial (1a), fat-suppressed T2-weighted coronal (1b), and proton density-weighted sagittal (1c,1d) images are provided. What...

Tibial Intercondylar Eminence Fractures

Clinical history: A 7 year-old boy was tackled two day ago. He twisted the knee and felt a pop. Evaluate for anterior cruciate ligament (ACL) tear. (1a) Fat-suppressed proton density and (1b) T1-weighted sagittal images and a (1c) lateral radiograph of the knee are...

Pathologic Fractures

Clinical History: A 58 year-old female with Stage 3A breast cancer presents to her family physician with back pain. A radiograph reveals a severe L1 compression fracture. She is referred to an orthopaedist. On physical exam she exhibits axial type pain without...

Infrapatellar Ganglion Cyst

Clinical History: A 41 year-old male presents with a history of lateral knee pain for 6 months. (1a) Axial proton density-weighted with fat saturation and (1b) Sagittal T1-weighted images of the left knee are provided. What are the findings? What is your diagnosis?...

Flexor Tendon Injuries

Clinical History: A 16 year-old male presents with loss of flexion at the distal interphalangeal joint (DIP) of the ring finger, following an injury playing flag football 2 weeks before. T1-weighted axial (1a), fat-suppressed proton density-weighted axial (1b), and...

Turf Toe

Clinical History: A 20 year-old collegiate football running back presents with severe pain and inability to bear weight following an acute hyperextension injury to his great toe. Fat-suppressed T2-weighted (1a) sagittal and (1b) coronal (short axis) images are...

Lateral Hindfoot Impingement

Clinical History: A 52 year-old man presents with history of 10 years of right ankle pain, and clinical suspicion of subtalar arthritis. Sagittal T1- and fat-suppressed T2-weighted (1a,1b), and coronal fat-suppressed proton density-weighted (1c,1d) images are shown...

Acute Musculotendinous Tears of the Latissimus Dorsi and Teres Major

Clinical History: A 20 year-old professional baseball pitcher presents with axillary pain. (1a) Oblique coronal fat suppressed T2-weighted and (1b) sagittal T2-weighted and (1c) axial fat suppressed proton density-weighted images are provided. What are the findings?...

Snapping Triceps

Clinical History: A 19 year-old male presents with numbness and tingling in the ring and small fingers, tenderness to palpation over the cubital tunnel, subluxation of the ulnar nerve with elbow flexion, and medial elbow snapping. (1a) Axial T1-weighted magnetic...

Femoroacetabular Impingement

Clinical History: A 22 year old collegiate soccer player presents with bilateral groin pain. MR arthrography was performed bilaterally. What are the findings? What is your diagnosis? Findings   Diagnosis...

Trapped Periosteum

Clinical History: A 14 year-old male complains of knee pain after landing awkwardly while playing basketball. A radiograph (not shown) shows mild widening of the medial femoral physis. A fat-suppressed Proton density-weighted coronal image (1a) of the knee is...

Gout

Clinical History: A 55 year-old male complains of chronic swelling and pain in the foot with inability to walk on concrete and waking at night, without relief from medication. Axial long axis T1-weighted (1a) and coronal short axis fat suppressed T2-weighted (1b)...

Multi-ligamentous and Tendon Injury Suggesting Knee Dislocation

Clinical History: A 35 year-old man sustained a hyperextension injury to his right knee while playing football. (1a,1b) Sagittal proton-density and (1c) coronal fat-suppressed T2-weighted images from the MR examination are provided. What are the findings? What is your...

Schwannoma of the Median Nerve

Clinical History: An 80 year-old male presents with a one year history of a left forearm mass and left hand numbness. Axial T1-weighted (1a) and coronal STIR (1b) images of the forearm are presented. What are the findings? What is your diagnosis?   ...

Posteromedial Corner Injury of the Knee

Clinical History: A 13 year-old male twisted his knee playing basketball 2 weeks ago. The MR demonstrates an ACL tear (not shown). Fat-suppressed proton density axial (1a) and coronal (1b) images from the study are provided. What additional findings can be seen? What...

Acute Injuries of the Lumbar Neural Arch in Adolescents

Clinical History Case 1: 13 year old male track and field athlete with constant back pain, increased with running.(1a,1b) Sagittal STIR image right and left of midline and (1c) axial T2 weighted images are provided. What are the findings? What is your diagnosis?...

