TL;DR
MRI confirms that the main injury in tennis leg is a tear at the tendon-muscle junction of the medial head of the gastrocnemius, often accompanied by coexisting injuries to the soleus muscle.
MRI provides a detailed evaluation of knee injuries, aiding diagnosis and management, and MRI detection of associated abnormalities helps guide treatment and improve patient outcomes.
Background / Objective. To perform a detailed ultrasound (US) analysis of pathologically altered periarticular soft tissue structures in the medial compartments of the knee in patients with grade II–III knee osteoarthritis (OA) and to assess the relationship of these changes with anterior medial knee pain. Materials and Methods. A prospective randomized single‑center study enrolled 82 patients. The main group (n=42) included patients with grade II–III OA, varus/valgus deformity and anterior medial knee pain; the control group (n=40) comprised patients with grade 0–I OA without pain. All participants underwent physical examination (Tinel sign), US assessment of superior femoral ligament (SFL) protrusion and anteroposterior dimension of the interfascial space (APDIFS) in the infrapatellar nerve (IPN) projection, numeric pain rating scale (NRS), and PainDetect questionnaire. Results. The two groups did not differ significantly in age or sex; women predominated (>98%). SFL protrusion was significantly higher in the main group (7.2–13.8 mm vs. 2.5–6.8 mm, p≤0.05), while APDIFS was significantly lower (0–0.8 mm vs. 1.2–2.1 mm, p≤0.05). Based on SFL protrusion, a practical classification was proposed: type 0 (<7.0 mm) – minimal/no CIN symptoms; type 1 (7.0–10 mm) – episodic symptoms; type 2 (>10 mm) – persistent severe manifestations. Severe CIN was confirmed in 90.4% of type 2 patients (n=38). In 23 type 2 patients not responding to conservative treatment, US‑guided saphenous nerve block and subsequent radiofrequency ablation provided pain regression to 2–3 NRS points in 21 patients; 15 patients underwent total knee arthroplasty with complete pain resolution. Conclusion. Anterior medial knee pain in OA has a neuropathic origin due to IPN compression caused by SFL protrusion and interfascial space narrowing. US allows reliable verification of these changes, expands clinical interpretation of patient complaints, and helps to choose optimal diagnostic and therapeutic strategies.
Background The mechanical properties of muscles and their interactions with three-dimensional spinal deformities are difficult to quantify with a single method. This study aimed to quantitatively characterize the paraspinal muscle groups in adolescent idiopathic scoliosis (AIS) using multimodal methods. Methods The patients with AIS who received corrective surgery at our hospital from June 1, 2025, to August 31, 2025 were enrolled in this prospective study. Two independent evaluators used 3.0T magnetic resonance imaging (MRI) and digital radiography (DR) to analyze parameters in the bilateral paraspinal muscle groups. Results This study enrolled 25 patients with AIS, including 15 cases with lumbar curvature and 10 with thoracic curvature. There were significant differences in the multimodal quantitative characterization of the convex and concave sides of scoliosis in AIS patients (p < 0.05). On the concave sides of the lumbar curvature, the erector spinae, multifidus muscles and psoas major muscles showed a higher fat fraction, higher signal intensity, and smaller volume than those on the convex sides. The erector spinae muscle was significantly thicker on the concave side in lumbar curvature, and on the convex side in thoracic curvature. Two evaluators showed good intra- and inter-observer consistency, with intraclass correlation coefficients (ICC) ranging from 0.75 to 0.85. The Cobb angle showed almost no correlation with the flexibility index on the concave side. For cases of thoracic curvature, the maximum vertebral inclination angle showed a strong positive correlation with the erector spinae thickness ratio on the convex side (r = 0.85). Conclusion The quantitative assessment results of this exploratory study using MRI and DR methods showed that muscle asymmetry in the paraspinal muscles may interact with three-dimensional spinal deformity in patients with AIS.
