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Sharing a nice case from this week! Hx: 37-year-old male, avid cyclist (125+ miles per weekend), experiencing perineal pain, clinical suspicion for soft tissue mass vs. hamstring tendinopathy. MR Findings: Edema and scarring of the subcutaneous layer of bilateral perineal fat pads/medial proximal thighs, left greater than right, without significant contrast enhancement. Diagnosis: "Biker’s Saddle […]

I had signed out the report as consistent with either Morphea or Eosinophilic fasciitis I received many comments from people who either thought this was morphea (limited scleroderma) or suggested the DDx of Morphea vs Eosinophilic Fasciitis….as that is apparently the main differential. I’ve included highlights from an online reference about eosinophilic fasciitis. Summary Eosinophilic

This is an asymptomatic comparison The medial sesamoid appears to be fractured / fragmented I was all set to diagnose Turf Toe…based on the widening of the medial and lateral sesamoid – phalanx distance (medial is 9-9.5 mm and lateral is 11-11.6mm), but it seems that the distance is bilaterally increased and pretty symmetric How

Tatiane Cantarelli just shared these companion cases and comments (I have never reported elastofibroma in the subacromial region…perhaps I have missed it) Hi Hilary, I wanted to share one more case with you.This patient has bilateral peritrochanteric elastofibroma, but only has mild bursitis on the right side, which is where he reported pain. Interestingly, the

There is articular and bursal fraying with intrasubstance bright PDFS signal proximal to the insertion of the mid-posterior supraspinatus tendon Contrast is imbibed into the tendon over the same segment, but does not extend into the bursa There is a chronic superior labral tear Same non insertional changes in the mid-posterior supraspinatus tendon There’s also

Dear Dr. Rustam, Thank you for your good case. I am not a neuroradiologist but I have common sense. One of my differential diagnoses is hyperammonemia. Please don’t argue with me. Yours, Kyung Dear neurons, Please help with this case of 30 y/o male. What does these periventricular (on right) and subcortical (on left temporal)

SLAP lesion Mild anteroinferior capsular thickening and edema, but no anteroinferior labral tear Oddly, they ordered this without and with iv contrast….had anyone asked me, I would have said it wasn’t indicated I was surprised by the degree of circumferential capsular enhancement The SLAP lesion enhances I have to say that, years ago, I tried

I was recently consulted by Rheumatology for a lupus patient with progressively worsening periarticular calcifications/swelling in the small joints of her hands. She does have nephritis but medications to treat her lupus have not stalled the progression of joint involvement. Aspiration of one of the joints showed a thick white paste- many WBCs, no crystals,

Apropos Atul’s case, I believe this case precedes any biopsy proof or treatment for his suspected prostate cancer.The prostate MRI was only 1-2 weeks ago….and the findings were incidental on the prostate MRI. The subsequent bilateral hip MRI adds nothing and appears no different. From Atul: I believe the differential between PMR and Adhesive Capsulitis