I received 5 replies from Sorin, Linda, Atul, Avneesh and Anthony with the following DDx.
Bone island. Don’t worry about that
Osteoblastoma less less less probably
I see a focal avulsion of the deep tibiotalar portion of the deltoid ligament complex at the talar attachment.
I also see a small hypointense lesion at the anterior aspect of the distal tibia. It has hairy, speculated margins, which is in keeping with a small enostosis.
Are you talking about that dark lesion on T1, anterior margin of distal tibia?
I would consider a non-agressive and chronic lesion, such as bone island or small osteoma
OT-RADS II
bone island or subchondral cyst- I dont see fspd image in axial
I think this is a possible osteoid osteoma and would definitely get a CT, which i find is often better in showing the true nature of the lesion.
Indeed I was referring to the small round T1 hypointense lesion at the ant. tibial margin. I do not think this is a bone island. The close correlation with the PD fs sequence shows me something different. Along with a few of you, I also think along the lines of OO, despite some missing typical features. I recommended CT.
Björn
Sent: 01 February 2022 18:59
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31 y/o patient with ankle instability.
I am not sure about a possible lesion in the tibia. What’s your take?
Bone island. Don’t worry about that
Osteoblastoma less less less probably
I see a focal avulsion of the deep tibiotalar portion of the deltoid ligament complex at the talar attachment.
I also see a small hypointense lesion at the anterior aspect of the distal tibia. It has hairy, speculated margins, which is in keeping with a small enostosis.
Are you talking about that dark lesion on T1, anterior margin of distal tibia?
I would consider a non-agressive and chronic lesion, such as bone island or small osteoma
OT-RADS II
bone island or subchondral cyst- I dont see fspd image in axial
I think this is a possible osteoid osteoma and would definitely get a CT, which i find is often better in showing the true nature of the lesion.
Indeed I was referring to the small round T1 hypointense lesion at the ant. tibial margin. I do not think this is a bone island. The close correlation with the PD fs sequence shows me something different. Along with a few of you, I also think along the lines of OO, despite some missing typical features. I recommended CT.
Björn
Sent: 01 February 2022 18:59
—EXTERNAL EMAIL. Please exercise caution when opening attachments or clicking on links—
31 y/o patient with ankle instability.
I am not sure about a possible lesion in the tibia. What’s your take?
http://www.cmrad.com/cases/1308347046<eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cmrad.com%2Fcases%2F1308347046&data=04%7C01%7Cbjobke%40telemedicineclinic.com%7C8b0d2ad1b32b4a8ac2d208d9e5ac96ad%7C564ea4415b6b4b8ca9ec…>
Björn
Björn Jobke, MD
Deputy Head of MSK Section
Senior Clinical AI Advisor Radiology
TMC – a Unilabs company<eur01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.telemedicineclinic.com%2F&data=04%7C01%7Cbjobke%40telemedicineclinic.com%7C8b0d2ad1b32b4a8ac2d208d9e5ac96ad%7C564ea4415b6b4b8ca9eca0ab9…>