Pes anserine bursitis is not an uncommon pathology especially in the context of knee osteoarthritis; however, ruptured pes anserine bursitis is a rare event. Herein, the authors present a case of diving pes anserine bursal rupture in a patient with knee osteoarthritis who developed postero-medial knee tender swelling. In our case, the bursal rupture was contained, and dived posteriorly, resulting in a cystic calf swelling; the original bursa itself was collapsed beneath the pes anserine tendon, giving a taillike appearance, such tail-like appearance could help in accurate localization of swelling origin and make the diagnosis of bursal rupture much easier. The tail-like appearance deep to the pes anserine tendon was found to be a helpful imaging feature when assessing cystic calf swelling; it should be kept in mind when pes anserine bursal rupture is a differential diagnostic consideration, as it could indicate the origin of resultant swelling. Keywords Pes anserine bursitis . Diving pes anserine bursal rupture . Knee osteoarthritis . Cystic calf swelling This article is part of the Topical Collection on Imaging

Background The aim of this study was to assess the added value of chemical shift imaging when used with routine MRI study in evaluation of bone marrow changes in SCD. Forty-two patients with SCD and bone pain were included in the study; they underwent CSI and routine MRI study on the symptomatic anatomic part of the skeleton. Results Four patterns of diffuse bone marrow changes were recognized; they varied from persistent red marrow to diffuse hypointense patterns with abnormal signal loss percentage on CSI that suggest presence of iron overload (n = 28, 66.6%). Serum ferritin level was increasing in accordance to the degree of signal changes found on CSI with significant high negative correlation between the percentage of signal loss on CSI obtained from IP-OP/IP formula and serum ferritin level. In focal marrow lesions, all T1 hyperintense lesions demonstrated corresponding hyperintensity on IP and OP; the detection frequency on CSI was relatively higher on OP compared with IP images. Conclusion CSI has high diagnostic performance in detecting diffuse marrow changes and development of iron overload in SCD. In SCD-related focal marrow lesions, CSI could have a complementary role in detection of T1 hyperintensity and lesion conspicuity.

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Background: Cerebrovascular steno-occlusive disease constitutes one of the most dangerous complications of sickle cell disease (SCD). It could result in overt or silent cerebral infarctions (SCI). Objective: The aim of this study was to demonstrate silent parenchymal and vascular brain changes that are incidentally observed in neurologically free SCD children using screening MRI and MRA. Patients and methods: This prospective cross-sectional study was conducted on 78 children diagnosed with SCD who were neurologically free. Magnetic resonance imaging (MRI) and Magnetic Resonance Angiography (MRA) were done to all the participant children. Results: Thirty (38.4%) of our children demonstrated pathologic parenchymal features on their MRI. There were 29 (37.17%) patients had pathologic changes in MRA; 6 of them had isolated vascular abnormality, whereas the remaining patients had concurrent parenchymal abnormalities. There was significant high positive correlation between low hemoglobin and presence of silent cerebral infarction (SCI). Moya-moya vasculopathy showed significant positive correlation with arterial occlusion and old SCI. HB SS phenotype was significantly correlated with moya-moya vasculopathy, arterial occlusion and old SCI. Conclusions: Silent cerebral and cerebrovascular changes in SCD children are frequent abnormalities requiring utilization of MRI and MRA to find out their exact prevalence and their risk factors.