Hip Arthroplasty

Clinical History: A 60 year-old male presents with recurrent left hip pain 13 years following total joint replacement of the left hip. (1a) Coronal T1-weighted and (1b) coronal STIR images of the hip are provided. What are the findings? What is your diagnosis? [figure...

Median Nerve Entrapment

Clinical history: A 53 year-old male presents with a 3 week history of forearm pain and acute onset of loss of thumb flexion. Fat-suppressed proton density-weighted axials images through the distal forearm (1a) and (1b) are presented for interpretation. What are the...

Evaluating the Varied Appearances of Normal and Abnormal Marrow

Clinical History: A 43 year old male presents with radicular type pain. Past medical history is non-contributory. (1a) T1- and (1b) T2-weighted sagittal and (1c) T1-weighted axial images are provided. The imaging findings are such that the radiologist feels compelled...

Osteoarthritis (OA) of the Knee

Clinical History: A 55 year-old woman presents with right knee pain. There has been no known injury. A meniscal tear is suspected.  (1a) Axial proton density with fat saturation, (1b) sagittal proton density with fat saturation and (1c) coronal proton density with fat...

Posterior Ankle Impingement

Clinical History: A 48 year-old female presents with persistent lateral ankle pain and edema 5 months following trauma. (1a) Sagittal T2-weighted with fat-saturation, (1b) axial T1-weighted, and (1c) coronal intermediate-weighted with fat-saturation images of the...

Slipped Capital Femoral Epiphysis

Clinical History: A 10 year-old girl presents with a limp and pain in the right thigh and knee after a fall onto the right knee five months ago. MR imaging of the right knee was normal. MRI of the right hip was obtained and coronal T1 (1a), coronal fat-suppressed T2...

Patella Alta and Baja

Clinical History: A 20 year-old woman is referred for MRI of the knee with complaints of chronic bilateral anterior knee pain and instability. Sagittal 2D gradient echo MRI sequences of the left (1a) and right (1b) knees are provided. What are the findings and what is...

High Ankle Sprains

Clinical History: A 17 year-old female injured her right ankle 4 days ago during a soccer game. MRI of the ankle was obtained with axial fast spin-echo T2-weighted (1a), coronal STIR (1b), and oblique coronal proton density-weighted (1c) images. What are the findings?...

Morel-Lavallee Lesions

Clinical History: A 39 year-old male patient complains of right thigh/pelvic pain and swelling, after being dragged along rocks while parasailing. (1a) Axial T1, (1b) coronal T1, (1c) axial STIR, and (1d) coronal STIR-weighted MRI images are provided. What are the...

Piriformis Syndrome

Clinical History: A 48 year-old female presents with chronic right hip and pelvic pain. Coronal T1-weighed (1a), axial T2-weighted (1b) and coronal inversion recovery (1c) images are provided. What are the findings? What is the diagnosis?  ...

Acromioclavicular Joint Trauma

Clinical History: A 28 year-old male complains of shoulder pain after falling while playing ultimate Frisbee. A (1a) fat-suppressed T2-weighted coronal oblique image through the plane of the acromioclavicular joint and a (1b) fat-suppressed T2-weighted coronal oblique...

Distal Triceps Injuries

Clinical History: A 45 year old male complains of pain and swelling at the posterior elbow following a lifting injury three days ago. A sagittal inversion recovery image at the mid elbow is provided (1a). What are the findings? Is there a complete or an incomplete...

Athletic Pubalgia

Clinical History: A 20 year-old skater complains of chronic pubic pain radiating to the left groin. (1a) Fat-suppressed T2-weighted coronal, (1b) proton density-weighted axial, and (1c) proton density-weighted sagittal images are provided. What are the findings? What...

Ulnar Collateral Ligament Tears of the Elbow

Clinical History: A 22 year-old professional baseball pitcher experienced a painful pop and medial elbow pain while throwing. An (1a) inversion recovery coronal image of the elbow is provided. What are the findings? What is your diagnosis?  ...

Lesser Metatarsophalangeal Joint Instability

Clinical History: A 56 year-old female presents with gradual onset of right forefoot pain over 4 months. Physical examination reveals point tenderness over the plantar second metatarsophalangeal joint. MRI of the right forefoot was obtained with (1a) sagittal...

