Posts Categorized: MSK

What should you be looking for in this baseball player’s elbow injury?

This 21-year-old has sharp pain (worse with movement) and weakness after a baseball injury. Evaluate contusion. What’s the mechanism of injury? Pure valgus insult leads to proximal ulnar collateral ligament tear (arrow) and fracture with hyperintense edema of the radius. Your next move should be to evaluate the rest of the study and exclude an… Read more »

You recognize the wrist lesion, but what is its typical location?

This is a 15-year-old female with a dorsal soft tissue mass. You are shown two images, a short-axis T1-weighted spin echo (image 1) and a short-axis T2-weighted spin echo image (image 2). There really is not a differential diagnosis. So a more challenging question is: where does such a lesion normally occur in the wrist?… Read more »

Guess the sport for this 30-year-old with knee pain

This 30-year-old male presents with knee pain after a motor vehicle accident. But his imaging should have you immediately thinking about his athletic background. Which two sports stand out as his likely hobbies? Bonus points if you know a position in one of the sports that seems to see this injury even more frequently.  … Read more »

Why I took antibiotics and my tendon screamed!

This 80-year-old female presents with lower left leg soft tissue swelling and limb pain for three months. She also has a history of Levaquin therapy. What two ruptures must you take note of in her imaging? This patient has a plantaris rupture (yellow arrow, image one) and an achilles rupture (orange arrow, image two), both… Read more »

Do you see the unusual finding in this adolescent’s patella?

This 17-year-old male has patellar pain in his right knee. The cause of his pain is somewhat unusual. What is the most common locale of patellofemoral osteochondritis dissecans? What is the best treatment in a juvenile? What is the underlying cause?   The unusual finding is stage 2 osteochondritis dissecans (OCD). Take note of the… Read more »

Why is this 18-year-old having foot pain?

This 18-year-old female presents with a palpable soft tissue mass subjacent to the first metatarsophalangeal (MP) joint that she has noticed for 1-2 months. It is painful with shoes and ambulation, and you are evaluating her for a soft tissue tumor. What is the cause of her problem, and what pertinent negatives must you notice?… Read more »

What abnormality (that often produces a labral tear) is seen in this patient?

The three axial oblique images in this 43-year-old with hip pain demonstrate an abnormality. What are the associated potential imaging findings that might accompany this abnormality? The lack of tapering of the femur head to the neck is known as asphericity. This lack of tapering is associated with a bump in the anterior aspect of… Read more »

What is the appropriate treatment for this chronic fracture?

This 15-year-old has knee pain months after a collision injury. What do the arrows identify on the axial MRIs through the patella? Is it surgical? What are some options for treatment? The arrows point to large flaps and fragments of cartilage. These have resulted from a chronic osteochondral fracture that includes a defect extending through… Read more »

With no recent injury or surgery, what explains this woman’s knee pain?

This 35-year-old woman presents with pain and locking when bending joint in her right knee. She has no recent injury and no history of surgery to this knee. She has patellofemoral maltracking, but what is the most important finding? Answer: The most important finding is the septated cystic structure involving the upper fibers of the… Read more »