Cases

Path: metastatic melanoma

Clinical: 62 y/o male s/p ski injury to thumb. Dx: Classic Stener lesion….articles attached. Read Thumb Stener Article Read Thum Stener Skel Rad 1995 Article Read Thumb Historical Gamekeeper’s Article References: Hinke D, Erickson S, Chamoy L, Timins M.  AJR: 1994 – vol. 163, pp. 1431-1434. Campbell CS.  The Journal of Bone and Joint Surgery: […] Read More >

Clinical: 49 y/o male with history of gout. Dx:  Tophaceous gout involving the interphalangeal joint of the thumb.

Clinical:  36 y/o male with wrist pain. Dx:  Dorsal carpal boss extending off the dorsal and radial aspects of the proximal third metacarpal; likely incidental. Read Article References: Conway W, Destouet J, Gilula L, Bellinghausen H, Weeks P.  Radiology: 1985 – vol. 156, pp. 29-31.

Clinical: 70 y/o female with acute on chronic back pain. Dx: Acute pedicle stress/insufficiency fractures at the L4 and L5 levels without spondylolisthesis.  These are likely insufficiency fxs given age. Read Article References:     Parvataneni H, Nicholas S, McCance S.  SPINE: 2004 – vol. 29, no. 2, pp. E19-E21.

HCG 1,500 Findings: small “sac-like” structure in endometrium; large right adenxal mass with some peripheral flow Dx: ovarian torsion (don’t forget this one) (ectopic is cetainly the other consideration vs mass of other causes)

Clinical: 47 y/o female with pain and limited plantar flexion s/p injury. Dx: Acute or subacute complete tear the flexor hallucis longus tendon occurring at the level of the talus with a 3.8-cm tendinous gap.

Clinical: Ski injury Dx: Complete avulsion of the ulnar collateral ligament at the first metacarpophalangeal joint from the phalangeal attachment.  There is approximately 7 mm of proximal retraction of the torn ligament with interposition of the adductor aponeurosis between the retracted ligament and the phalangeal attachment.  These findings are consistent with a Stener lesion. Read […] Read More >

Clinical: 50-year-old female with history of injury and subsequent persistent ankle pain and locking.  Clinically suspected impingement. Dx:  1.  Moderate scarring of the deltoid ligament complex which could be a source of posteromedial ankle impingement (PoMI lesion).  There is adjacent mild to moderate tendinosis and tenosynovitis involving the tibialis posterior and flexor digitorum longus tendons. […] Read More >

63 y/o F with pain and swelling after a recent fall.  Findings:  Xrays show a bipartite patellar defect and round ossific body superiorly.  MRI shows the bony body attached to the vastus lateralis fibers of the quad tendon.  Central and medial components of the quad tendon and patella remain intact. Read Article References: Gorva A, […] Read More >