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.
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.
The Anterior Meniscofemoral Ligament of the Medial Meniscus
Dr. Mark Awh discusses an under-recognized anatomical variant of the knee that may result in diagnostic pitfalls for the uninitiated.
Anterolateral Ligament Tear
Dr. Leon Toye discusses anatomy and pathology relevant to a lesser-known knee structure frequently injured in association with ACL tears.
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.
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.
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?
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?
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.
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?
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.
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.
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.
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.
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.
Medial Supporting Structures of the Knee with Emphasis on the Medial Collateral Ligament
A 68 year-old male presents after being injured during a motor vehicle accident. Fat-saturated T2-weighted coronal (1a) and sagittal (1b,c) images, as well as fat-saturated proton density-weighted axial images (1d,e,f) are 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.
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.
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.
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.
MR Imaging of Rheumatoid Arthritis
A 47 year-old woman presents with polyarthralgias and morning stiffness.
Deep Venous Thrombosis
A 62 year-old female complains of progressive knee pain that worsens with exercise.
Hereditary Multiple Exostoses
A 19 year-old male presents with distal femur pain from a running injury 1 week ago.
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.
Accessory Muscles of the Knee
A 45 year-old male presents with chronic knee pain.
Hypermobile Lateral Meniscus
A 16 year-old male presents with persistent lateral knee pain and snapping for 10 months.
Subacute and Chronic Avulsion Injuries of the Extensor Mechanism of the Knee
Clinical History: A 13 year-old boy presents with constant dull ache in the anterior aspect of the knee. He has a history of basketball and football injuries. A marker was placed over a palpable nodule at the time of the MR imaging. T1-weighted and fat-suppressed...
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...
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...
Unstable Osteochondritis Dissecans of the Medial Femoral Condyle
Clinical History: A nineteen year-old male presents with knee pain for several years. A (1a) STIR sagittal image is provided. What are the findings? What is your diagnosis? Findings Diagnosis Unstable osteochondritis dissecans of...
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...
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?...
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...
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...
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...
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...
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...
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...
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...
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....
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...
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...
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 ...
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...
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...
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 ...
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 ...
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...
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...
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...
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...
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...
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 ...
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