Ultrasound Features of the Proximal Hamstring Muscle-Tendon-Bone Unit.

The hamstring muscle complex is made by a group of posterior biarticular thigh muscles, originating at the ischial tuberosity, which extend the hip and flex the knee joint. Proximal hamstring injuries are frequent among athletes, commonly involving their long myotendinous junction during an eccentric contraction. In this pictorial essay, we describe the ultrasound technique to visualize the normal anatomy of the proximal hamstring muscle-tendon-bone complex and present ultrasound findings in patients with traumatic injuries and tendinopathies.

Intermittent flexor hallucis longus dislocation: ultrasound findings.

We report a case of intermittent dislocation of the flexor hallucis longus at its passage in the retro-malleolar area, related to a post-traumatic detachment of the retrotalar pulley from the medial tubercle of the talus. High-resolution ultrasound depicted the anterior dislocation of the tendon during dynamic stress, by asking the patient to flex his hallux against the examiner resistance, with the ankle in slight dorsiflexion. The tendon normally relocated after the dynamic maneuver. Tendon dislocation was associated with a painful snap.

High ankle sprain: sonographic demonstration of a posterior inferior tibiofibular ligament avulsion.

Syndesmotic injuries, also referred as high ankle sprains, may cause significant ankle instability and chronic pain. Ultrasound (US) is a well-proven imaging modality to evaluate the ligaments of the ankle, due to its high spatial resolution and the possibility to perform dynamic examinations. However, considering the syndesmosis complex, the sonographic appearance of the posterior inferior tibiofibular ligament (PITFL) is not well described in the pertinent literature and, to the best of our knowledge, we found no report of PITFL avulsion demonstrated at US, as in the case presented.

Killian-Jamieson diverticulum: real-time sonographic findings.

Killian-Jamieson diverticulum (KJD) is a pharyngoesophageal diverticulum that can be observed during a neck ultrasound examination. Because of its position, it is frequently misinterpreted as a thyroid nodule. We present a case of an incidental finding of KJD, where changes in shape during dynamic scanning led to the correct diagnosis, preventing from invasive procedures such as fine needle aspiration.

Intramuscular migration of calcific tendinopathy in the rotator cuff: ultrasound appearance and a review of the literature.

Calcific tendinopathy of the shoulder is a common condition caused by calcium hydroxyapatite crystals, affecting the tendons of the rotator cuff. Among uncommon complication, one is the migration of the calcium in the subacromion-subdeltoid bursa. More rare is the intraosseous migration. We present four cases of an even more rare condition, not well described in literature yet, the intramuscular migration of calcium.

Fracture of the sesamoid bones of the thumb associated with volar plate injury: ultrasound diagnosis.

The fractures of sesamoid bones of the hand are rare, sometimes the diagnosis is missed. We report a case of fracture of both the ulnar and radial sesamoids of the metacarpophalangeal (MCP) joint of the thumb. The trauma (hyperextension of the thumb during a soccer match) also caused a lesion of the volar plate. The diagnosis was made by ultrasound (US) and confirmed by CT scan.