An increasing use of WBCT in the assessment of the most common knee pathologies is found, and some new concepts have been introduced regarding the anatomy of the patellofemoral joint under physiological stance and the three-dimensional nature of osteoarthritis.
OBJECTIVES To determine the protocol-specific frequency, extent, and anatomic distribution of sacroiliitis-like and degenerative sacroiliac joint MRI findings in a large population-based cohort. MATERIALS AND METHODS This retrospective cross-sectional analysis used prospectively acquired SHIP-Trend-0 whole-body MRI (2008-2012). Of 4,420 participants, 2,187 underwent MRI; 124 exclusions for missing PD-FS or insufficient image quality left 2,063 evaluable (age, 48.8 ± 14.6 years; 999 men). Non-dedicated axial PD-FS was the primary sequence, with coronal TIRM supported lesion assessment. Two readers recorded bone marrow edema (BME)-like signal, extent, quadrants, structural/degenerative findings, and joint-space width. RESULTS BME-like signal was present in 225/2,063 (10.9%; 95% CI 9.6-12.3%): women, 12.1%; men, 9.6%; unadjusted odds ratio (OR), 1.30 (95% CI 0.98-1.72; p = 0.067). Maximum depth was 9.84 ± 3.53 mm; 85/225 (37.8%; 95% CI 31.4-44.5%) had depths ≥ 10 mm. Mean slice extent was 2.91 ± 0.82. Among 222 location-coded participants, 156 (70.3%; 95% CI 63.8-76.2%) had one quadrant, predominantly superior sacral. Bilateral signal occurred in 52/2,060 (2.5%; 95% CI 1.9-3.3%). Any structural or degenerative finding occurred in 349/2,063 (16.9%; 95% CI 15.3-18.6%). CONCLUSION Small, focal BME-like and degenerative SIJ findings are common on this non-dedicated whole-body protocol. These protocol-specific imaging background frequencies do not estimate axSpA prevalence or diagnostic accuracy; whole-body and dedicated SIJ MRI are not interchangeable. Isolated signal requires morphologic and clinical context.
BACKGROUND Subtalar ligament injuries occur in 10-25% of lateral ankle sprains (LAS) but remain underdiagnosed, partly because their radiological anatomy is insufficiently defined. PURPOSE This anatomo-radiological study aimed to systematically characterize the MRI appearance and anatomical morphology of the principal subtalar ligaments. STUDY DESIGN Descriptive, single-center anatomo-radiological reference study (Level IV). METHODS Seventeen patients underwent 3-Tesla 3D-MRI of the contralateral asymptomatic ankle after lateral ankle ligament repair. The inferior extensor retinaculum (IER), cervical ligament (CL), interosseous talocalcaneal ligament (ITCL), and calcaneofibular ligament (CFL) were evaluated on multiplanar reconstructions aligned with each ligament's axis. Length, width, and thickness were measured in all cases. RESULTS The mean age of the cohort was 35 ± 12.5 years; 7 women and 10 men were included, with a mean BMI of 28 ± 6.3 kg/m². All four ligaments were consistently visualized on 3D-MRI. Length, width, and thickness measured 34.6 ± 6.8, 5.6 ± 1.2, and 1.7 ± 0.2 mm for the IER; 19.0 ± 1.6, 5.3 ± 1.3, and 1.8 ± 0.5 mm for the CL; 16.9 ± 2.4, 10.0 ± 1.4, and 2.4 ± 0.9 mm for the ITCL; and 25.2 ± 4.8, 5.8 ± 2.0, and 2.8 ± 0.6 mm for the CFL. CONCLUSIONS This study provides reference identification methods and normative measurement values for 3D-MRI assessment of the IER, CL, ITCL, and CFL. These data improve the understanding of subtalar ligament morphology and may aid in the diagnosis and treatment of subtalar ligament injuries. LEVEL OF EVIDENCE Level IV (descriptive study).