Incidental Tibial Lesion

62-year-old patient. History of injury 2 years ago. Clinically signs of lateral meniscal tear with possible meniscal cyst.  No specific pain stated. No X-ray available.

Sequences, clockwise, starting top left corner: PD FS, T1w, PD FS, TIRM

Appears benign.

Ideas?

Björn Jobke, MD

Senior Clinical AI Advisor Radiology

MSK Radiology Consultant

TMC - a Unilabs company

San Francisco/ Barcelona

Patient with Recurrent Dislocations

28-year-old, status post Bankart repair 2 years ago. Recurrent dislocations.

Recurrent detachment. On ABER looks like a Perthes lesion.

https://www.ajronline.org/doi/10.2214/ajr.178.1.1780233

Phillip Tirman MD

Test Sinus Tarsi syndrome

This is the case I am currently reading. Work injury. First image that comes up looks to me like sinus tarsi syndrome. Agree?

Testing what it will look like and whether my sig transfers. 

--

Phillip Tirman MD
Renaissance Imaging Center Westlake Village

Two Dole Drive

Westlake Village, CA 91362

Tel: 818-575-8066

1st webspace mass

I don't remember this case from 2017...I'm just showing you that I can drag and drop an image into an email to ocad.manager.robot@blogger.com

Unless I embed my name, you don't see who posted it.

ECRB Laceration

Patient had garage door close on distal forearm. Hand surgeon said there is mild wrist weakness but no finger weakness. Had unknown surgery.

10 y/o with palpable lump on his finger. No pain.  3rd and 4th ray are affected.

62 M 6 weeks non-traumatic pain with acute onset

Biopsy proven Epithelioid Hemangioma

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314752/

Sudden onset thigh pain following admission with septic shoulder bursitis.

39 male
Sudden onset thigh pain week following hospital admission with septic subacromial/subcoracoid bursitis ( now treated)
However at this visit white cell count , CRP  not markedly elevated .

Although not volunteered on requisition form , further enquiry established patient has very poorly controlled/managed Type 2 diabetes mellitus
Diagnosis and discussion follows

POST GADOLINIUM

POST GADOLINIUM

DIAGNOSIS : DIABETIC MYONECROSIS

Occurs in poorly controlled diabetes

Commonly thigh muscles

Sudden onset pain .Lab markers ( CRP, WBC )  typically only mildly deranged

Usually self limiting

Another teaching point is that in my experience, diabetes is often not volunteered on requisition forms for MSK studies but may be very relevant

Link to recent clinical review follows

Diabetic muscle infarction: a systematic review

42 y/o patient referred for back pain.

Hi,

 

Just testing the output of this email.

 

Same case as  https://ocadmsk.blogspot.com/2019/09/42-yo-patient-referred-for-back-pain.html

 

 

Björn

Sudden onset thigh pain following admission with septic shoulder bursitis.

39 male

Sudden onset thigh pain week following hospital admission with septic subacromial/subcoracoid bursitis ( now treated)

However at this visit white cell count , CRP  not markedly elevated .

Although not volunteered on requisition form , further enquiry established patient has very poorly controlled/managed Type 2 diabetes mellitus

Diagnosis and discussion follows images

DIAGNOSIS : DIABETIC MYONECROSIS

Occurs in poorly controlled diabetes

Commonly thigh muscles

Sudden onset pain .Lab markers ( CRP, WBC )  typically only mildly deranged

Usually self limiting

Another teaching point is that in my experience, diabetes is often not volunteered on requisition forms for MSK studies but may be very relevant

Link to recent clinical review follows

Diabetic muscle infarction: a systematic review

How to create a teaser section followed by the answer

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Femoral head lesion

F 62, left hip pain. Suspected impingement.

There's a subchondral / subcortical bone lesion at the anterior aspect of the left femoral head with cystic and fatty components, possibly also some calcification.

To me it doesn't look like a typical impingement lesion / herniation pit.

More like cystic degeneration of an intraosseous lipoma, or an LSMFT.

She also has chondropathy with subchondral cysts and mild trochanter bursitis (not shown).

What is your impression?

Thanks,

Andrei

P.S.
I wanted to add a comment to my own post but it seems that's not possible.
As far as I can tell, one can only insert images or videos, no way to attach a powerpoint, pdf etc. If that's correct it would in my opinion be a severe limitation.

42 y/o patient referred for back pain.
Incidental L2 lesion.
CT and standard sequences top row, axial T1 VIBE fs C+ below with mild enhacement.

CT shows hazy sclerosis, no lytic areas.

CT + MR

Diagnosis: BNCT

Adhesive Capsulitis

38 yr old male with 5 months pain and severely limited ROM.

There is marked capsular thickening and edema, most pronounced in the axillary capsule; this is adhesive capsulitis.There is diffuse thickening of the MGHL.

I understand the MGHL is routinely thickened and resected in arthroscopic capsular release, but I have not found that it is commonly visible. 

There is no imaging abnormality of the cuff or labrum.

Although he is unusually young and male for this diagnosis, imaging features and clinical symptoms are diagnostic for adhesive capsulitis.

Symptomatic Os Vesalianum or old non-united zone 1 5th MT base fracture?

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