Fibular Tip Periostitis: New Radiographic Sign Predictive of Chronic Peroneal Tendon Subluxation-Dislocation in Pes Planovalgus.

Tearing of the superior peroneal retinaculum is a known cause of peroneal tendon subluxation-dislocation. However, with the exception of cortical avulsions at the fibular attachment, superior peroneal retinaculum injury and subsequent peroneal tendon subluxation-dislocation are typically radiographically occult. The purpose of this study was to evaluate the previously undescribed association between radiographic fibular tip periostitis and MRI evidence of peroneal tendon subluxation-dislocation in patients with hindfoot valgus.

Radiographic features and complications following coracoclavicular ligament reconstruction.

Objective: To report radiographic features and complications of coracoclavicular ligament reconstruction and the association of radiographic features with symptomatology.

Materials And Methods: Retrospective picture archiving and communication system query (1/2012-8/2018) identified subjects with prior coracoclavicular ligament reconstruction. Post-operative radiographs were reviewed with attention to the following: (1) acromioclavicular alignment, (2) coracoclavicular width, (3) distal clavicular osteolysis, (4) osseous tunnel widening, and (5) hardware complication or fracture.

Normal development imaging pitfalls and injuries in the pediatric shoulder.

The skeletal maturation of the shoulder has been well documented on radiographic and cadaveric studies. Recent increased use of MRI has provided increased understanding of the soft-tissue and osseous changes that occur during development. Thus recognizing normal maturation, imaging manifestations and pitfalls is crucial when evaluating the pediatric shoulder joint.

Anteroposterior Radiograph of the Ankle with Cross-Sectional Imaging Correlation.

The focus of this article is to illustrate various pathologic entities and variants, heralding disease about the ankle, based on scrutiny of AP radiographs of the ankle, with correlative findings on cross-sectional imaging. Many of these entities can only be detected on the AP ankle radiograph and, if not recognized, may lead to delayed diagnosis and persistent morbidity to the patient. However, a vigilant radiologist, equipped with the knowledge of the characteristic appearance and typical locations of the imaging findings, should be able to make the crucial initial diagnosis and surmise additional findings to be confirmed on cross-sectional imaging.

Stener-Like Lesions of the Superficial Medial Collateral Ligament of the Knee: MRI Features.

To listen to the podcast associated with this article, please select one of the following: iTunes or Google Play. The purpose of this article is to describe Stener-like lesions of the superficial medial collateral ligament (sMCL) of the knee, which, to our knowledge, have not yet been reported in the radiologic literature. This lesion, defined as a distal tear with interposition of osseous or soft-tissue structures between the ligament and its tibial attachment, often requires surgical intervention.

Imaging features of glenoid bare spot in a pediatric population.

Objective: The bare spot (BaS) is a central, well-circumscribed focal defect in the glenoid articular surface, with reported adult incidence of 1-2%. We aimed to reassess MRI features of BaS in the pediatric population and determine its etiology.

Materials And Methods: A retrospective search of our database from June 2014 to October 2015 was performed for shoulder MRI in patients between 5 and 25 years and then subdivided into four groups: group 1, 5-10 years; group 2, 10-15 years; group 3, 15-18 years; group 4, 20-25 years.

Growth plate injury at the base of the coracoid: MRI features.

Purpose: To assess the MRI features of growth plate injury at the base of the coracoid process.

Materials And Methods: Subjects were identified through retrospective search of our department imaging database and teaching files and the teaching files of two outside academic institutions. The coracoid base growth plate was examined with attention to widening, irregularity, abnormal signal intensity of the growth plate, and the presence of adjacent soft tissue edema.

MR Imaging of the Midfoot Including Chopart and Lisfranc Joint Complexes.

Following a brief description of the normal anatomy and biomechanics of the midfoot, this article focuses on MR imaging features of common osseous, tendon, and ligament abnormalities that affect the midfoot. Discussion of the anatomy and pathology affecting the Chopart and Lisfranc joint complexes, both of which play important roles in linking the midfoot to the hindfoot and the forefoot respectively, is also included.

Tarsal tunnel disease and talocalcaneal coalition: MRI features.