Upper Extremity Sports Injuries

Clinical History: Images from four different upper extremity sports injuries are presented. Match each patient with the associated sport. A) Boxing B) Gymnastics C) Golf D) Bowling Case 1:   Case 2:     Case 3: [figure...

Developmental Variants

Clinical history: An 8 year old gymnast who injured the knee 5 days ago presents with posterior knee pain. (1a) T1 and (1b) fat suppressed proton density-weighted sagittal images are provided. What is the finding? What is your diagnosis? Findings...

Glenohumeral Instability

Clinical History: A 30 year old male with shoulder pain and instability. Fat-suppressed (1a) axial proton density and (1b) T2-weighted oblique coronal images are provided. What are the findings? What is your diagnosis? Findings Diagnosis...

Lisfranc Ligament Tear

Clinical History: A 17 year-old male presents with the history of pain due to a football injury incurred three days prior. (1a) Axial T2-weighted and (1b) coronal fat suppressed T2-weighted images of the right midfoot are provided. What are the findings? What is your...

Tight Filum Syndrome

Clinical History: A 59 year-old woman complains of chronic low back pain and bilateral foot paresthesias. Her knee and ankle reflexes are brisk. On further questioning, she relates a history of stress incontinence diagnosed by her family physician. (1a,1b) T1 and...

SLL Tear and DISI Deformity

Clinical History: Each of two patients presents with wrist pain. What are the findings in relation to the scapholunate ligament? Which patient has the more significant abnormality? Patient 1. Patient 2. Findings Patient 1. 1. Incomplete...

Incidentaloma

Clinical History: A 64 year-old male complains of back pain extending into the left leg. (1a) A left lateral T2-weighted sagittal and (1b) and T1-weighted axial image at the level of the L4-5 disc are provided. What are the findings? What is the diagnosis? [figure...

Plantar Fasciitis

Clinical History: A 47 year-old male presents with a history of acute onset of heel pain while running, with an audible pop. Sagittal (1a) T1-weighted and (1b) fat-suppressed T2-weighted and (1c) coronal fat-suppressed proton density weighted images are provided. What...

Hydroxyapatite Deposition Disease

Clinical History: A 48 year-old female presents with pain in the left shoulder with reduced range of motion. (1a) A coronal oblique T2-weighted fat-suppressed image and (1b) an axial T2-weighted image are provided. What are the findings? What is the diagnosis? [figure...

Extensor Carpi Ulnaris Subsheath Injury

Clinical History: A 44 year old recreational tennis player complains of chronic, worsening ulnar sided wrist pain. (1a) Gradient echo coronal, (1b) T1-weighted axial, and (1c) STIR axial images of the wrist are provided. What are the findings? What is your diagnosis?...

Lateral Ulnar Collateral Ligament

Clinical History: A 51 year old female with a history of lateral release for treatment of lateral epicondylitis presents with posterolateral pain and difficulty achieving full elbow extension. The patient was reported as being very anxious when extending the elbow...

Tarsal Coalition

Clinical History: A 12 yo female presents with a history of medial pain and clinician's note to "evaluate posterior tibial tendon." (1a) Fat-suppressed T2-weighted sagittal, (1b) fat-suppressed proton density-weighted coronal, and (1c) T2-weighted axial images of the...

Accessory Muscles of the Ankle

Clinical History: A 43 y/o female presents with Achilles region pain. An (1a) axial T1-weighted image is provided. What are the findings? What is the diagnosis? Findings     Diagnosis Flexor Digitorum Accessorius Longus...

Hypothenar Hammer Syndrome

Clinical History: A 35 year old male carpenter presents with pain in the hypothenar region of the right hand and ischemia in the third, fourth and fifth fingers. (1a) An axial T1-weighted image and (1b) a coronal plane maximal intensity projection (MIP) image from a...

Patellar Fat Pad Abnormalities

Clinical History: 25 year old female presents with a history of chronic lateral knee pain and instability. (1a) Axial and (1b) sagittal fat-suppressed proton density weighted images of the left knee are provided. What are the findings" What is your diagnosis? [figure...

Spondylolisthesis, Spondylolysis

Clinical History: A 22 year-old man presents with right-sided back pain which radiates to his right hip and leg. His symptoms began while running. (1a) T1- and (1b) T2-weighted sagittal and (1c) T2-weighted axial images of the lumbar spine are provided. What are the...

