Tendinous Signal Alterations on MRI in the Asymptomatic Elbow: A Retrospective Cross-Sectional Study.

Objectives: It is clinically relevant to prevent overtreatment of tendinopathy diagnosed solely on imaging. Therefore, the prevalence of presumable asymptomatic signal changes in the common flexor origin, biceps insertion, brachialis insertion, and triceps insertion were assessed. Materials and methods: Two hundred and five magnetic resonance imaging (MRI) exams of the elbow with coronal and axial fat-saturated fluid-sensitive sequences between January 1, 2018 and July 31, 2022 were retrospectively identified in our center.Two radiology residents reviewed the exams independently. The elbow tendons were given a score from 0 to 4. Score 0: no signal abnormality; score 1: increased T2-weighted signal around the tendon; score 2: increased T2-weighted signal compared to muscle within the tendon; score 3: partial tear; and score 4: complete tear. Results: The common flexor tendon showed signal alterations in 8% of patients; nine patients had an increased signal around the tendon, and eight patients had an increased signal within the tendon. Three patients (1.5%) had an altered signal intensity in the biceps tendon. All triceps tendons showed a linear hyperintense signal, suggesting that it is physiological. There were no partial or complete tears. No signal abnormalities were noted in the brachialis tendon among all patients. Conclusion: The prevalence of presumable asymptomatic signal alterations seen in the common flexor origin on MRI is not negligible; therefore, clinical correlation is advised to prevent overtreatment of tendinopathy in these cases. No partial or complete tears were seen.

Gas Density Within the Pancreas: A Case of Emphysematous Pancreatitis.

Teaching Point: Computed tomography is the imaging modality of choice to detect the presence of gas within or around the pancreas in emphysematous pancreatitis.

Gastric Outlet Obstruction Caused by Complicated Cholelithiasis: Bouveret Syndrome.

Teaching Point: Bouveret syndrome can be diagnosed on plain film, ultrasound, computed tomography and magnetic resonance imaging by demonstrating Rigler's triad which includes a dilated stomach, pneumobilia, and ectopic gallstone.

Parsonage-Turner Syndrome.

Teaching Point: Magnetic resonance imaging is a valuable imaging tool in Parsonage-Turner syndrome, a rare neurological disorder that presents as acute denervation in the distribution of the brachial plexus.

Cervical Myelopathy Caused by Engorged Epidural Cervical Plexus Associated with Iatrogenic Intracranial Hypotension.

Teaching Point: Iatrogenic overdrainage of cerebrospinal fluid may cause intracranial hypotension with secondary engorgement of the epidural venous plexus, resulting in potentially reversible compression radiculopathy or myelopathy.

A Rare Case of Cemento-Ossifying Fibroma of the Maxilla.

Teaching Point: Cemento-ossifying fibromas are rare, benign tumours that are mostly found in the tooth-bearing areas of the mandible or maxilla and can be seen on cone-beam computed tomography.

Hyperdense Basal Ganglia on Brain CT in Non-Ketotic Hyperglycemia Associated with Hemichorea.

Teaching Point: Unilateral choreiform movements combined with contralateral hyperdense lentiform and/or caudate nucleus on computed tomography is suggestive for non-ketotic hyperglycemia, warranting further metabolic workup.

Mirror-image Artifact of a Cephalhematoma Mimicking an Epidural Hematoma in a Newborn.

Teaching Point: When performing ultrasound examination of a cephalhematoma, the occurrence of a mirror-image artifact can mimic the presence of an epidural hematoma.