Tuesday, November 18, 2014

Tennis Leg- MRI

Increased signal and fluid in relation to the medial head of gastrocnemius muscle with fluid deep to muscle belly between gastrocnemius and soleus. There is proximal retraction of muscle belly along with fluid signal in the myotendinous junction suggesting tear of the medial gastrocnemius.

 MRI findings of tennis leg include: 
1) high T2 signal fluid deep to medial gastrocnemius and superficial to the soleu
2) focal area of disruption of muscle continuity noted along the deep aspect of the medial head of the gastrocnemius, with associated oedema of the muscle

Heel Fat Pad Syndrome

Patient with heel pain shows: Altered signal in the heel fat pad with hypointense signal on T1 weighted images and hyperintense on STIR images. These findings likely heel fat pad syndrome or inflammation.

Saturday, November 15, 2014

Slipped Upper Femoral Epiphysis-MRI

14 yr old boy with history of trauma presents with limp and MRI shows slipped capital femoral epiphysis (posteriorly) with diffuse ill-defined marrow edema and cranial migration of the distal fragment with femoracetabular alignment maintained.

 Teaching points by Dr MGK Murthy, Mr Hari Om, Mr Charles

1.    Most common adolescence age group abnormality of hip joint and primary cause of early OA. Usually misdiagnosed early on, more in boys than girls.  It can be spontaneous or traumatic.
2.    Xray particularly AP Pelvis and Lateral frog-leg   views show slip better. Widening of physis , demineralization and Metaphyseal blanch(blush) sign (opacity on X-ray)  are present 
3.    SUFE(Slipped Upper Femoral Epiphysis) grading is made on AP and true lateral  Projections .
4.    On AP Line along the superior margin of femoral neck (kleins)should intersect the lateral corner of Epiphysis. In SUFE, Metaphysis divides in to thirds (mild=lateral edge of epiphysis within the lateral 1/3 of metaphysis) (moderate=Middle third) (Severe= Medial Third)
5.    On True lateral Xray, angle at which epiphysis makes with Metaphysis (Southwick head-shaft angle) (normal = 0 deg, mild=0-30 Deg,moderate30-60 deg, Severe=>60 deg)

6.    CT is useful for measuring degree of tilt. USG has not been usually advocated though can suggest with fluid presence. MRI  shows slip earliest. MRI also  helps in follow up  and also to keep a check on contralateral hip.

Friday, November 14, 2014

DAMS students shine in AIIMS Nov 2014

Aiims Nov 2014 Damsonian tops the exam again!
Rank 1 siddharth jain
Rank 2 Ravi sharma
Rank 5 Amit Gupta
Rank 3 vivek lanka
Rank 6 Abhenil Mittal
Rank 12 vivek bagaria
Rank 17 Mandula phani priya
Rank 20 Saurav Varma
Rank 23 Neha Taneja
Rank 28 shashank raj
Rank 30 Aamir Mohammed
Rank 33 charanpreet singh
Rank 34 Samrat mandal
Rank 35 Manidipa Majumdar
Rank 41 saif memon
Rank 49 Ranjan Patel
Rank 57 swati sharma
Rank 72 Sayoni Roy
Rank 73 Rohan kamat
Rank 84 Yogita gupta
Rank 127 Raghavendra Rao
Rank 149 Divya joshi
Rank 161Manish De
Rank 175 Rahul yadav
More results coming we shall update, 
Heartiest congratulations toppers

Meet Proud DAMSONIAN Dr Sidharth Jain Rank 1 AIIMS Nov 2014.

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