Suprapatellar fat-pad edema with a mass effect on the suprapatellar joint recess is a common finding at MRI examinations of the knee that is rarely associated with anterior knee pain.

• MRI is an excellent method to evaluate knee alignment and articular cartilage damage. • Significant associations exist between alignment parameters and osteoarthritis of the patellofemoral joint. • The "sulcus angle" and "sulcus depth" were the most valuable osteoarthritic markers.

The dynamic susceptibility contrast magnetic resonance imaging perfusion technique was used to investigate possible hemodynamic changes in normal appearing white matter and deep gray matter (DGM) of 30 patients with clinically isolated syndrome (CIS) and 30 patients with relapsing-remitting multiple sclerosis. Thirty normal volunteers were studied as controls. Cerebral blood volume, cerebral blood flow (CBF), and mean transit time values were estimated. Normalization was achieved for each subject with respect to average values of CBF and mean transit time of the hippocampi's dentate gyrus. Measurements concerned three regions of normal white matter of normal volunteers, normal appearing white matter of CIS and patients with relapsing-remitting multiple sclerosis, and DGM regions, bilaterally. All measured normal appearing white matter and DGM regions of the patients with CIS had significantly higher cerebral blood volume and mean transit time values, while averaged DGM regions had significantly lower CBF values, compared to those of normal volunteers (P < 0.001). Regarding patients with relapsing-remitting multiple sclerosis, all measured normal appearing white matter and DGM regions showed lower CBF values than those of normal volunteers and lower cerebral blood volume and CBF values compared to patients with CIS (P < 0.001). These data provide strong evidence that hemodynamic changes--affecting both white and DGM--may occur even at the earliest stage of multiple sclerosis, with CIS patients being significantly different than relapsing-remitting multiple sclerosis patients.

Spontaneous TIH should be suspected in patients presenting with a sudden palpable chest wall bulge and associated thoracoabdominal symptoms in the absence of preceding injury.

Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.

Introduction:To investigate the healing process of the harvested patellar tendon at 12±2 and 24±2 months following Bone-Patellar-Bone (BTB) Anterior Cruciate Ligament (ACL) reconstruction.Methods:30 football players were enrolled in our study and examined at 12±2 and 24±2 months postoperatively. Donor and contralateral tendons evaluated with a high frequency ultrasound transducer. The maximum anteroposterior (MAP) and maximum transverse (MT) diameters of the patellar tendon and associated defect at the site of the tendon incision measured at its proximal, middle and distal thirds. The presence of vascular flow was examined with Doppler imaging. Echogenicity of the patellar tendon defect was graded as low, mixed or normal compared to the contralateral tendon.Results:There was no statistically significant difference between the mean MAP and MT diameters of the donor tendons at 12±2 and 24±2 months postoperatively (P>0.05). The mean MAP and MT diameters of the patellar tendon defect at 24±2 months were significantly smaller compared to 12±2 months postoperatively (P<0.01). The mean MAP diameter of the harvested tendon was significantly greater at all measured sites in comparison to the contralateral tendon at 12±2 and 24±2 months postoperatively (P<0.01). There was no statistically significant difference between the mean MT diameters of the donor and healthy tendons at 12±2 and 24±2 months postoperatively (P>0.05). At 12±2 months, the mean MAP diameter of the patellar tendon defect was 4.0±2.1 mm, 4.7±2.8 mm and 4.1±2.4 mm at the proximal, middle and distal third of the tendon respectively. The mean MT diameter of the defect was 3.3±2.2 mm (proximal third), 2.9±1.6 mm (middle third) and 2.1±0.9 mm (distal third). 2 of tendon defects showed low echogenicity, 6 mixed echogenicity, 2 patients normal echogenicity. At 24±2 months the mean MAP diameter of the patellar tendon defect was 0.3±0.3 mm, 0.4±0.4 mm and 0.3±0.3 mm at the proximal, middle and distal third of the tendon respectively. The mean MT diameter of the defect was 0.3±0.3 mm (proximal third), 0.2±0.2 mm (middle third) and 0.2±0.2 mm (distal third). 27 of patients demonstrated normal echogenicity, 1 low echogenicity, while 2 mixed echogenicity. No tendon exhibited any signs of neovascularization at 12±2 and 24±2 months postoperatively.Conclusions:Patellar tendons after BTB ACL reconstruction were characterized by increased thickness at 12±2 and 24±2 months postoperatively. Solid healing were evident in 2 patients by 12±2 months and in 27 by 24±2 months. No inflammatory changes were observed at 12±2 and 24±2 months postoperatively.picture 1ultrasonographic image of patellar tendonpicture 2ultrasound