Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Practice Cases
Week 1
6 topics, 11 min.
Practice Cases
Week 2
6 topics, 18 min.
Practice Cases
Week 3
6 topics, 27 min.
Practice Cases
Week 4
6 topics, 7 min.
Practice Cases
Week 5
6 topics, 45 min.
0:00
This is a 14-year-old ballet dancer with posterior
0:04
ankle pain, sagittal fluid sensitive ester images
0:10
and T one demonstrate the presence of an all
0:14
trigonum articulating to the posterior tailor
0:19
tubercle in the setting of all Trigonum syndrome.
0:24
The OAL demonstrates very pronounced.
0:27
Diffuse marrow edema on fluid sensitive
0:31
sequences with indistinctness of the
0:35
bony trabecula on T1 weighted images.
0:39
There are also reactive marrow changes in the
0:43
opposing surface of the posterior talus with
0:46
fluid signal identified at the interface.
0:51
These are typical findings of
0:53
Osteregonome syndrome in the setting
0:56
of posterior ankle impingement.
0:57
Posterior ankle impingement syndrome
1:01
encompasses Osteregonome syndrome as well
1:05
as impingement due to alterations of the
1:10
posterior ankle ligamentous structures.
1:14
In this case, the entrapment is Related to the
1:18
presence of an ossicle interposed between the
1:22
posterior tibial lip and the calcaneus, which
1:26
isn't trapped when the patient goes into plantar
1:31
flexion related to ballet dancing activities.
Wk 4, Case 2 - Review
HIDEInteractive Transcript
0:00
This is a 14-year-old ballet dancer with posterior
0:04
ankle pain, sagittal fluid sensitive ester images
0:10
and T one demonstrate the presence of an all
0:14
trigonum articulating to the posterior tailor
0:19
tubercle in the setting of all Trigonum syndrome.
0:24
The OAL demonstrates very pronounced.
0:27
Diffuse marrow edema on fluid sensitive
0:31
sequences with indistinctness of the
0:35
bony trabecula on T1 weighted images.
0:39
There are also reactive marrow changes in the
0:43
opposing surface of the posterior talus with
0:46
fluid signal identified at the interface.
0:51
These are typical findings of
0:53
Osteregonome syndrome in the setting
0:56
of posterior ankle impingement.
0:57
Posterior ankle impingement syndrome
1:01
encompasses Osteregonome syndrome as well
1:05
as impingement due to alterations of the
1:10
posterior ankle ligamentous structures.
1:14
In this case, the entrapment is Related to the
1:18
presence of an ossicle interposed between the
1:22
posterior tibial lip and the calcaneus, which
1:26
isn't trapped when the patient goes into plantar
1:31
flexion related to ballet dancing activities.
Report
Patient History
14-year-old ballet dancer complaining of posterolateral ankle pain
Findings
SKELETAL/BONES:
Moderate-sized os trigonum or fractured Stieda process (measuring 8 x 5 mm) with diffuse osteoedema. Subjacent osteoedema of the dorsal/posterior talus, consistent with abutment/posterior impingement. Reactive sclerosis of the posterior talus. Adjacent reactive synovitis of the posterior subtalar recess with a small effusion extending into Kager’s fat pad.
No further pattern of reactive osteoedema. Focal osteochondral lesion.
No os peroneus or os navicularis. No pes planus or hindfoot valgus deformity.
ARTICULATIONS:
Tibiotalar joint/talar dome: No osteochondral defect of the talar dome or tibial plafond.
Ankle mortise/syndesmosis: The ankle mortise is in anatomic alignment. No syndesmosis widening.
Chopart joint: Unremarkable.
Midfoot/hindfoot: No fracture or injury of the anterior calcaneal process. No prominent midfoot or hindfoot arthrosis.
Lisfranc joint: The Lisfranc joint is intact, without fracture or joint space widening.
LIGAMENTS:
High ankle: Intact.
Low ankle: Intact.
Subtalar/Chopart: Intact.
TENDONS:
Intact.
GENERAL:
Sinus tarsi: Unremarkable.
Muscles: No traumatic muscle injury. No volumetric muscle atrophy.
Soft tissue: Unremarkable.
Plantar fascia: Intact.
Neurovascular complex/tarsal tunnel: Unremarkable. No evidence of entrapment neuropathy.
Intra-articular/loose bodies: None.
Impressions
Posterior impingement with edematous os trigonum versus a fractured Stieda process with abutment/impingement.
Case Discussion
Faculty
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
Todd D. Greenberg, MD
Radiologist
ProScan
Tags
Musculoskeletal (MSK)
MRI
Foot & Ankle
© 2024 Medality. All Rights Reserved.