Ventriculus Terminalis

Clinical History: A 47 year-old man presents with chronic right hip and leg pain. Reflexes are normal. No weakness is found on physical exam. The patient denies bowel or bladder dysfunction. (1a) T2-weighted sagittal and (1b) axial images of the lumbar region are...

Apophyseal Avulsion Injury of the Pelvis

Clinical history: A 15 year-old male soccer player presents with left hip pain and weakness for four weeks without known injury. He has severe pain over the left anterior superior iliac spine (ASIS) after activity. (1a) An axial fat-suppressed T2-weighted images of...

Intraosseous Lipoma

Clinical History: A 16 year old male complains of intermittent right heel pain for 7 years, with a recent increase after sports activities. Plain radiographs suggest a "bone cyst". (1a,1b) Sagittal and axial T1-weighted and (1c,1d) STIR images were obtained. What are...

Spine Nomenclature

Clinical History: A 32-year old female presents with back and left leg pain. (1a) T2-weighted sagittal and (2a) T1-weighted axial images are provided.   The best diagnosis in this case is: Herniated nucleus pulposus Disc protrusion...

Longitudinal Stress Fracture

Two patients with the same diagnosis:   What are the findings? What is your diagnosis? Findings   Diagnosis Longitudinal stress fracture of the tibia. Introduction Marrow edema visible on MRI can...

Meniscal Tear Patterns

A gradient-echo T2*-weighted sagittal image demonstrates a tear within the posterior horn of the medial meniscus (arrow). The preferred nomenclature for this tear pattern is: A. Radial Tear B. Horizontal Tear C. Vertical Tear D. Longitudinal Tear E....

Spring Ligament Tear

Clinical History: A 59 year-old male with a 3 year history of medial ankle pain is referred for MR imaging. (1a) Fat-suppressed proton density-weighted coronal and (1b) T2-weighted axial oblique images are provided. What are the findings" What is your diagnosis?...

Oblique Meniscomeniscal Ligament

Clinical History: A 14 year-old female presents with medial knee pain after a basketball injury. (1a) T1-weighted sagittal and (1b) fat-suppressed proton density-weighted axial images are provided. What are the findings" What is your diagnosis? Findings...

Venous Malformations

Clinical History: A 28 year-old female presents with calf swelling and pain. Sagittal (1a) T2-weighted and (1b) proton density-weighted images are provided. What are the findings? What is your diagnosis? Findings Diagnosis Venous...

Sacral Insufficiency Fractures

Clinical History: A 73-year-old female presents with chronic low back pain with recent worsening in severity. Sagittal (1a) T1 and T2-weighted images are provided. What are the findings? Which of the findings is the most likely cause of her worsening pain? [figure...

Pes Anserinus Bursitis

Clinical History: A 67 year old male presents with medial knee pain and swelling for 1.5 years, no known injury. (1a) Coronal fast spin-echo inversion recovery and (1b) axial fast spin-echo proton density images are presented. What are the findings" What is your...

Os Acromiale

Clinical History: A 28 year-old male with persistent shoulder pain and limited range of motion presents for MR imaging. (1a) T1-weighted coronal and (1b) fast spin echo T2-weighted sagittal images are provided. What are the findings? What is your diagnosis? [figure...

Arachnoiditis

Clinical History: A 67 year old man presents with a history of chronic low back pain radiating into both buttocks, the back of both legs, and into the calves. He also complains of paresthesias manifested as a "pins and needles" sensation in a non-dermatomal pattern....

Ulnocarpal Abutment

Clinical History: A 62 year old female presents with an 11 month history of ulnar sided wrist pain, swelling, and limited range of motion. (1a) Gradient echo and (1b) T1-weighted coronal images are provided. What are the findings" What is your diagnosis? [figure...

Silicone Synovitis

Clinical History: A 64 year-old female underwent a surgical procedure on her left ankle approximately 40 years ago. She now presents with pain and swelling. A sagittal T1-weighted image (1a) and a coronal proton-density, fat suppressed image (1b) are provided. What...

Partial Rotator Cuff Tears

Clinical History: A 53 year-old female presents with shoulder pain. A fat-suppressed coronal T2-weighted image (1a) and sagittal T2-weighted image (1b) are provided. What are the findings? What is your diagnosis? Findings Diagnosis...

