US and MRI of Pelvic Tendon Anatomy and Pathologic Conditions.

The bony pelvis serves as the attachment site for a large number of powerful muscles and tendons that drive lower extremity movement. Organizing the pelvic tendons into groups that share a common function and anatomic location helps the radiologist systematically evaluate these structures for injury, which can be caused by repetitive stress, acute trauma, or failure of degenerated tissues. Tears of the anteromedial adductors around the pubic symphysis and anterior flexors traversing anterior to the hip principally affect younger male athletes.

Intra-articular Neoplasms and Masslike Lesions of the Knee: Emphasis on MR Imaging.

Intra-articular masses affecting the knee joint are uncommon lesions that encompass a range of neoplastic and nonneoplastic disorders. A joint mass limited to a single articulation is most commonly related to neoplastic or focal proliferative disease, whereas masses affecting multiple articulations are typically caused by underlying inflammatory arthritides, metabolic abnormalities, or systemic deposition disorders. This article focuses on those masses that present in a monoarticular fashion, emphasizing the lesions that most commonly affect the knee joint.

Periosteal stripping in high ankle sprains: An association with osteonecrosis.

Objective: We present a series of 20 cases of a sleeve-type injury of the distal tibia characterized by traumatic periosteal stripping caused by a high ankle sprain. We characterize the magnetic resonance imaging findings associated with this injury and highlight its association with distal tibial osteonecrosis.

Materials And Methods: We collected 20 cases of high ankle sprains with periosteal stripping of the distal tibia through teaching files and a search through our PACS database.

Imaging of the Acromioclavicular Joint: Anatomy, Function, Pathologic Features, and Treatment.

The acromioclavicular joint is an important component of the shoulder girdle; it links the axial skeleton with the upper limb. This joint, a planar diarthrodial articulation between the clavicle and the acromion, contains a meniscus-like fibrous disk that is prone to degeneration. The acromioclavicular capsule and ligaments stabilize the joint in the horizontal direction, while the coracoclavicular ligament complex provides vertical stability.

Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings.

Objective: To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)).

Materials And Methods: Knee MRI examinations at four institutions were selected which showed tears of the sMCL located distal to the joint line. MRIs were evaluated for a SLL, a wavy contour to the sMCL, and the location of the proximal sMCL stump.

Asthma biologics: Comparing trial designs, patient cohorts and study results.

Objective: Five biologic therapies have FDA-approved indications for difficult-to-control asthma. The clinical trials that proved the efficacy and safety of these biologics were often similar in their inclusion criteria, study designs, and endpoints. Many of these trials have been reanalyzed post hoc to identify subsets of subjects considered to be enhanced responders.

Radiographic/MR Imaging Correlation of the Shoulder.

This article discusses the typical findings seen on conventional radiography in 3 common shoulder pathologies, namely glenohumeral instability, rotator cuff pathology, and acromioclavicular joint dislocation. Correlative MR images are used to explain and illustrate the significance of radiographic findings that suggest the presence of underlying shoulder pathology.

Adult Acquired Flatfoot Deformity: Anatomy, Biomechanics, Staging, and Imaging Findings.

Adult acquired flatfoot deformity (AAFD) is a common disorder that typically affects middle-aged and elderly women, resulting in foot pain, malalignment, and loss of function. The disorder is initiated most commonly by degeneration of the posterior tibialis tendon (PTT), which normally functions to maintain the talonavicular joint at the apex of the three arches of the foot. PTT degeneration encompasses tenosynovitis, tendinosis, tendon elongation, and tendon tearing.

Pes Anserinus: Anatomy and Pathology of Native and Harvested Tendons.

The purpose of this article is to review the anatomy and pathology of the pes anserinus to increase the accuracy of imaging interpretation of findings affecting these medial knee structures. The pes anserinus, consisting of the conjoined tendons of the sartorius, gracilis, and semitendinosus muscles and their insertions at the medial aspect of the knee, is often neglected during imaging assessment. Common pathologic conditions affecting the pes anserinus include overuse, acute trauma, iatrogenic disorders, and tumors and tumorlike lesions.

Core curriculum online lecture series in musculoskeletal imaging: initial results.

Objective: To augment the educational resources available to training programs and trainees in musculoskeletal (MSK) radiology by creating a comprehensive series of Web-based open-access core curriculum lectures.

Materials And Methods: Speakers with recognized content and lecturing expertise in MSK radiology were invited to create digitally recorded lecture presentations across a series of 42 core curriculum topics in MSK imaging. Resultant presentation recordings, organized under curriculum subject headings, were archived as open-access video file recordings for online viewing on a dedicated Web page (http://radiologycorelectures.

The peroneus longus muscle and tendon: a review of its anatomy and pathology.

This article will review the anatomy and common pathologies affecting the peroneus longus muscle and tendon. The anatomy of the peroneus longus is complex and its long course can result in symptomatology referable to the lower leg, ankle, hindfoot, and plantar foot. Proximally, the peroneus longus muscle lies within the lateral compartment of the lower leg with its distal myotendinous junction arising just above the level of the ankle.

Layered Approach to the Anterior Knee: Normal Anatomy and Disorders Associated with Anterior Knee Pain.

