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Understanding of the normal anatomy of the plantar aponeurosis (PA) and familiarity with pathologic conditions are required for an accurate evaluation of the patient with subcalcaneal heel pain. In this study, we evaluated the diagnostic capabilities of magnetic resonance (MR) imaging in the assessment of the PA with close anatomic correlation. Herein, we describe the MR imaging features of plantar fasciitis and fascial rupture in 26 patients. High-spatial-resolution MR imaging was performed in four cadaveric feet, and a prescribed imaging plane was used for depiction of the peroneal component of the PA. MR imaging delineated the anatomy of the PA and perifascial soft tissues. The peroneal component was best visualized in prescribed sagittal oblique images. Perifascial edema was the most common finding of plantar fasciitis, and it was remarkable in those cases with acute fascial rupture. MR imaging reliably delineated the anatomy of the PA and may allow precise localization and definition of the extent of involvement in disease processes.

Although the presumptive diagnosis of skeletal muscle disease (myopathy) may be made on the basis of clinical-radiological correlation in many cases, muscle biopsy remains the cornerstone of diagnosis. Myopathy is suspected when patients complain that the involved muscle is painful and tender, when they experience difficulty performing tasks that require muscle strength or when they develop various systemic manifestations. Because the cause of musculoskeletal pain may be difficult to determine clinically in many cases, MRI is increasingly utilised to assess the anatomical location, extent and severity of several pathological conditions affecting muscle. Infectious, inflammatory, traumatic, neurological, neoplastic and iatrogenic conditions can cause abnormal signal intensity on MRI. Although diverse, some diseases have similar MRI appearances, whereas others present distinct patterns of signal intensity abnormality. In general, alterations in muscle signal intensity fall into one of three cardinal patterns: muscle oedema, fatty infiltration and mass lesion. Because some of the muscular disorders may require medical or surgical treatment, correct diagnosis is essential. In this regard, MRI features, when correlated with clinical and laboratory findings as well as findings from other methods such as electromyography, may facilitate correct diagnosis. This article will review and illustrate the spectrum of MRI appearances in several primary and systemic disorders affecting muscle, both common and uncommon. The aim of this article is to provide radiologists and clinicians with a collective, yet succinct and useful, guide to a wide array of myopathies.

We describe the clinical features and MRimaging findings of spontaneous spinal subarachnoid hemorrhage located in the lumbar spine associated with subdural hematoma at a higher, thoracic level in a 66-yearold man without neurological deficit. The sequential MRimaging changes of hemorrhage at various stages in its evolution are portrayed. The possible pathogenetic mechanism for these very unusual, combined hemorrhages in both spinal compartments is discussed.Keywords Spontaneous . Subarachnoid hemorrhage . Subdural hematoma . Spine . MRI Case reportA 66-year-old man presented to the emergency department with history of 1 week of lower back pain, headache, and left lower limb pain. He had no history of trauma, physical exertion, anticoagulant therapy, or any known bleeding dyscrasias. The patient had a fever of 100°F. He did not develop paraparesis, loss of sensation, numbness or urinary dysfunction. Physical examination disclosed localized tenderness over the lumbar spine. Neurologic examination was normal. Pertinent laboratory data were within normal limits except for mild elevation of lactate dehydrogenase (262 IU/l).Urgent CT scan of the head showed no evidence of subarachnoid or intracerebral hemorrhage. MR imaging of the spine performed on the same day of admission demonstrated a linear subarachnoid lesion extending from L1 to L5, ventral to the conus medullaris and cauda equina. The subarachnoid process was of increased signal intensity relative to the spinal cord on both T1-and T2-weighted images; which was suggestive of subacute hemorrhage (Fig. 1). In addition, a subdural lesion with a smooth contour was seen extending from T11 to T12 vertebrae and overlying the ventrolateral aspect of the spinal canal. This abnormal area displayed predominantly increased signal intensity relative to the spinal cord on T1-weighted images. On T2-weighted images, the lesion showed heterogeneously increased signal intensity with a focus of low signal intensity compatible with subacute hematoma containing deoxyhemoglobin (Fig. 2). The subdural hematoma was compressing the adjacent spinal cord without obvious signal changes within the cord. No MR-imaging evidence of vascular abnormalities was visualized in the spine. Although the patient was advised to undergo spinal angiography, he did not consent to.

Paget disease is the second most common bone disease after osteoporosis that affects elderly persons in the United States. We revisit Paget disease of bone and present the gamut of imaging findings associated with this skeletal disorder, both uncomplicated and complicated. Conclusion Paget disease of bone shows a plethora of imaging patterns and variable appearances that are related to the pathologic stage of the disease. Because patients with Paget disease may develop various musculoskeletal complications, recognition of the key imaging features of the condition may allow prospective diagnosis of the disease and its associated musculoskeletal complications and can preclude biopsy.

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Stress fractures involving the fabella can be a clinically important entity in the patient with persistent or new knee pain after total knee arthroplasty. Scrutiny of radiographs, when coupled with clinical information, allows correct diagnosis of this potentially debilitating injury in symptomatic postoperative patients.

The pathogenesis of fractures of the proximal portion of the fifth metatarsal bone appears to be related to avulsion injury of PAL and SPM tendon fibers.