Fingertip Lesions

Clinical History: A 50 year-old female presents with pain along the ulnar side of her distal long finger. (1a) Proton-density weighted coronal, (1b) STIR coronal and (1c) contrast-enhanced fat-suppressed T1-weighted axial images are provided. What are the findings?...

Hamstring Tears

Clinical History: A 29 year-old professional football player was injured while trying to make a catch. (1a) Sagittal T2-weighted, (1b) fat-suppressed axial proton density-weighted, and (1c) fat-suppressed coronal proton density-weighted images are provided. What are...

ACL Graft Tear

Clinical History: A 28 year-old professional football player with a history of ACL reconstruction presents with recurrent pain and instability following reinjury. Fat-suppressed proton density-weighted (1a) sagittal and (1b) coronal images are provided. What are the...

Jumper’s Knee

Clinical History: A 24 year-old volleyball player presents with anterior knee pain and swelling. (1a) T1-weighted and (1b) Proton density fat-suppressed sagittal images are provided. What are the findings" What is your diagnosis? Findings ...

Vertebral Hemangioma

Clinical History: A 46 year-old female with a history of breast cancer presents with low back pain. (1a) Sagittal T2-weighted, (1b) sagittal T1-weighted and (1c) axial T1-weighted images are provided. What are the findings" What is your diagnosis? ...

Peroneal Tendon Dislocation and Superior Peroneal Retinaculum Injury

Clinical History: A 35 year-old female with history of prior ankle sprain presents with lateral pain and bruising. T2-weighted axial images are provided at a level just above the tip of the fibula (1a) and 1 cm above this site (1b). What are the findings" What is your...

Pectoralis Tear

Clinical History: A 26 year-old male was injured while bench-pressing. (1a) Coronal oblique T2-weighted fat-suppressed and (1b) axial proton density-weighted fat-suppressed images are provided. What are the findings" What is your diagnosis? Findings...

Tennis Leg / Plantaris Tendon Rupture

Clinical History: A 44 year-old male presents with calf pain after being injured while pushing a vehicle, at which time he heard a "pop" in his calf. (1a) Axial and (1b) coronal T2-weighted images are provided. What are the findings" What is your diagnosis? [figure...

Internal Impingement

Clinical History: A 22 year-old professional baseball pitcher presents with persistent posterior shoulder pain after throwing. A fat suppressed T2-weighted oblique coronal image (1a) and a gradient echo T2*-weighted axial image (1b) are provided. What are the...

Extensor Tendon Injuries of the Finger

Clinical History: A 39 year-old female who cut her long finger on a tuna can presents with pain and limited extension at the MCP joint. Sagittal T1 (1a) and axial proton-density fat-suppressed (2a) images are provided. What are the findings" What is your diagnosis?...

PCL Tear

Clinical History: A 17 year-old female presents after falling on her knee while playing soccer. Sagittal (1a) and axial (1b) proton-density weighted fat-suppressed images are provided. What are the findings" What is your diagnosis? Findings [figure...

Scaphoid Fracture

Clinical History: A 28 year-old male with a history of scaphoid fracture presents with persistent wrist pain despite four months of casting. A T1-weighted coronal image (1a) is provided. What are the findings? What is your diagnosis? Findings [figure...

Partial ACL Tear

Clinical History: A 40 year-old female presents after a skiing injury. Proton-density weighted fat-suppressed sagittal (1a) and axial (1b) images are provided. What are the findings" What is your diagnosis? Findings ...

Lumbar Synovial Cyst

Clinical History: A 53 year old female presents with back and left leg pain. A T1-weighted sagittal image (1a) and a fast spin-echo T2 weighted axial (1b) image are provided. What are the findings" What is your diagnosis? Findings ...

Morton Neuroma

Clinical History: 45 year-old female with pain and swelling in the web space between the 3rd and 4th toes. (1a) T1-weighted coronal and (1b) T2-weighted fat-suppressed coronal images through the distal metatarsals are provided. What are the findings" What is your...

Pulley Lesion of the Fingers

Clinical History: A 28 year-old rock climber presents with persistent pain and swelling at the index finger. (1a) A T2-weighted sagittal image with fat-suppression and (1b) a proton density-weighted fat-suppressed axial image are provided. What are the findings" What...

