Case Challenge

Stephen J Pomeranz

Gain confidence interpreting Musculoskeletal (MSK) MRI Cases w/ MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Musculoskeletal (MSK)

Case 1 - 20-year-old female presents with left hip pain

Case 2 - 33-year-old weight lifter with anterior shoulder pain and popping

Case 3 - 15-year-old female with dorsal soft tissue mass

Case 4 - 26-year-old male presents with anterior knee pain

Case 5 - 15-year-old male with elbow pain for two months

Case 6 - 43-year-old female with ankle pain and paresthesia

Case 7 - 33-year-old female with mass in palmar area

Case 8 - 6-year-old with generalized muscular pain and swelling

Case 9 - 53-year-old male has left knee pain since a fall at work

Case 10 - 29-year-old male reports with left midfoot pain

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 10 unique MSK MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Musculoskeletal (MSK) MRI Cases

<div><figure class="wp-block-image"><img src="https://process.fs.teachablecdn.com/ADNupMnWyR7kCWRvm76Laz/resize=width:750/https://www.filepicker.io/api/file/LCEgdauzSbW0mctD5QeF" alt="Shoulder 2.png"></figure>MOST LIKELY DIAGNOSIS: Clavicular OsteolysisThis 33-year-old weight lifter presents with anterior shoulder pain and popping.CLINICAL CONSIDERATIONS:Q1 &#8211; Using images 1 through 4, what are the imaging findings?Q2 &#8211; What intraarticular AC joint pathology is most likely?CLINICAL CONSIDERATIONS:A1 &#8211; The diagnosis is clavicular osteolysis. Osteolysis of the clavicle more commonly affects younger adult males (mid 30s). MRI imaging characteristics include bone marrow edema of the distal clavicle, cysts or erosions of the distal clavicle, and a subchondral line within the distal clavicle (images 1 and 2, arrows). Additional imaging findings include resorption of the distal clavicle as well as periarticular swelling. Etiologies include fracture, AC joint dislocation as well as microtrauma related to sporting activities and weight lifting; especially bench and military pressing. Treatment is conservative (avoidance of overload activity, stretching, and steroid injection in particular) with resection of the distal clavicle reserved for refractory cases.A2 &#8211; The most common intraarticular abnormality associated with osteolysis clavicle is labral pathology (approximately one-third). This patient has a posterior labral tear with a paralabral cyst (images 3 and 4, arrows). Less commonly, partial-thickness rotator cuff tears are also present. This is a sub-type of &#8220;peel-back&#8221; labral pathology seen in weightlifters.Diagnosis: &#8220;Weightlifters Shoulder&#8221; with clavicular osteolysis and posterior labral &#8220;peel-back&#8221;.CLICK "COMPLETE &amp; CONTINUE" TO ADVANCE</div>

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