Hi all –
Thanks so much for your prompt and detailed replies. They were a bit varied (which makes me happy since my own thoughts were a bit all over the place on it too)
A slight majority favored muscular atrophy secondary to disuse (longstanding inability to plantar flex)
There were a few respondents who suggested a *primary* neuromuscular process given the pes planus seen as well.
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As always, I am thankful for being a member of this group. You all are an awesome (and free) resource 😊
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
 good morning OCAD –
Was hoping some of you could help me clarify my thinking on this case.
In the attached PowerPoint I have what looks like a nice case of posterior impingement at the ankle … elongate posterior process, marrow edema process and os, surrounding st edema, some impaction changes at the calcaneus …
then as I am looking at the more proximal slices it looks like the posterior compartment musculature is all fatty replaced. I’ve never noted that as an associated finding before. Should I be considering some more proximal denervation changes or do these two findings go together in a way in which I’m not familiar? Maybe just disuse?
thanks
pete
Peter C. Young, MD
Section Head, Division of Musculoskeletal Radiology University Hospitals Cleveland Medical Center
Case Western Reserve University
11100 Euclid Avenue Cleveland, OH 44102
(216) 844-1542
posterior impingement with post comp fatty replacement.pptx