AVN of the Hip

Clinical History: A 62 year-old male with a history of right sciatica and previous right femoral head core decompression for avascular necrosis (AVN) presents with recurrent pain. A coronal T1-weighted image (1a) is shown. What is the unexpected finding and what is...

Incidental Findings on Musculoskeletal MR

Clinical History: A 58 year-old female presents with low back pain and is referred for a lumbar spine MR examination. (1a) T1- and (1b) T2-weighted axial images are provided. What are the findings? What is your diagnosis? Findings ...

Posterior Tibial Tendinopathy

Clinical History: A 55 year old woman presents with a history of chronic progressive arch pain. Sagittal T1-weighted (1a), axial T2-weighted (1b), and fat suppressed coronal proton density-weighted (1c) images are shown below. What are the findings and what is your...

Posterior Interosseous Nerve Syndrome

Clinical history: Persistent forearm pain in a 72 year-old male after a fall. Axial fat suppressed T2-weighted (1a and 1b) and sagittal fat suppressed proton density-weighted (1c) images are shown below. What are the findings and what is your diagnosis? ...

Triangular Fibrocartilage Tear

Clinical History: A 35 year-old female presents with ulnar-sided wrist pain. (1a) A fat-suppressed T2-weighted 3D gradient-echo coronal image is provided. What are the findings? What is your diagnosis? Findings Diagnosis Complex tear of...

POLPSA Lesion

Clinical History: A 37 year-old male presents with shoulder discomfort, particularly in adduction and mild internal rotation. A fat suppressed proton density-weighted axial image (1a) is provided. What are the findings? What is your diagnosis? Findings...

Little League Elbow

Clinical History: A 15 year-old baseball pitcher presents with persistent medial elbow pain. Fat suppressed proton density-weighted (1a) coronal and (1b) axial images are provided. What are the findings? What is your diagnosis? Findings ...

Iliotibial Band Friction Syndrome

Clinical History: A 30-year-old female distance runner presents with lateral knee pain. (1a) T1-weighted and (1b) STIR coronal images are provided. What are the findings? What is your diagnosis? Findings Diagnosis Iliotibial band friction...

Pigmented Villonodular Synovitis

Clinical History: A 39 year-old female presents with right knee pain and swelling. (1a) Proton density weighted axial and (1b) gradient-echo weighted sagittal images are provided. What are the findings? What is the diagnosis? Findings ...

Adhesive Capsulitis

Clinical History: 54-year-old female with decreased range of motion and right shoulder pain increasing over the last 2 months. (1a) Sagittal T2-weighted and (1b) Coronal fat-suppressed T2-weighted images of the right shoulder are provided. What are the findings? What...

Posterior Root Tear of the Medial Meniscus

Clinical History: 53 year old female with 2-3 weeks of knee pain and instability. Fat suppressed proton density coronal and sagittal images are provided. What are the findings? What is your diagnosis? Findings Diagnosis Posterior root...

Achilles Tendinosis & Achilles Tendon Rupture

Clinical History: A jolly, white-haired gentlemen presented on December 23rd with sudden onset of pain at the back of the heel after pushing a sled (1a). (1b) T1-weighted and (1c) fat-suppressed T2-weighted sagittal images of the ankle are provided. What are the...

Biceps Tendon Rupture Elbow

This clinic was updated on January 2, 2014. See the updated version here. Clinical History: 45 year-old male experienced a "pop" and acute onset pain while lifting a heavy bucket. What are the findings? What is your diagnosis? Findings ...

Tarsal Tunnel Syndrome

Clinical History: 34 year old female complains of medial foot pain and numbness. (1a) A T1 weighted axial image and (1b) fat-suppressed T2 weighted sagittal image are provided. What are the findings? What is your diagnosis? Findings ...

De Quervain’s Tenosynovitis

Clinical History: Dorsoradial wrist pain in a 50 year-old golfer. Axial (1a) fat-suppressed proton density and (1b) T1-weighted images through the distal radius are provided. What are the findings? What is your diagnosis? Findings [figure...

Lesser Tuberosity Avulsion Fracture

Clinical History: A 14 year old water polo player presents with chronic anterior shoulder pain. Axial proton density (1a) and oblique sagittal (1b) T1-weighted images are submitted for review. What are the findings? What is your diagnosis? Findings...

