Snapping Shoulder Secondary to Subluxation of an Accessory Coracobrachialis.

Numerous snapping syndromes have been reported in the musculoskeletal system. Identifying the cause of these symptoms can often be challenging as the underlying abnormality may not be appreciable on routine static examinations. We report a 30-year-old female who presented with an unusual snapping sensation in her right anterior shoulder. This was readily reproducible during shoulder abduction with a palpable clicking evident on clinical examination. Dynamic ultrasound revealed this to be secondary to an accessory coracobrachialis muscle, which subluxed suddenly over the anterior subscapularis tendon during abduction. An accessory coracobrachialis muscle is a rare normal variant that is often asymptomatic. Extra-articular causes of shoulder snapping have been rarely reported, and this is the first case report of an accessory coracobrachialis muscle causing a snapping shoulder phenomenon.

Top-Ten Tips for Imaging Groin Injury in Athletes.

Athletic groin injury remains a challenging prospect for sports clinicians and radiologists because of the closely related anatomical structures and overlapping clinical presentations. Recent consensus work designated four causative clinical entities, with the adductor/rectus aponeurosis and pubic symphysis capsule emphasized as key areas. This article highlights these key aspects of athletic groin injury with tips on anatomy, potential abnormalities, acronyms, and imaging appearances in this complex but common and potentially incapacitating entity. Many clinical and radiologic terms are in use such as cleft, enthesitis, plate injury, or defect that can cause confusion, and thus anatomical descriptions are preferable.Detailed clinical assessment is necessary but remains challenging because of the nonspecific presentations. Imaging, and in particular magnetic resonance imaging, plays an essential role in the evaluation process. But only when the two are used in combination can an accurate diagnosis be reached because several studies in asymptomatic athletes show that reactive changes are common.

Ultrasound of the Distal Insertions of the Ankle and Foot Tendons With Anatomical Correlation: A Review.

The distal insertions of the tendons crossing the ankle as well as the tendons originating in the foot are less well known by radiologists. We review the anatomy and ultrasound appearance of these insertions using our own cadaveric sectioning and dissection. The ultrasound images were correlated with anatomical slices. Occasionally magnetic resonance images were also used for better understanding. Understanding the normal appearance of these tendon insertions is important for diagnosing pathology in this region.

Imaging of the Painful Hip Arthroplasty.

The incidence of complications following total hip arthroplasty is low, but due to the frequency of the procedure, they are quite commonly encountered and require appropriate investigation. Complications include aseptic loosening, infection, foreign body granulomatosis (osteolysis), adverse reactions to metal debris, periprosthetic fracture, heterotopic ossification, hardware failure, and a range of soft tissue complications, all of which may result in pain. Relevant imaging findings are illustrated and the role of various imaging modalities is reviewed. A suggested approach for the radiological investigation of each potential complication is outlined, based on our experience at a specialist referral unit.

Sclerosing bone dysplasias: genetic, clinical and radiology update of hereditary and non-hereditary disorders.

There is a wide variety of hereditary and non-hereditary bone dysplasias, many with unique radiographic findings. Hereditary bony dysplasias include osteopoikilosis, osteopathia striata, osteopetrosis, progressive diaphyseal dysplasia, hereditary multiple diaphyseal sclerosis and pyknodysostosis. Non-hereditary dysplasias include melorheostosis, intramedullary osteosclerosis and overlap syndromes. Although many of these dysplasias are uncommon, radiologists should be familiar with their genetic, clinical and imaging findings to allow for differentiation from acquired causes of bony sclerosis. We present an overview of hereditary and non-hereditary bony dysplasias with focus on the pathogenesis, clinical and radiographic findings of each disorder.

Normal Anatomy and Compression Areas of Nerves of the Foot and Ankle: US and MR Imaging with Anatomic Correlation.

The anatomy of the nerves of the foot and ankle is complex, and familiarity with the normal anatomy and course of these nerves as well as common anatomic variants is essential for correct identification at imaging. Ultrasonography (US) and magnetic resonance (MR) imaging allow visualization of these nerves and may facilitate diagnosis of various compression syndromes, such as "jogger's heel," Baxter neuropathy, and Morton neuroma. It may be difficult to distinguish the nerves from adjacent vasculature at MR imaging, and US can help in differentiation. The authors review the normal anatomy and common variants of the nerves of the foot and ankle, with use of dissected specimens and correlative US and MR imaging findings. In addition, the authors illustrate proper probe positioning, which is essential for visualizing the nerves at US. The authors' discussion focuses on the superficial and deep peroneal, sural, saphenous, tibial, medial and lateral plantar, medial and inferior calcaneal, common digital, and medial proper plantar digital nerves.

A minimally invasive approach to undergraduate anatomy teaching.

Anatomy is one of the cornerstones of medical education. Unfortunately, sufficient evidence has accumulated to suggest a worldwide decline in the resources and time allocated to its teaching. Integration of anatomy with clinical medicine has been frequently advocated as the solution to this academic crisis. Consequently, new ways of harnessing clinical relevance to the teaching of anatomy must be sought to make it applicable to contemporary clinical practice. Human cadavers have been used to teach laparoscopic skills to surgical trainees for some time. More recently, centers in the United States have piloted the use of minimally invasive techniques in the teaching of anatomy to undergraduates. We believe that the use of laparoscopy on human cadavers may also be used to complement the teaching of anatomy to United Kingdom and European medical students. This would not only familiarize students with the topography and morphology of human anatomy, but also with the concept of manipulating anatomical structures to achieve a clinical outcome. Other benefits include improved three-dimensional orientation, increased dexterity, and development team-working skills amongst students. A UK feasibility study is currently underway.