Tibial Tunnel Cyst

About diagnostic imaging of postoperative complication of anterior cruciate ligament (ACL) reconstruction.

This is the case of a patient the came to my observation for a palpable mass into the anterior-medial pretibial region, two years after ACL reconstruction.

Tunnel cyst formation is a rare complication after ACL reconstruction, usually occurring 1-5 years post-operatively, which may occasionally be symptomatic. The ultrasound exam in this case is not enough. The study is completed with MRI and Cone-Beam CT examination.

Tibial Tunnel Cyst MRI

MRI-Cone-Beam CT

Why Cone-Beam CT? Same diagnostic capability of total-body CT but low radiation dose!

Low Radiation Dose

The computed tomography dose index (CTDI) is a commonly used radiation exposure index in X-ray computed tomography (CT); in this case 4,74 mGy was the value detected. 16.98 mGy is the estimated absorbed dose by using a total-body CT scan for the same examination.

Total-Body CT

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Vastus Lateralis Injury

about ultrasound and mri findings of vastus lateralis injury

 

This is the case of a young rugby player presenting an high degree strain of the vastus lateralis muscle at its proximal insertion, togheter with an aponeurotic fascial injury on the subcutaneous lateral side.

I always suggest to perform both the Mri and ultrasound investigations; with the Mri exam it is evident the bone marrow edema, due to the avulsion injury at the intertrochanteric line, suspected during the clinical evaluation but impossible to see on ultrasound exam.

Vastus Lateralis Injury

Coronal (left) and Sagittal (right) PD-Fs Mri scans (1.5 Tesla).

Vastus Lateralis Injury Axial Mri

Axial PD-Fs Mri scan (1.5 Tesla). The bone marrow edema and the avulsion injury are evident.