[Ultrasound of the tarsal tunnel: Normal and pathological imaging features]. / Échographie du tunnel tarsien : aspect normal et pathologique.

Tarsal tunnel syndrome is a condition that is caused by compression of the tibial nerve or its associated branches. Diagnosis is based on clinical findings but imaging is performed to exclude a cause of compression, identified in 60 to 80% of cases. Ultrasound is a useful examination because of its high spatial resolution and ability to rapidly perform an axial survey of the nerves. The ultrasound imaging features of the tarsal tunnel are described. The etiologies and different types are illustrated through a review of clinical cases.

[Imaging of total hip arthroplasty: normal and pathological imaging features, role of ultrasound, CT and MRI]. / Imagerie des prothèses totales de hanche: aspect normal et pathologique, place de l'échographie, du scanner et de l'IRM.

Total hip arthroplasty is a frequent procedure with functional outcome that generally is excellent and lasting. Routine imaging follow-up is necessary to detect complications such as loosening and wearing out. Additional imaging with scintigraphy, CT, ultrasound or MRI may be necessary.

[Plantar plate and second ray syndrome: Normal and pathological US imaging features and proposed US classification]. / Echographie de la plaque plantaire et syndrome du 2e rayon: sémiologie normale, aspects pathologiques et proposition d'une classification échographique.

Second ray syndrome is due to degenerative changes of the plantar plate frequently associated to hallux valgus that may require dedicated surgical correction. An US classification is proposed and its impact on patient management is assessed. A total of 52 patients with hallux valgus and associated metatarsal pain scheduled for surgery were imaged. US resulted in modification of the treatment plan in 32% of patients. The surgical procedure was modified due to a plantar plate lesion not suspected on clinical and routine imaging findings. US improves the surgical management of patients with hallux valgus and second ray syndrome.

[US of the ulnal collateral ligament (UCL) at the first metacarpophalangeal (MCP) joint: a new dynamic maneuver to detect Stener lesions]. / Echographie de l'entorse du ligament collatéral ulnaire (LCU) de l'articulation métacarpo-phalangienne (MCP) du pouce: une nouvelle manoeuvre dynamique pour visualiser l'effet Stener.

Sprain of the first MCP joint is frequent. In patients with UCL tear, the adductor aponeurosis may become interposed between the distal site of ligament attachment and the ruptured ligament: this lesion, described by Stener, prevents ligamentous healing and requires surgical intervention. We present the results from a prospective study of 56 patients with first MCP sprain in order to determine the value of US by correlating with surgical findings. We propose a new dynamic maneuver during flexion-extension of the IP joint. This enables visualization of the adductor aponeurosis and its relationship to the UCL on US allowing detection of a Stener lesion when it exists. All patients with Stener lesion on US underwent surgery (32 operated patients): the sensitivity of US was 95.4% with a specificity of 80% for detection of Stener lesions. US, with the use of this specific dynamic maneuver is a reliable and reproducible tool for detecting Stener lesions. Review of video recordings allows visual comprehension of the examination for other health care providers.

[Imaging of the postoperative knee in athletes: articular cartilage, menisci, and ligaments]. / Imagerie du genou du sportif opéré: cartilage, ménisques et ligaments.

This article focuses on the common surgical procedures and reviews the clinical and imaging features of the postoperative knee following prior surgical treatment of meniscal, articular cartilage, and ligamentous injuries.

[MR imaging of anatomical variants of ligaments, muscles and tendons at the ankle]. / Aspect IRM des variantes anatomiques des muscles, tendons et ligaments de la cheville.

PURPOSE: To illustrate the MR imaging features of anatomical variants of ligaments, muscles and tendons at the ankle. MATERIAL AND METHODS. The MRI features of the typical anatomy of the ankle is first reviewed in order to better understand the appearance of anatomical variants. The features of those anatomical variants are reported based on data from the literature and from a retrospective study of 63 ankle MRI and/or MR-arthrography performed for chronic instability. RESULTS: Ankle anatomical variants can be separated into 3 groups For each variant, we report the frequency, the differential diagnosis and the potential clinical consequence that may, at times, require a specific treatment. CONCLUSION: Anatomical variants are important to consider because these structures can simulate disease and can sometimes be symptomatic.

Patellar instability: assessment on MR images by measuring the lateral trochlear inclination-initial experience.

Lateral trochlear inclination (LTI) of the knee was compared on magnetic resonance (MR) images obtained in 30 patients with patellar instability (PI) and 30 patients with nonspecific internal knee derangement. Differences in LTI values between the two populations were significant (P <.001). Reproducibility of the measurement was judged excellent with an intraclass correlation superior to 0.98. Below a threshold value fixed at 11 degrees, LTI appears to be an excellent diagnostic test of PI with a sensitivity of 0.93 (28/30), a specificity of 0.87 (26/30), and an accuracy of 0.90 (54/60).

Radiographic assessment of hip and knee osteoarthritis. Recommendations: recommended guidelines.

Pathological lesions of osteoarthritis, demonstrated by conventional radiography, can be assessed by scoring systems and/or measurement with a quite acceptable reproducibility. Scores are recommended for a rough staging of osteoarthritis and of bone changes. Measurement is recommended for assessment of joint space narrowing progression. A good assessment of progression implicates a perfect reproducibility of the radiographic image of the joint. Accuracy of standard radiograph is improved by some views such as the hip profile and the schuss view.

Magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder.

OBJECTIVES: To describe magnetic resonance imaging findings in idiopathic adhesive capsulitis of the shoulder. PATIENTS AND METHODS: Twenty patients with idiopathic adhesive capsulitis of the shoulder underwent magnetic resonance imaging involving two spin-echo T2-weighted sequences with fat saturation and two spin-echo T1-weighted postgadolinium sequences; for all sequences, sections were obtained in the oblique coronal and transverse axial planes. Findings were compared to those obtained using the same imaging protocol in 15 patients with clinical manifestations of rotator cuff tear. RESULTS: Postgadolinium enhancement of the joint capsule and synovial membrane was seen in the rotator interval in all 25 adhesive capsulitis patients and in the axillary recess in 22 of the 25. Only one of the 15 rotator cuff tear patients had this finding. In both groups, postgadolinium enhancement occurred in the subacromial bursa, in the rotator cuff tendons, and in the acromioclavicular joint. No significant rotator cuff tears were found in any of the adhesive capsulitis patients. CONCLUSION: In difficult cases, magnetic resonance imaging with gadolinium injection can contribute to the diagnosis of idiopathic adhesive capsulitis of the shoulder.