Dynamic MSK Imaging of Metacarpal Fracture

About dynamic msk imaging modalities in the study of post-traumatic metacarpal fracture

4th metacarpal fracture

Acute 4th metacarpal spiroid fracture of a professional football goalkeeper; first diagnosis was made directly on pitch with an ultrasound examination. Plain radiographs and Mri exam were performed just one hour after trauma.

One month after surgical fixation the fracture is studied with dynamic US, Mri and Cone-Beam CT imaging. The US and MR dynamic evaluations, show a regular tendon sliding over the fixation devices.

No metal-induced artifacts were seen, allowing a perfect visualization of the implanted devices.

CBCT Reconstruction

Cone-Beam CT Sagittal (left) and Coronal (right) reconstructions.

The study was completed with dynamic Mri (0.3 Tesla) and Cone-Beam CT scans, performed with active flexion-extension of carpal-metacarpal joint structures.

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Patellar Tendon Tear

about dynamic ultrasound and mri evaluation of partial patellar tendon tear

Today I show you the case of a partial tear at proximal insertion of the patellar tendon in a professional football player. The patient refears pain during flexion-extension at inferior patellar pole; hystory of repetitive trauma as usual in football players.

Patellar Tendon Tear

Sagittal Xbone T1w (left) and T1w TSE (right) Mri scan (o.3 Tesla)

The Mri exam shows a partial tear of the patellar tendon proximal insertion. In these kind of injury I always need a dynamic ultrasound exam, both in clino and orthostatic position.

The partial tear is better depicted with the dynamic ultrasound evaluation; the dynamic Mri is also useful to appreciate the tendon relationship with the patella.

Dorsal Scapholunate Ligament Tear

about dynamic mri and ultrasound examination of carpal instability

In my previous post Dynamic Evaluation of Dorsal Scapholunate Ligament I showed the usefulness of both ultrasound and Mri dynamic evaluation in the study of this important ligament structure. Today I want to show you the dorsal scapholunate ligament (SL) tear in a patient that came to my observation after a regular healing of post-traumatic scaphoid fracture.

SL Tear

Coronal Stir (left) and T1w (right)  Mri scans (0.3 Tesla): correct visualization with no artifacts of post-surgical treatment with scaphoid screw. Tear of the dorsal scapholunate ligament is evident (red arrow).

For the appropriate treatment is crucial to see also the dynamic behaviour of this kind of injuries. I always perform both ultrasound and Mri dynamic evaluation in these cases.

The dynamic ultrasound exam shows the post-traumatic carpal instability; dorsal SL tear is evident, togheter with the scapholunate dissociation and DISI picture.

For the correct ultrasound scanning please see my previous post Dynamic Evaluation of Dorsal Scapholunate Ligament.

The Dynamic Mri evaluation (0.3 Tesla) during flexion-extension and ulnar-radial deviation confirms the clinical picture, better defining all the pathologic findings. The radiology technician plays a crucial role for this kind of examination, explaining to the patient the correct wrist movement during the Mri acquisitions.