Posts By: Daniel

It’s as if her shoulder was “frozen”

This 40-year-old female presents with right shoulder pain that started two weeks prior. There is no known source of injury. Movement has limited range, and there have been no injections or physical therapy. Q1 – What are the primary abnormal features of this case? Q2 – Which common diagnosis could be easily misdiagnosed in this… Read more »

While observing the mass, we noticed she had a tail

This 44-year-old female presents with right wrist pain. You are shown five images. A coronal proton density (image 1), a coronal proton density fat suppression (image 2), two sagittal proton density fat suppression (images 3 and 4), and an axial or short-axis proton density (image 5). A hyperintense mass around the ulna is obvious. Q1 –… Read more »

A close look at a transspatial thoracic spine abscess

This 55-year-old male patient has history of quadriplegia due to transsection of the upper cervical spinal cord (image 1, orange arrow). Within the last six months, the patient noticed an absence of muscle spasms from the lower lumbar and lower extremities. At the level of the T11-T12 intervertebral disc space, large loculated fluid collection /… Read more »

What can happen when you combine a 33-year-old shoulder with weight lifting?

This 33-year-old weight lifter presents with anterior shoulder pain and popping. Q1 – Using images 1 through 4, what are the imaging findings? Q2 – What intraarticular AC joint pathology is most likely?   A1 – The diagnosis is clavicular osteolysis. Osteolysis of the clavicle more commonly affects younger adult males (mid 30s). MRI imaging characteristics include… Read more »

Watch out for other diagnoses that look similar in this pediatric brain case

This 10-year-old male has a history of encephalitis. Q1 – The most likely diagnosis is: (a) Herpes encephalitis (b) Adrenoleukodystrophy (c) Acute disseminated encephalomyelitis (d) Acyl-CoA oxidase deficiency (e) Metachromatic leukodystrophy   A1 – (b) Adrenoleukodystrophy Adrenoleukodystrophy (ALD) is an X-linked disorder affecting young males due to the accumulation of very long chain fatty acids… Read more »

At a glance, how would you assess this ankle?

This 43-year-old female presents with ankle pain and paresthesia. Using images 1 through 5, what is your diagnosis?   When looking at image 6, note four tendons in the medial flexor compartment. This is known as “the sign of too many tendons”. The arrows in image 6 point to a complex longitudinal split tear of… Read more »

Anatomy Queen or King for a day

Here is your chance to be an anatomy king or queen for a day. We plan on dispersing these anatomic snippets of the brain in small groups so as not to overwhelm you, however, you will find complete descriptions at MRI Online. You are shown one T1 sagittal image of a 71-year-old male. Focus on the… Read more »

ACL contusion patterns: The importance of medial sided contusions

This 52-year-old male presents with knee pain following an injury one week ago. Q1 – What is the most likely mechanism of injury in this individual with an ACL tear? Q2 – What are the potential internal derangements associated with this knee contusion pattern?   A1 – Image 7 demonstrates an acute ACL tear (blue… Read more »

Don’t miss the salient finding in this brain case

A 55-year-old man presents with headache, neck pain and dizziness. See if you can answer the questions below by looking at images 1 through 3 before looking at the duplicate images with arrows (images 4 through 6). Q1 – What is the salient finding on the presented MRI study? (a) Cortical atrophy (b) Dural venous thrombosis… Read more »

Be kind to your AC joint. It can only take so much.

Many of us have experienced pain in the shoulder. It is often attributed to some deep-seated joint abnormality, and we wonder if it is the dreaded rotator cuff tear. However, one of the most common causes of shoulder pain is premature degeneration from overuse of the acromioclavicular (AC) joint, the so-called “joint on top”. If… Read more »