Lateral Cord Insertional Fasciopathy

In this month’s Radsource MRI Web Clinic, Dr. Christopher Smith examines an under-recognized cause of lateral foot pain, and discusses differential diagnoses that may cause similar symptoms.

Shoulder Cysts

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

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).

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?

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.

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?  What is your diagnosis? [figure...

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.

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. 

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.

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.

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.

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.

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.

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.

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