Objective: To assess, utilizing MRI, tarsal tunnel disease in patients with talocalcaneal coalitions. To the best of our knowledge, this has only anecdotally been described before.

Materials And Methods: Sixty-seven ankle MRIs with talocalcaneal coalition were retrospectively reviewed for disease of tendons and nerves of the tarsal tunnel.

Imaging features of iBalance, a new high tibial osteotomy: what the radiologist needs to know.

Objective: To describe the post-surgical imaging appearance and complications of high tibial osteotomy in patients with the iBalance implant system (iHTO; Arthrex, Naples, FL, USA).

Materials And Methods: Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant review of imaging after 24 iBalance procedures was performed with attention to: correction of varus malalignment, healing at the osteotomy site, resorption of the osteoinductive compound, and complications.

Results: Immediate correction of the varus deformity was present in all cases.

Differentiating os acromiale from normally developing acromial ossification centers using magnetic resonance imaging.

Objective: Acromial fusion may not be complete until age 18-25, making it questionable to diagnose os acromiale in adolescents. Os acromiale may exist in adolescents and can be differentiated from a developing acromial ossification center based on MRI findings.

Materials And Methods: A total of 128 MRIs of the shoulder were randomly and blindly reviewed retrospectively by two musculoskeletal radiologists.

Skeletal developmental patterns in the acromial process and distal clavicle as observed by MRI.

Objective: To provide an MRI timeline of normal skeletal developmental patterns in the acromial process and distal clavicle in children up to 18 years of age.

Materials And Methods: Retrospective review of all shoulder MRIs obtained at our institution between January 2003 and March 2012, in children up to age 18, was performed. When available, radiographs and CT scans for these children were also reviewed.

Skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population: MRI features.

Objective: To assess the MRI appearance of normal skeletal development of the glenoid and glenoid-coracoid interface in the pediatric population. To the best of our knowledge, this has not yet been studied in detail in the literature.

Materials And Methods: An IRB-approved, HIPAA-compliant retrospective review of 105 consecutive shoulder MRI studies in children, ages 2 months to 18 years was performed.

Plantar tendons of the foot: MR imaging and US.

Tendon disorders along the plantar aspect of the foot may lead to significant symptoms but are often clinically misdiagnosed. Familiarity with the normal anatomy of the plantar tendons and its appearance at magnetic resonance (MR) imaging and ultrasonography (US) is essential for recognizing plantar tendon disorders. At MR imaging, the course of the plantar tendons is optimally visualized with dedicated imaging of the midfoot and forefoot.

US and MR imaging of the extensor compartment of the ankle.

Injuries to the extensor compartment of the ankle are uncommon and often are overlooked or misinterpreted at clinical presentation. Ultrasonography (US) and magnetic resonance (MR) imaging play a critical role in the diagnosis and evaluation of these injuries. US is a dynamic, quick, cost-effective imaging method for assessing ankle extensor compartment injuries as an alternative or adjunct to MR imaging.

Magnetic resonance neurography of the pelvis and lumbosacral plexus.

Recent advances in magnetic resonance (MR) imaging have revolutionized peripheral nerve imaging and made high-resolution acquisitions a clinical reality. High-resolution dedicated MR neurography techniques can show pathologic changes within the peripheral nerves as well as elucidate the underlying disorder or cause. Neurogenic pain arising from the nerves of the pelvis and lumbosacral plexus poses a particular diagnostic challenge for the clinician and radiologist alike.

Healing delayed but generally reliable after bisphosphonate-associated complete femur fractures treated with IM nails.

Background: Bisphosphonate therapy for osteoporosis has been associated with atypical femoral fractures. To date, there have been few reports in the literature regarding the preoperative and postoperative courses of patients who have sustained bisphosphonate-associated complete atypical femur fractures.

Objectives/purposes: The purposes of this study were to (1) characterize the preoperative course of patients who eventually presented with bisphosphonate-associated complete atypical femur fractures (duration of bisphosphonate treatment, pain history, risk of converting a nondisplaced fracture to a complete fracture); (2) evaluate the percentage of patients who achieved radiographic union of those fractures after treatment; and (3) determine the patients' recovery of function using the Short Musculoskeletal Functional Assessment.

