Evaluation of Knee Pain in Athletes: A Radiologist's Perspective.

Lower limb injuries account for most of all injuries suffered by athletes and the knee joint accounts for over half of these. The etiology of knee pain is multifactorial; a good history focusing on the mechanism of injury and the chronicity of pain is extremely useful in correlating with radiologic findings and establishing a clinically meaningful diagnosis. This review article will discuss several important and common causes of acute and chronic knee pain in athletes, focusing on their mechanism of injury and site of pain as well as their salient imaging findings.

The Management of the Symptomatic Patient With a Metal-on-Metal Hip Prosthesis.

Metal-on-metal (MoM) hip implants have gained popularity due to their greater stability and reduction in implant failure compare to metal-on-polyethylene prostheses. However, as well as carrying general risks of hip implantation, risks specifically associated with MoM implants have been well documented in recent years. Conditions such as pseudotumours or aseptic lymphocyte-dominated vasculitis-associated lesions are specific to MoM hip implants. In this review we discuss the typical patient presentation, the investigations that should be performed, the typical findings on various imaging modalities, and the treatment options of symptomatic patients with MoM hip arthroplasties.

Iliopsoas tendon rupture: a new differential for atraumatic groin pain post-total hip arthroplasty.

Groin pain post-total hip arthroplasty (THA) is of concern for the patient and the surgeon, especially when there is no history of any traumatic event. Obvious concern centres on complications from the prosthesis. The use of multiple imaging modalities allow for accurate diagnosis of groin pain. Atraumatic iliopsoas rupture is rare and has only been reported once before in the setting of THA. We present the case of 53-year old female with atraumatic rupture of the iliopsoas tendon that presented with severe groin pain and limited flexion. We discuss the clinical presentation, radiological features and follow-up of the patient. We also discuss the relevant published literature on the topic. This is a rare phenomenon but should be consider in patients with groin pain post-THA, especially after prosthesis complications have been ruled out.

Assessment of snared-loop technique when standard retrieval of inferior vena cava filters fails.

PURPOSE: To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. METHODS: A retrospective review of all Cook Günther Tulip filters and Cook Celect filters retrieved between July 2006 and February 2008 was performed. During this period, 130 filter retrievals were attempted. In 33 cases, the standard retrieval technique failed. Retrieval was subsequently attempted with our modified retrieval technique. RESULTS: The retrieval was successful in 23 cases (mean dwell time, 171.84 days; range, 5-505 days) and unsuccessful in 10 cases (mean dwell time, 162.2 days; range, 94-360 days). Our filter retrievability rates increased from 74.6% with the standard retrieval method to 92.3% when the snared-loop technique was used. Unsuccessful retrieval was due to significant endothelialization (n = 9) and caval penetration by the filter (n = 1). A single complication occurred in the group, in a patient developing pulmonary emboli after attempted retrieval. CONCLUSION: The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.

Rendezvous technique following thermal ureteric injury after radiofrequency ablation in a solitary kidney.

Percutaneous radiofrequency (RF) ablation is a promising treatment for solid renal tumors in selected patients. Nontarget thermal damage is a known risk of the procedure. The authors describe a case of a patient who underwent RF ablation of a lower pole renal lesion and subsequently developed a ureteric stricture secondary to thermal injury. Successful management of the ureteric stricture required a rendezvous procedure. This report illustrates the potential complication of ureteric stricture formation after a RF ablation procedure and the management challenges posed by such thermal injuries.