In the May 2024 Radsource MRI Web Clinic, Dr. Benjamin Eyer discusses MR imaging of a relatively uncommon clinical entity that causes dorsal wrist pain, swelling and dysfunction.
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?
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.
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.
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.
Ossification of the Posterior Longitudinal Ligament: Bone in a Bad Place
A 64-year-old man developed neck pain after falling off a truck one week ago. T1- and T2-weighted sagittal MR images (1a and 1b) are provided.
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.
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.
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.
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.
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.
Spinal Epidural Lipomatosis with Review of Visceral Fat Deposition in Obesity
A 49 year-old moderately obese male with a one-year history of chronic low back pain, numbness and sensation of weakness at bilateral thighs, without neurological deficits on clinical exam, undergoes lumbar spine MR imaging.
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.
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.
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.
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