RESUMO
Complete rupture of the conjoint pes anserinus tendon is rare, and isolated rupture without injury to associated structures has not been previously reported in the literature. A case of complete isolated rupture of the pes anserinus tendon is described in a young, healthy male. The non-specific nature of the presentation and rarity of the condition makes diagnosis from history and examination alone challenging. Magnetic resonance imaging was critical in making the correct diagnosis and excluding other potential-associated injuries with the diagnosis confirmed intraoperatively. The patient underwent surgical repair and rehabilitation and made significant progress. The diagnosis may be overlooked on a routine knee MRI, particularly in the absence of other associated injuries. An untreated injury may result in a poor outcome for the patient, with chronic pain and reduced function. Hence it is important to consider it in traumatic injuries to the region, with a view for an extended scan to visualise the full extent of the pes tendons to their insertion, particularly when there is high fluid signal in the popliteal fossa along the semitendinosus.
Assuntos
Músculos Isquiossurais , Traumatismos do Joelho , Humanos , Joelho , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/cirurgia , Extremidade Inferior , Masculino , TendõesRESUMO
PURPOSE: To quantify the prevalence of complete tibial insertion of the biceps femoris tendon in patients presenting for knee MRI scans. METHODS: Knee MRI scans over a 4-year period (2014-2018) were accessed at a tertiary referral centre and community-based private practice. A total of 433 scans were reviewed. 30 scans were excluded from the study due to repeat imaging or incomplete coverage of the biceps femoris tendon insertion. Appearances of the distal biceps tendon bony insertion were scrutinized on the remaining 403 scans. Each biceps femoris tendon insertion was classified into one of the four categories-complete fibular insertion, predominant fibular insertion, predominant tibial insertion and complete tibial insertion. RESULTS: Out of the final 403 scans included in the study, five cases of complete tibial insertion of the biceps femoris tendon were identified (just over 1% of the total population). 42 cases were identified as having predominant tibial insertion (10% of the total population). 113 cases had predominantly fibular insertion and 243 cases had complete fibular insertion. CONCLUSION: Complete anomalous insertion of the biceps femoris tendon on the anterolateral tibia is an uncommon entity. Such an attachment is found in approximately 1% of patients presenting for MRI evaluation of the knee.
Assuntos
Variação Anatômica , Tendões dos Músculos Isquiotibiais/anormalidades , Articulação do Joelho/anormalidades , Tíbia/anormalidades , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Tendões dos Músculos Isquiotibiais/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Adulto JovemRESUMO
A juvenile yellow-tailed black cockatoo (Calyptorhynchus funereus) was presented with paresis of the right wing, ptosis, and miosis of the right eye; feather erection of the right side of the head and neck; and a penetrating injury over the right pectoral muscle. Temporary reversal of ptosis, miosis, and feather erection after administration of phenylephrine drops confirmed a diagnosis of Horner syndrome. Computed tomographic imaging revealed a fractured rib, traumatic lung lesions, and subcutaneous emphysema. The right-sided Horner syndrome and wing paresis were attributed to a sympathetic nerve trauma of the eye and feathers and to the brachial plexus, respectively. This report describes the diagnosis and resolution of ptosis and miosis within 8 weeks and recovery of feather symmetry and wing function within 11 weeks of the cockatoo's initial presentation with a conservative-management treatment plan.
Assuntos
Doenças das Aves/diagnóstico , Cacatuas/lesões , Síndrome de Horner/veterinária , Ferimentos Penetrantes/veterinária , Animais , Animais Selvagens , Doenças das Aves/diagnóstico por imagem , Blefaroptose/complicações , Blefaroptose/diagnóstico , Blefaroptose/veterinária , Diagnóstico Diferencial , Síndrome de Horner/complicações , Síndrome de Horner/diagnóstico , Paresia/complicações , Paresia/diagnóstico , Paresia/veterinária , Músculos Peitorais/lesões , Austrália do Sul , Tomografia Computadorizada por Raios X/veterinária , Ferimentos Penetrantes/complicações , Ferimentos Penetrantes/diagnósticoRESUMO
Lumbrical strain is a relatively unknown hand injury. We report four cases of lumbrical origin strain involving the ring finger flexor tendons. Three patients sustained the injury during rock climbing and one while working with a jackhammer. In all cases, circumferential fluid around the flexor tendons of the ring finger was demonstrated on MRI and/or ultrasound at the distal palmar level at the "bare area," which is normally devoid of a synovial sheath. There is a paucity of information in the literature regarding this injury and its specific imaging features. Lack of awareness of this injury renders accurate diagnosis difficult.
Assuntos
Traumatismos dos Dedos/diagnóstico por imagem , Entorses e Distensões/diagnóstico por imagem , Adulto , Dedos/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tendões , UltrassonografiaRESUMO
INTRODUCTION: Intravenous lobular capillary haemangioma (IVLCH) is a rare benign lesion with minimal published reports containing a description of its appearance at medical imaging. We present the ultrasound and MRI images of a histologically proven IVLCH and provide the first review of the imaging findings reported in the literature. METHODS: The imaging findings of a case of IVLCH are presented. A PubMed search of English language articles was performed from 1966 to October 2016, and all relevant papers were reviewed. Imaging findings from those papers are summarised. RESULTS: Key features on ultrasound are of a well-defined, usually hypoechoic, mass which is highly vascular. The host vein is usually apparent. MRI imaging usually shows T1 signal isointense to muscle and variable T2 signal, either isointense or of high signal relative to the vein. The lesions enhance with gadolinium. CONCLUSION: Intravenous lobular capillary haemangioma has distinctive ultrasound but less consistent MRI features although radiological diagnosis should usually be possible. Review of reported cases shows that a previously described gender bias is incorrect.