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Musculoskeletal Imaging
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Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
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
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