The Accessory Iliotibial Band-Meniscal Ligament of the Knee: Association With Lesions of the Lateral Meniscus.

OBJECTIVE. The anchoring of the medial meniscus is consistent, whereas the attachment of the lateral meniscus is variable. On routine MRI examinations, we analyzed the prevalence of a distinct fibrous connection between the anterolateral aspect of the lateral meniscus and the iliotibial band-which we have termed the "accessory iliotibial band-meniscal ligament" or "AIML"-and investigated an association between lesions of the lateral meniscus and the presence of an AIML. MATERIALS AND METHODS. We retrospectively reviewed 1019 knee MRI examinations for lesions of the lateral meniscus, presence and morphology of an AIML, and Hoffa edema. Descriptive statistics were applied and univariate analyses were performed to assess the association between the presence of an AIML and meniscal lesions as well as Hoffa edema. RESULTS. An AIML was present, with a mean length of 22.8 mm (range, 12.9-36.8 mm; SD, 5.8 mm), in 13.3% of the patients (136/1019). A lesion of the anterior horn of the lateral meniscus was recorded in 1.2% of patients without an AIML (11/883) and 23.5% of patients with an AIML (32/136; p < 0.001). A lesion of the lateral meniscus body was found in 1.6% of patients without an AIML (n = 14/883) and 16.2% of patients with an AIML (22/136, p < 0.001). Hoffa edema was seen in 0.2% of patients without an AIML (2/883) and 14.0% of patients with an AIML (19/136; p < 0.001). CONCLUSION. The AIML represents an anatomic variant of fixation of the lateral meniscus that is strongly associated with lesions of the lateral meniscus and Hoffa edema.

DYKE-DAVIDOFF-MASSON SYNDROME - TYPICAL IMAGING FEATURES.

INTRODUCTION: Dyke-Davidoff-Masson syndrome is an uncommon neurological disorder clinically presented with seizures, various degrees of mental retardation, motor weakness and sometimes body asymmetry. Typical neuroimaging features include cerebral hemiatrophy with ipsilateral hyper pneumatization of paranasal sinuses. The purpose of this report was to present a rare cause of seizures revealed by Magnetic resonance imaging. CASE REPORT: We report a case of a 17-year-old boy admitted to hospital due to a severe headache. He had been treated because of partial epileptic seizures for six years. Neuropsychological examination revealed mild mental retardation, mild speech and reading difficulties and discrete right-sided hemiparesis. Typical magnetic resonance imaging features confirmed clinical suspicion of Dyke-Davidoff-Masson syndrome. revealing left frontal lobe atrophy, with consecutive widening of the left lateral ventricle frontal horn, thickening of the nearby frontal squama and hypertrophy of left frontal sinus. CONCLUSION: Magnetic resonance imaging is the key imaging modality that confirms clinical suspicion of Dyke-Davidoff-Masson syndrome based on a proper physical and neurological examination.

Magnetic resonance imaging comparison of lateral collateral ligament and patellar tendon length.

INTRODUCTION: The problem of using patellar tendon auto or allografts for lateral collateral ligament reconstruction results in the occurrence of ligaments mismatch. The length of patellar tendon does not match the lateral collateral ligament. MATERIAL AND METHODS: Out of 151 patients, who formed the study, 102 were men with the mean age of 30 years (18-54) and 49 women, with the mean age of 34 (18-55), and they all underwent magnetic resonance imaging of the knee. Both patellar tendon and lateral collateral ligament were measured using a three-dimensional isovoxel true-fast-imaging with steady-state precession sequence with water excitation and secondary multiplanar reformations. In order to visualize the lateral collateral ligament insertions precisely, sagittal images were reformatted according to the anatomical, oblique ligament position, in anteriorly tilted, paracoronal plane. The length of the patellar tendon was measured from the patellar apex to the tibial tuberosity insertion site. RESULTS: The mean patellar tendon length was 52.88 +/- 7.56 mm (37-75) with a significant difference between men and women. The mean lateral collateral ligament length was 61.21 +/- 5.77 mm (46-80) with a significant difference between genders. The average differences between lateral collateral ligament and patellar tendon length was 8.38 +/- 7.23 mm (-9 to 26) without a significant difference between the genders. In 18 (11.92%) patients, the patellar tendon was longer than the lateral collateral ligament; in 7 patients (4.63%) they were equal; and in 126 patients (83.44%) the patellar tendon was shorter than the lateral collateral ligament. CONCLUSION: The length of patellar tendon does not match the length of lateral collateral ligament. If patellar tendon auto or allograft is used for lateral collateral ligament reconstruction, the lengths of both ligaments must be determined preoperatively in order to avoid intraoperative complications.

Perineural tumor spread - Interconnection between spinal and cranial nerves.

The secondary neoplastic involvement of the cervical plexus in patients with head and neck malignancies is extremely rare. MR examination of the neck revealed the diffuse neoplastic infiltration of the right C2 root, in a 57-year-old patient with several months long pain in the right ear region and a history of the tongue squamous cell carcinoma. Associated perineural tumor spread and consequent distal involvement of great auricular nerve and vagus nerve were evident. Best of our knowledge, this is the first reported involvement of the cervical plexus in patients with head and neck cancers, associated with the clearly documented interconnection between the cervical plexus and cranial nerves via great auricular nerve.