HAGL Lesion

Clinical History: A 28 year-old male sustained a shoulder injury while playing hockey. (1a) Fat-suppressed T2-weighted coronal-oblique and (1b) fat-suppressed proton density-weighted axial images are provided. What are the findings? What is your diagnosis? [figure...

Gluteus Minimus Tear & Trochanteric Bursitis

Clinical History: 70 year-old female with chronic left hip pain. Coronal T1-weighted (1a), Coronal STIR (1b), and Axial T2-weighted (1c) images are provided. What are the findings? What is your diagnosis?   Findings ...

ACL Ganglion Cysts

Clinical History: 37 year-old male with no known injury, complaining of diffuse knee pain and stiffness, worsening over the last 3 months. Sagittal T1-weighted (1a) and fat-suppressed proton density-weighted (1b) images are provided. What are the findings? What is...

Rotator Cuff Tear with Biceps Tendon Dislocation

Clinical History: A 52 year old man presents with chronic shoulder pain. Oblique coronal fat-suppressed T2-weighted (1a) and axial fat-suppressed proton density-weighted (1b) images are provided. What are the findings? What is your diagnosis?   ...

Subchondral Insufficiency Fracture of the Knee

Clinical History: 78 year-old female with recent increase in right knee pain and no history of trauma. T1-weighted sagittal (1a) and fat-suppressed T2-weighted coronal (1b) images are provided. What are the findings? What is your diagnosis? Findings...

Free Disc Fragment

Clinical History: 55 year-old man with right leg pain. T1-weighted sagittal (1a), T2-weighted sagittal (1b) and T2-weighted axial (1c) images are provided. What is your diagnosis? Findings Answer Right paracentral free disc fragment from...

Cartilage Defect of Lateral Femoral Condyle

Clinical History: 40 year-old male status-post twisting injury--now with knee pain and clicking. Fat-suppressed water excitation sagittal (1a) and fat-suppressed proton density weighted fast spin-echo coronal (1b) images are provided. What are the findings? What is...

Lateral Epicondylitis

Clinical history: 40 year old male carpenter with lateral elbow pain. Fat-suppressed T2-weighted coronal (1a) and axial (1b) images demonstrate the abnormality. What is your diagnosis?   Answer Diagnosis Lateral epicondylitis...

Wrisberg Pseudotear and Wrisberg Rip

Clinical History: 16 year-old male s/p soccer injury with an ACL tear. Web Clinic Challenge: Fat-suppressed proton density sagittal images (1a,1b) are provided. Note the meniscofemoral ligament of Wrisberg (arrow) coursing behind the PCL on image (1a). The edematous...

Ulnar Collateral Ligament Tear of Thumb (and Stener Lesion)

Clinical history: 28 year-old female who fell while skiing. An inversion recovery coronal image centered at the thumb metacarpophalangeal joint is provided. What is your diagnosis? Findings Diagnosis Acute ulnar collateral ligament tear...

Ankle Ligamentous Injury

Clinical History: 32 year-old male s/p twisting injury while playing basketball. Fat-suppressed T2-weighted axial (1a) and proton density weighted coronal (1b) images are provided. What are the findings? What is your diagnosis? Findings ...

Suprascapular Nerve Entrapment

Clinical History: 35 year-old male weight-lifter with shoulder pain. T1-weighted coronal (1a) and T2-weighted fat-suppressed coronal (1b) and sagittal (1c) images are provided. What is your diagnosis? Findings Diagnosis Entrapment of the...

Posterolateral Corner Injury

Clinical History: 20 year-old male injured playing soccer. Sagittal proton-density weighted fat-suppressed images are provided. What are the findings? What is your diagnosis? Findings Diagnosis Anterior cruciate ligament...

Bucket-handle Tear of the Medial Meniscus

Clinical History: 35 year old male with medial knee pain and locking. Gradient-echo sagittal (1a,1b) and STIR coronal (1c) images are provided. What are the findings? What is your diagnosis?   Findings     ...

Kienbock’s Disease

Clinical History: 32 year-old construction worker with persistent wrist pain. A gradient-echo coronal MR image of the wrist is provided below (1a). What are the findings? What is your diagnosis?   Answer     Findings...

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