Checkpoint Inhibitor Immune-Related Adverse Events: A Multimodality Pictorial Review.

Cancer immunotherapies are drugs that modulate the body's own immune system as an anticancer strategy. Checkpoint inhibitor immunotherapies interfere with cell surface binding proteins that function to promote self-recognition and tolerance, ultimately leading to upregulation of the immune response. Given the striking success of these agents in early trials in melanoma and lung cancer, they have now been studied in many types of cancer and have become a pillar of anticancer therapy for many tumor types. However, abundant upregulation results in a new class of side effects, known as immune-related adverse events (IRAEs). It is critical for the practicing radiologist to be able to recognize these events to best contribute to care for patients on checkpoint inhibitor immunotherapy. Here, we provide a comprehensive system-based review of immune-related adverse events and associated imaging findings. Further, we detail the best imaging modalities for each as well as describe problem solving modalities. Given that IRAEs can be subclinical before becoming clinically apparent, radiologists may be the first provider to recognize them, providing an opportunity for early treatment. Awareness of IRAEs and how to best image them will prepare radiologists to make a meaningful contribution to patient care as part of the clinical team.

MRI of the annular ligament of the elbow: review of anatomic considerations and pathologic findings in patients with posterolateral elbow instability.

OBJECTIVE: The annular ligament is one of the major stabilizers of the proximal radioulnar joint. However, it is one of the least studied structures in the lateral elbow because of imaging challenges and low pathologic incidence. This article will examine the anatomy of the annular ligament, its biomechanics, and its functional importance. Eight surgically proven cases of annular ligament abnormality in patients with posterolateral and nursemaid elbow, along with the associated findings, are presented. CONCLUSION: Adequate understanding of the anatomy and familiarity with the associated injuries that can be seen in annular ligament displacement or rupture will improve detection of annular ligament abnormality.