Roca disease: An osteochondrosis of the inferior pole of the scapula with review of the literature.

Osteochondrosis is a developmental condition affecting the endochondral ossification. It is commonly idiopathic however can be due to vascular anomalies, dietary conditions, hormonal irregularity, or overuse trauma. Osteochondrosis occurring in the inferior pole of the scapula is an extremely rare condition and is referred to as roca disease. A higher degree of suspicion is required especially in a young patient with atraumatic shoulder pain and additional unconventional MRI sequences focusing on the inferior pole of scapula can be taken to rule out such conditions. We report a case of Roca disease in a 16-year male who presented with right shoulder pain. This is the third case report of roca disease in the English literature according to our knowledge and the first case report to demonstrate extensive MRI imaging features with a normal radiograph. Imaging, particularly MRI, plays a pivotal role in the diagnosis of this extremely rare entity. Also, the inferior pole of the scapula is usually not included in routine shoulder MRI imaging thus close scrutiny with additional MRI sequences should be done to diagnose such a rare entity.

Osteochondroses of the bilateral metacarpal heads: Dieterich disease. A case report with review of the literature.

Osteochondroses is a well-known entity and typically affecting immature skeleton with few common locations involved are femoral head epiphysis, tibial tubercle apophysis, calcaneal apophysis, humeral capitellum and anterior vertebral end plates. We report a rare case of osteochondroses showing avascular necrosis involving metacarpal heads known as Dieterich disease, involving the head of the third metacarpal and probably the first case with a history of rock climbing as an etiology. Chronic repetitive microtrauma plays a significant role in the disease, as is seen in our patient. Imaging plays a crucial role in diagnosing, as well as monitoring progress, with MRI being a critical modality. The fact that this entity is rare does not necessarily make it difficult to detect. It may be clinical underdiagnosed due to lack of familiarity with this entity and radiographic findings may be subtle or inapparent. Bone scan is likely sensitive but not specific. MRI also likely has a role for early detection. This article is written with educational intent for the reader for the benefit of the patients with this rare disease.

Insufficiency and nondisplaced fractures of the talar head: MRI appearances.

OBJECTIVE: We present nondisplaced talar head fractures in two patient groups. CONCLUSION: Talar head insufficiency fractures should be considered in older patients, particularly perimenopausal women. Nondisplaced talar head fractures may occur in younger patients after trauma.

MR arthrography of the second and third metatarsophalangeal joints for the detection of tears of the plantar plate and joint capsule.

OBJECTIVE: Tears of the plantar plate and joint capsule of the metatarsophalangeal joint are underrecognized causes of lesser metatarsalgia. This study evaluated MR arthrography for evaluation of this condition in 45 metatarsophalangeal joints in 41 patients. CONCLUSION: Most metatarsophalangeal joint capsular tears occur at the distal lateral border of the plantar plate, often with injury of the adjacent interosseous tendon. Plantar plate tears are less common. MR arthrography of the metatarsophalangeal joint delineates capsular tears and associated abnormalities.