Frequency of incomplete atypical femoral fractures in asymptomatic patients on long-term bisphosphonate therapy.

Objective: The purpose of our study was to determine the frequency and imaging features of atypical femoral fractures in a consecutive asymptomatic patient population on long-term bisphosphonate treatment and search for distinguishing clinical and laboratory parameters in the subset of patients with fractures.

Subjects And Methods: Two hundred femoral radiographs in 100 asymptomatic patients (93 women and seven men; age range, 47-94 years; mean age, 69.3 years) were prospectively reviewed by two radiologists.

Bisphosphonate-related complete atypical subtrochanteric femoral fractures: diagnostic utility of radiography.

Objective: The objective of our study was to evaluate the diagnostic utility of conventional radiography for diagnosing bisphosphonate-related atypical subtrochanteric femoral fractures.

Materials And Methods: Retrospective interpretation of 38 radiographs of complete subtrochanteric and diaphyseal femoral fractures in two patient groups-one group being treated with bisphosphonates (19 fractures in 17 patients) and a second group not being treated with bisphosphonates (19 fractures in 19 patients)-was performed by three radiologists. The readers assessed four imaging criteria: focal lateral cortical thickening, transverse fracture, medial femoral spike, and fracture comminution.

Bone marrow edema patterns in the ankle and hindfoot: distinguishing MRI features.

Objective: Many disorders produce similar or overlapping patterns of bone marrow edema in the ankle. Bone marrow edema may present in a few hindfoot bones simultaneously or in a single bone. The purpose of this pictorial essay is to provide guidelines based on clinical history and specific MRI patterns and locations to accurately identify the cause of ankle bone marrow edema.

MRI features of cortical desmoid in acute knee trauma.

Objective: The purpose of this study was to describe the MRI features of cortical desmoids associated with acute trauma.

Conclusion: Marrow edema, periostitis, and adjacent soft-tissue edema can be seen in cases of cortical desmoid associated with acute trauma.

MRI of ankle and lateral hindfoot impingement syndromes.

Objective: The objective of this article is to review the pathophysiology and clinical presentation of impingement syndromes at the ankle joint (anterolateral, anterior, anteromedial, posteromedial, and posterior) and the role of MRI in evaluating impingement at the ankle joint and at extraarticular locations, lateral to the ankle joint (talocalcaneal and calcaneofibular).

Conclusion: MRI is valuable in assessing both osseous and soft-tissue abnormalities associated with impingement syndromes.

MR imaging of entrapment neuropathies of the lower extremity. Part 2. The knee, leg, ankle, and foot.

Entrapment neuropathies of the knee, leg, ankle, and foot are often underdiagnosed, as the results of clinical examination and electrophysiologic evaluation are not always reliable. The causes of most entrapment neuropathies in the lower extremity may be divided into two major categories: (a) mechanical causes, which occur at fibrous or fibro-osseous tunnels, and (b) dynamic causes related to nerve injury during specific limb positioning. Magnetic resonance (MR) imaging, including high-resolution MR neurography, allows detailed evaluation of the course and morphology of peripheral nerves, as well as accurate delineation of surrounding soft-tissue and osseous structures that may contribute to nerve entrapment.

MR imaging of entrapment neuropathies of the lower extremity. Part 1. The pelvis and hip.

Entrapment neuropathies can manifest with confusing clinical features and therefore are often underrecognized and underdiagnosed at clinical examination. Historically, electrophysiologic evaluation has been considered the mainstay of diagnosis. Today, cross-sectional imaging, particularly magnetic resonance (MR) imaging and specifically MR neurography, plays an increasingly important role in the work-up of entrapment neuropathies.

Subtrochanteric femoral fractures in patients receiving long-term alendronate therapy: imaging features.

Objective: A paradoxical association between long-term alendronate therapy and low-energy subtrochanteric femoral fractures has been recently recognized. A retrospective review of 34 such femoral fractures was performed.

Conclusion: Subtrochanteric femoral fractures associated with long-term alendronate therapy present with minimal trauma, may be chronic, and when incomplete may be missed.