Anterior knee pain is a common complaint that can be caused by a wide spectrum of disorders affecting the many varied tissues at the anterior knee. The anatomy and pathologic conditions of the anterior knee can be approached systematically by organizing the region into four layers: (a) superficial layer of fat, fascia, and bursae; (b) functional layer composed of the extensor mechanism and patellar stabilizers; (c) intracapsular extrasynovial layer containing the fat pads; and (d) intra-articular layer. The superficial layer is composed of delicate tissues that are predisposed to blunt and penetrating trauma, irritation, and infection.

Muscle-Tendon-Enthesis Unit.

Injuries to the muscle-tendon-enthesis unit are common and a significant source of pain and loss of function. This article focuses on the important anatomical and biomechanical considerations for each component of the muscle-tendon-enthesis unit. We review normal and pathologic conditions affecting this unit, illustrating the imaging appearance of common disorders on magnetic resonance imaging and ultrasound.

MR Imaging of Atraumatic Muscle Disorders.

Atraumatic disorders of skeletal muscles include congenital variants; inherited myopathies; acquired inflammatory, infectious, or ischemic disorders; neoplastic diseases; and conditions leading to muscle atrophy. These have overlapping appearances at magnetic resonance (MR) imaging and are challenging for the radiologist to differentiate. The authors organize muscle disorders into four MR imaging patterns: (a) abnormal anatomy with normal signal intensity, (b) edema/inflammation, (c) mass, and (d) atrophy, highlighting each of their key clinical and imaging findings.

MR Imaging of Muscle Trauma: Anatomy, Biomechanics, Pathophysiology, and Imaging Appearance.

Muscle is an important component of the muscle-tendon-bone unit, driving skeletal motion through contractions that alter the length of the muscle. The muscle and myotendinous junction (MTJ) are most commonly injured in the young adult, as a result of indirect mechanisms such as overuse or stretching, direct impact (penetrating or nonpenetrating), or dysfunction of the supporting connective tissues. Magnetic resonance (MR) imaging is widely used for assessment of muscle injuries.

Hereditary Angioedema: Implications of Management.

Hereditary angioedema (HAE) is a genetic condition that is characterized by frequent episodes of localized angioedema. It is a rare disorder that a primary care provider, otolaryngologist, dermatologist, or rheumatologist may encounter only occasionally. This disease is being reviewed because of the significant advances in further understanding the genetics, biology, and therapeutic management surrounding the condition.

Management of granulomatous lymphocytic interstitial lung disease in a patient with common variable immune deficiency.

A 61-year-old woman presented with longstanding cough and progressive dyspnoea. She underwent an extensive evaluation and was diagnosed with common variable immunodeficiency (CVID) with granulomatous lymphocytic interstitial lung disease (GLILD). She was initially treated with subcutaneous immunoglobulin therapy, having declined intravenous immunoglobulin (IVIG) therapy.

Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective.

Bone or cartilage, or both, are frequently injured related to either a single episode of trauma or repetitive overuse. The resulting structural damage is varied, governed by the complex macroscopic and microscopic composition of these tissues. Furthermore, the biomechanical properties of both cartilage and bone are not uniform, influenced by the precise age and activity level of the person and the specific anatomic location within the skeleton.

Intramuscular migration of calcium hydroxyapatite crystal deposits involving the rotator cuff tendons of the shoulder: report of 11 patients.

Objective: The intent of the study is to describe an unusual pattern of intramuscular migration of calcific deposits related to hydroxyapatite deposition disease (HADD) involving the rotator cuff, to illustrate the characteristic imaging features of this phenomenon, and to discuss the clinical significance of such migration.

Materials And Methods: A series of cases of intramuscular accumulation of calcium hydroxyapatite crystals collected over a 7-year period at multiple hospitals within the same academic institution were retrospectively reviewed.

Results: The patient group was composed of seven men and four women, ranging in age from 51 to 79 years, with a mean age of 63 years.

Posterolateral and posteromedial corner injuries of the knee.

Posterolateral (PLC) and posteromedial (PMC) corners of the knee represent complex anatomic regions because of intricate soft tissue and osseous relationships in small areas. Concise knowledge of these relationships is necessary before approaching their evaluation at imaging. Magnetic resonance imaging offers an accurate imaging diagnostic tool to establish normal anatomy and diagnose and characterize soft tissue and osseous injury.

Intramedullary fat globules related to bone trauma: a new MR imaging finding.

Objective: The purpose of this study is to describe intraosseous fat globules related to bone trauma that are detectable with magnetic resonance imaging (MRI), to define the relationship of this finding to fracture and bone contusion, to establish the frequency and associated findings. A proposed pathogenesis is presented.

Materials And Methods: We retrospectively reviewed 419 knee MRI examinations in patients with a history of recent injury and MRI findings of fracture or bone contusion.

Cosmeceutical effect on skin surface profiles and epidermis in UV-B-irradiated mice.

Importance: These data may be useful for developing guidelines for clinicians and the general population related to the reversal of photoaging effects on the aging face damaged by solar radiation.

Objective: To investigate antiaging effects of 4 commercially available topical agents on the dorsal skin in photoaged hairless mice.

Design And Setting: Animal study at an academic medical center.