Geoffrey M. Riley

Intraosseous lipoma of the calcaneus.

We present two patients with pathologically proven intraosseous lipoma of the os calcis. A review of the literature, the radiologic criteria, and the differential diagnosis are provided.

Magnetic Resonance Arthrography

Magnetic resonance arthrography is widely used throughout the world for joint imaging. It extends the capabilities of conventional MR imaging because contrast solution distends the joint capsule, outlines intraarticular structures, and extends into soft tissue tears and defects. MR arthrography exploits the natural advantages gained from a joint effusion and can be performed on any joint.

Magnetic resonance imaging of sports injuries of the elbow.

Many abnormalities seen in the elbow result from trauma, often from sports such as baseball and tennis. Elbow problems are frequently related to the medial tension-lateral compression phenomenon, where repeated valgus stress produces flexor-pronator strain, ulnar collateral ligament sprain, ulnar traction spurring, and ulnar neuropathy. Lateral compression causes osteochondral lesions of the capitellum and radial head, degenerative arthritis, and loose bodies. Other elbow abnormalities seen on magnetic resonance imaging include radial collateral ligament injuries, biceps and triceps tendon injuries, other nerve entrapment syndromes, loose bodies, osseous and soft-tissue trauma, arthritis, and masses, including bursae.

MRI of the Hip for the evaluation of femoroacetabular impingement; past, present, and future

The concept of femoroacetabular impingement (FAI) has, in a relatively short time, come to the forefront of orthopedic imaging. In just a few short years MRI findings that were in the past ascribed to degenerative change, normal variation, or other pathologies must now be described and included in radiology reports, as they have been shown, or are suspected to be related to, FAI. Crucial questions have come up in this time, including: what is the relationship of bony morphology to subsequent cartilage and labral damage, and most importantly, how is this morphology related to the development of osteoarthritis? In this review, we attempt to place a historical perspective on the controversy, provide guidelines for interpretation of MRI examinations of patients with suspected FAI, and offer a glimpse into the future of MRI of this complex condition. J. Magn. Reson. Imaging 2015;41:558–572.

Foot and ankle injuries in sport: imaging correlation with arthroscopic and surgical findings.

Foot and ankle injuries are common in sport. Although many available imaging techniques can be useful in identifying and classifying injuries, magnetic resonance imaging (MRI) provides high levels of sensitivity and specificity for articular and soft-tissue injuries. Arthroscopic and minimally invasive treatment techniques for foot and ankle injuries are rapidly evolving, minimizing morbidity and improving postoperative rehabilitation and return to play. Correlation between MRI and surgical findings can aid in both accessing and treating pathologic processes and structures.

Magnetic resonance imaging in the evaluation of sports injuries of the foot and ankle: a pictorial essay.

Magnetic resonance imaging is playing an increasingly important role in evaluation of the injured athletes foot and ankle. Magnetic resonance imaging allows accurate detection of bony abnormalities, such as stress fractures, and soft-tissue abnormalities, including ligament tears, tendon tears, and tendinopathy. The interpreter of magnetic resonance images should systematically review the images, noting normal structures and accounting for changes in soft-tissue and bony signal.

Approach to MR Imaging of the Elbow and Wrist: Technical Aspects and Innovation

Wrist and elbow MR imaging technology is advancing at a dramatic rate. Wrist and elbow MR imaging is performed at medium and higher field strengths with more specialized surface coils and more variable pulse sequences and postprocessing techniques. High field imaging and improved coils lead to an increased signal-to-noise ratio and increased variety of soft tissue contrast options. Three-dimensional imaging is improving in terms of usability and artifacts. Some of these advances have challenges in wrist and elbow imaging, such as postoperative patient imaging, cartilage mapping, and molecular imaging. This review considers technical advances in hardware and software and their clinical applications.

Hip-Femoral Acetabular Impingement

Magnetic resonance imaging (MRI) has become a valuable technology for the diagnosis and treatment of femoroacetabular impingement (FAI). This article reviews the basic pathophysiology of FAI, as well as the techniques and indications for MRI and magnetic resonance arthrography. Normal MRI anatomy of the hip and pathologic MRI anatomy associated with FAI are also discussed. Several case examples are presented demonstrating the diagnosis and treatment of FAI.

Ruptured malignant ovarian tumor mimicking ruptured ectopic pregnancy.

Ovarian carcinoma is uncommon in premenopausal women and few cases appear during pregnancy. Acute symptoms, such as pain secondary to rupture or torsion, are unusual. The majority of women with epithelial ovarian carcinoma remain asymptomatic for long periods of time. When symptoms do occur they are often vague and nonspecific. Unsuspected ovarian carcinomas may be detected incidentally during routine obstetrical examinations. We present a case of ovarian carcinoma complicating an early pregnancy in a young woman with findings suggestive of ectopic pregnancy. The ultrasonographic findings also were initially thought to be consistent with ectopic pregnancy.

Extraskeletal Osteosarcoma of the Hand: The Role of Marginal Excision and Adjuvant Radiation Therapy

BackgroundExtraskeletal osteosarcoma of the hand is rare, and its optimal modality of local control is not currently known.MethodsA literature search was performed to identify studies that describe the treatment and outcomes of extraskeletal osteosarcoma. A second literature search was performed to identify studies that describe the treatment and outcomes of extraskeletal osteosarcoma of the hand specifically.ResultsThe role of adjuvant radiation for extraskeletal osteosarcoma is not well defined. All cases in the literature describing treatment of extraskeletal osteosarcoma of the hand utilized amputation, and none of the patients described received radiation therapy. However, there are multiple reports showing excellent local control, minimal toxicity, and superior functional outcome with limb conservation and radiation rather than amputation of the hand in pediatric and adult soft tissue sarcoma.ConclusionFor extraskeletal osteosarcoma of the hand, we recommend a treatment approach with the goal of preservation of form and function using limb-sparing surgery and planned postoperative radiation.