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Hypothenar Hammer Syndrome

History: 30 y/o male oil rig worker. Finger pain. Numbness and discoloration of the third finger. Diagnosis: Hypothenar Hammer Syndrome. There is “corkscrew” elongation and ectasia of the ulnar artery extending into the proximal portions of the deep and superficial palmar arches.  There are also findings of microemoblic disease to the radial digital artery to […] Read More >

Knee: MCL Stener-Type Lesion

Clinical: 31 year old male status post twisting injury. Dx: 1. Acute full-thickness ACL tear. 2. Acute full-thickness tear/avulsion of the distal MCL with 12 mm of proximal retraction. The retracted ligament stump is located superficial/proximal to the pes anserinus tendons; a type of MCL injury that may require surgical intervention (MCL Stener-type lesion). 3. […] Read More >

Thigh: Rectus Femoris

Clinical: 13 y/o female status post injury 1 month prior. Progressive pain. Dx: Subacute partial tear of the rectus femoris centered at the deep musculotendinous junction at the mid thigh. There is approximately 19 mm of muscle retraction and a subacute hematoma at the tear site measuring 20 x 15 x 10 mm. The tear […] Read More >

38 Y/O with Liver Failure

38yo male w/ long alcohol history, hepatic failure and seizures Ammonia  211   (normal = 9-33 mcmol/L) Dx – Acute hyperammonemic encephalopathy associated with liver failure. Read the AJNR article here. Read the Neurohospitalist article here. References: 1. U-King-Im JM, Bartlett E, Soobrah R, Kucharczyk W. AJNR: Feb. 2011 – vol. 32, pp. 413-418. 2. Rosario […] Read More >

Lipoma and Stress Fracture

Clinical: Recent trauma with heel pain. Lytic calcaneal lesion on radiograph without fracture. Dx: 1. Acute stress fracture of the posterior calcaneus with surrounding edema.   2. Intraosseous lipoma within the calcaneal body resulting in significant thinning of the lateral calcaneal body cortex and moderate thinning of the medial calcaneal body cortex. This could place the patient […] Read More >

Calcific Tendonitis

Clinical: 31 y/o female with acute onset of pain, redness, and swelling.  No injury. Evaluate for infection or abscess. Dx: Calcific tendonitis of the adductor hallucis. The xray findings here are very subtle and the MRI really helped out.  Old case report attached. Note: Calcific tendonitis presents acutely and symptoms can be severe;  with patients […] Read More >

32 Y/O with Spinal Mass

32 yo male with bilateral foot drop and tingling in feet. Intradural mass displacing nerve roots of cauda equina to periphery of thecal sac.  Good look for myxopappilary ependymoma, though could be other intradural tumors (e.g. meningioma, schwannoma, met)

15 Y/O with Ankle Pain

HISTORY: 15yo male, pain with walking, chronic. Referring physician indicated talonavicular dislocation and postierior tibial tendon rupture as well. DX: Accessory anterolateral talar facet, with MRI findings of osseous impingement including bone marrow edema and sclerosis. This is seen in conjunction with hindfoot valgus and pes planus. There is attenuation/stretching of the spring ligament (superomedial […] Read More >

60 Y/O with Hypercalcemia

Slide 1: The pt had a 4D CT to evaluate for parathyroid hyperplasia or adenoma. This study highlights the importance of the reformats and is a nice example of a sign described in the U/S literature and in AJNR (linked below) for the same sign on CT. Slide 2: The thyroid U/S described the partially calcified nodule […] Read More >