Lateral Meniscus Cyst

about ultrasound appearance of lateral meniscus cyst degeneration

In my previous post Meniscal Cyst I showed the ultrasound appearance of a medial meniscus cyst, together with a suspected meniscal tear. Today I present the case of a young football player that came to my observation one year after a lateral collateral partial strain injury. As you certainly know peripheral attachments of the lateral meniscus are more lax than on the medial side, permitting greater mobility of the lateral meniscus.

lateral-meniscus-cyst

The dynamic ultrasound exam allows to appreciate a gross meniscal fissuring, with a meniscal cyst and partial extrusion; no alterations were seen along the course of the lateral collateral ligament.

Meniscus extrusion is usually associated with meniscal degeneration and tears, so it is crucial to always perform also the Mri examination.

lateral-meniscus

Coronal T2w (left) and Axial T2w (right) Mri scans (0.3 Tesla). The meniscal cyst and degeneration are evident.

lateral-meniscus-complex-tear

Coronal T2w (left) and Axial T2w (right) Mri scans (0.3 Tesla). Complex tear of the lateral meniscus.

 

Advertisements

Soleus Myotendinous Junction Injury

About aponeurotic medial insertion injury of the soleus muscle.

Knowing the anatomy and biomechanics of the gastrocnemius-soleus complex – or triceps surae – is crucial for an understanding of the etiology and treatment of all its possible injuries. Today I want to show you a painful partial lesion at the aponeurotic medial insertion of the soleus muscle in a professional soccer player.

One month after a soleus injury, a patient suffered for pain and discomfort at the distal soleus myotendinous junction; first examination was made with an ultraportable device directly on the pitch during a daily training session. A partial injury of the aponeurotic medial insertion was evident, togheter with muscle perilesional edema.

soleus-injury

Sagittal Ultrasound comparative examination of the medial soleus myotendinous junction; normal findings on the right side.

soleus-medial-insertion

Sagittal GeStir (left) and Coronal T2w Mri scans of the same patient (0.3 Tesla).

fse_t2__2__and_fse_t2__4_

Axial (left) and Sagittal (right) T2w Mri scans (0.3 Tesla).

With the dynamic ultrasound examination is better appreciated also an inflammation along the course of the posterior tibial nerve.

Also in this case the elastosonography evaluation works like a “contrast agent” well depicting the lesional area.

You can find further information about the complex anatomy of the triceps surae in this interesting scientific paper: Anatomy of the Triceps Surae: A Pictorial Essay