Woman in her early 40’s came in for a DVT scan.

She had pain in her calf.

No DVT present.

Scanned her medial gastrocnemius muscle and saw this image.

I think it very much resembles myositis with the ‘cracked mud’ appearance.

My radiologist that day (MSK radiologist with > 30 years experience) reported this as fatty atrophy in the…[Read more]

I don’t really know the answer with absolute certainty,

But to me they look like completely different pathological conditions.

Sinding Larsen Johansson on one side and classic dysrepair phase tendinosis on the other.

If they were two seperate patients I would not have hesitated to call it this way,

The fact they are…[Read more]

I always think that planters tears are like unicorns (very rare indeed)

But your case has me convinced.

I think your planters tendon has failed distally and become “unplugged” from its distal insertion.

The distance you have measured is not a gap, but a section of crinkled up / detensioned plantaris tendon.

The…[Read more]

It’s been a hot minute.

I thought I would post this nice plantaris case. First one I have seen.
16 year old felt Achilles pain whilst playing footy on the weekend.
No specific incident, gradually got worse. Now in moon boot, and pain when walking.

Achilles intact, medial gastroc and soleus intact.
I noticed some oedema around…[Read more]

The case involves a…[Read more]

Even the erosion,

If it was hydroxyapatite it would show in the X-ray,

Being gout it is invisible on the X-ray.

The erosion may be visible, but not the crystals.

I think gout is the correct diagnosis.

You can do a dual energy CT scan or an aspiration for confirmation.

Nice one,

Steve.

Was just wondering what you thought of these US pics. They were querying gout. The XR did not say there was gout.

I just thought I saw these echogenic oval areas but wasn’t sure if it looked like tophus? Underlying OA/synovitis. I was just a bit confused when it was also visible on the contralateral side (he was also sore there too).…[Read more]

Have a great day scanning,

Steve.

There does not need to be a fracture to create a Stener lesion, however some do have a small avulsion fracture as the distal end of the UCL is pulled off the proximal phalangeal base.
When I saw the first image I thought “Classic Stener!)
I am assuming that the left of screen is proximal and the right of screen is distal.
I will ask…[Read more]

There does not need to be a fracture to create a Stener lesion, however some do have a small avulsion fracture as the distal end of the UCL is pulled off the proximal phalangeal base.
When I saw the first image I thought “Classic Stener!)
I am assuming that the left of screen is proximal and the right of screen is distal.
I will ask…[Read more]

Do you extend imaging to
Left kidney when there is left varicocele
Right hypochondria along IVC when there is right varicocele
And both when there are bilateral varicocele?
Noted there are consensus paper on this, but the red flag can be hard to determined (sudden onset, not resolving… )
Thank you!

The vertibrobasilar circulation is very variable with many anatomical variations commonly seen. These extend not just to dominant and non dominant vertebral arteries, but also include a myriad of circle for Willis variations that may impact.
The diameter of the vertebral artery will most certainly be a factor in…[Read more]