Ultrasound measurements of the normal peroneal tubercle: validation of the normal anatomical measurements and evaluation of the intra- and interobserver reliability.

Purpose: The aim of this study was to investigate if ultrasound could be a reliable and accurate tool to measure the size of the peroneal tubercle. Material and methods: This study measured the width, length, and height of the peroneal tubercle in 100 asymptomatic patients, comparing the measurements to prior radiographs of the foot (if available) and previously reported anatomical data. This study also assessed the intra- and interrater reliability of ultrasound as a measurement tool. Results: Our findings show that ultrasound measurements of the peroneal tubercle were consistent with values reported in the literature and prior radiographs concerning width. Both intra- and inter-observer measurements were reliable. Conclusions: This study highlights the potential of ultrasound imaging as a promising tool to measure the peroneal tubercle, and it could contribute to a better understanding of peroneal tendon disorders.

Congenital and Developmental Abnormalities of the Hand and Wrist.

Identification of congenital skeletal abnormalities is complex because of the large variety of individual syndromes and dysplasias that are often difficult to remember. Although a correct diagnosis relies on a combination of clinical, radiologic, and genetic tests, imaging plays an important role in selecting those patients who should be referred for further genetic counseling and expensive genetic tests. In addition to information derived from radiologic analysis of other skeletal elements, radiographs of the hand and wrist may provide particular useful information. In the first part of this article, we provide a guide for a systematic radiologic analysis of the hand and wrist bones that may help characterize congenital and developmental diseases. Special attention is given to the use of correct terminology. In the second part, we discuss typical examples of congenital and developmental diseases involving the hand and wrist, with an emphasis on skeletal dysplasias.

Granular Cell Tumor: A Mimicker of Breast Carcinoma.

Teaching point: Granular cell tumors are rare soft tissue tumors that may occur in the breast. While almost always benign, they may mimic a malignant tumor both clinically and on imaging.

Cone Beam Computed Tomography Imaging in Dental Implants: A Primer for Clinical Radiologists.

With the introduction of cone beam computed tomography (CBCT) into dentistry in the 1990s, radiologists have become more frequently involved in dental implant planning. This article describes the information that should be included in a radiology report to achieve a successful implantation. The justification to use CBCT during the preoperative planning phase is based on the need to evaluate patient-specific anatomy in detail (general condition of the jaw, bone quantity, and bone quality), the application of more advanced surgical techniques (maxillary sinus augmentation procedure, zygomatic implants), and the integrated presurgical planning and virtual patient approach. Postoperatively, CBCT is used when implant retrieval is anticipated and two-dimensional radiographs have not provided sufficient information, for evaluation of graft healing, or to assess complications, mostly related to neurovascular trauma.

Imaging of Mixed and Radiopaque Jaw Lesions.

Radiopaque lesions and lesions of mixed density are less frequent than radiolucent lesions of the jawbones. They comprise a spectrum of odontogenic and non-odontogenic lesions. The latter group includes inherited and developmental disorders, osteomyelitis, and benign and malignant primary bone tumors and metastases. Most odontogenic radiopaque or mixed lesions are either related to the apex or more rarely to the crown of the tooth, although there are exceptions to this rule. Some lesions, such as a torus mandibularis and torus palatinus, have a characteristic location, whereas others show no relationship to the dentition. This article describes the most characteristic and prevalent radiopaque and mixed lesions of the jaws and their imaging characteristics. Paget's disease, fibrous dysplasia, and rare sclerotic bone diseases of the maxillofacial bones are discussed elsewhere in this issue. Careful correlation of clinical presentation, panoramic radiographs, cone beam computed tomography, and histopathology are the cornerstones for appropriate lesion characterization.

Giant Frontal Paranasal Mucocele: Case Report and Review of the Literature.

Teaching point: Giant mucocele is a rare expansile lesion that may mimic other locally aggressive lesions of the cranial vault. Giant frontal mucoceles with massive osteolytic destruction mimicking an aggressive lesion are rare compared to smaller mucoceles. This article reports a giant mucocele of the frontal sinus and reviews the literature. Important imaging clues pointing toward the diagnosis of a mucocele on computed tomography (CT) and magnetic resonance imaging (MRI) are a well-defined expansile mass, an intimate relationship with the frontal sinus, subtle peripheral rim enhancement, and slow progression on serial imaging. The density on CT and signal on MRI may vary along with the lesion content. The potential role of diffusion-weighted imaging should be elaborated in future reports.

Radiographic/MR Imaging Correlation of Soft Tissues.

MR imaging is nowadays regarded as the preferred imaging modality for evaluation of soft tissue lesions. As plain radiographs are often the first step in evaluation of musculoskeletal disorders, identification of subtle soft tissue signs may be helpful to select patients who need to be referred for subsequent MR imaging. Although not very sensitive, certain plain film findings, such as intralesional calcification or gas, may allow one to make to a more specific tissue diagnosis and may obviate the need for invasive diagnostic procedures and potential harmful treatment.

Hand and Wrist: A Kaleidoscopic View of Accessory Ossicles, Variants, Coalitions, and Others.

Accessory bones, variants, and coalitions are not uncommon at the hand-wrist region. They are often overlooked because they are usually asymptomatic and found incidentally on imaging. However, they may sometimes present as a (painful) swelling or mimic a (sequel of a) fracture. Other symptoms may be attributed to impingement and exercise-related pain. Thorough knowledge of the anatomy, systematic imaging analysis, and the awareness of their existence are the clues to a correct identification. Plain radiography and magnetic resonance imaging (MRI) play a pivotal role in the correct diagnosis. In general, signal intensity on MRI is similar to the normal bony structures. However, concomitant bone marrow edema may indicate the presence of impingement. Therefore, MRI sequences with fat suppression should be included in case of symptomatic findings. This article provides a kaleidoscopic overview of some of the prevalent bony anomalies of the hand-wrist region and their potential pathogenic nature.