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History: man with ankle pain. This is an example of a dorsal talar osteophyte, which is a mimicker of a dorsal talar beak. A dorsal talar osteophyte indicates osteoarthrosis of the talocrural or talonavicular joint. A dorsal talar beak is seen in cases of tarsal coalitions where there are abnormal articulations typically between the calcaneus … Continue reading
History: adolescent with leg pain at night. This is a classic case of an osteoid osteoma. An osteoid osteoma is a benign osteoid producing bone tumor. They are radiolucent on radiographs and classically have tumor nidus surrounded by reactive sclerosis on radiographs and edema on MRI. Osteoid osteomas represent approximately 10-15% of benign bone tumors … Continue reading
History: 70 year old man with leg pain. This is a case of calcific myonecrosis of the anterior tibialis muscle. Calcific myonecrosis is a rare late complication of compartment syndrome. This patient actually had a history of compartment syndrome 30 years earlier. The current understanding according to this article here is that compartment syndrome initially leads to … Continue reading
History: 50 year old man with knee pain. This is an excellent example of a Bosch Bock bump, which is a healed Segond fracture. This finding is nearly 100% specific for prior injury to the anterior cruciate ligament. A Segond fracture is an avulsion fracture of the lateral tibial capsular ligament at the lateral tibial … Continue reading
History: male involved in high speed motor vehicle accident with chest pain. This is a good example of a ductus diverticulum, or ductus bump. A ductus diverticulum is a focal smooth outpouching of the aortic wall at the aortic isthmus where the obliterated ductus arteriosus (the ligamentum arteriosum) is attached to the aorta. The ductus … Continue reading
History: 70 year old male with hip pain. This is a case of metastatic prostate cancer to bone. Prostate cancer metastases are usually sclerotic (also called osteoblastic), leading to increased opacity on x-rays and CT scans. Prostate cancer metastases also have a preference for the axial skeleton over the appendicular skeleton. The gold standard for determining … Continue reading
History: male with headache. This is a case of osteopetrosis, also referred to as marble bone disease. In osteopetrosis, bones become abnormallly hardened, as opposed to osteoporosis where bone mineral density is abnormally decreased and osteomalacia where bones are abnormally soft. Osteopetrosis is thought to be caused by impaired osteoclast activity, resulting in impaired bone … Continue reading
History: 30 year old man with wrist swelling and pain. This is a case of a perilunate dislocation. A perilunate dislocation is a carpal instability pattern that usually results from hyperdorsiflexion of the wrist. In the perilunate dislocation pattern the capitate dislocates dorsally and moves proximally and rotates the lunate in a volar direction while … Continue reading
History: 35 year old male with knee pain. This is the appearance of an enchondroma on MRI. Enchondromas are benign lesions made up of hyaline cartilage that arise within medullary bone. They typically occur in the metaphysis or metadiaphyseal junction of the proximal humerus, proximal and distal femur, and proximal tibia, as in our case … Continue reading
History: middle aged man with right upper quadrant pain. This is a case of acute calculous cholecystitis. Cholecystitis can be classified as either acute or chronic, and acute cholecystitis can be either calculous or acalculous. Calculous cholecystitis occurs in 95% of cases of cholecystitis, and acalculous cholecystitis occurs in 5% of cases of cholecystitis. This … Continue reading
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