Intra-articular Lipoma of the Pisotriquetral Joint: A Rare Case Report.

Intra-articular lipomas are infrequently reported, with most reported cases occurring in the knee joint. A case of intra-articular lipoma in the small joints of the hand, specifically in the pisotriquetral joint, has been documented for the first time. A 24-year-old male visited the emergency department after a road traffic accident with a painful and swollen wrist. Radiographic examination revealed fractures of the distal radius and triquetrum. A subsequent wrist computed tomography scan identified an intra-articular lipoma within the pisotriquetral joint, further confirmed by ultrasonography. This article underscores the importance of recognizing that, though exceedingly rare, intra-articular lipomas should be considered in the differential diagnosis of soft-tissue tumors affecting the hand and wrist.

Cubital tunnel syndrome: anatomy, pathology, and imaging.

Cubital tunnel syndrome (CuTS) is the second most common peripheral neuropathy in the upper limb. It occurs due to ulnar nerve compression within the fibro-osseous cubital tunnel at the elbow joint. Although CuTS is typically diagnosed clinically and with electrodiagnostic studies, the importance of imaging in evaluating the condition is growing. Knowing the typical imaging findings of ulnar nerve entrapment is necessary for precise diagnosis and proper treatment. In this article, we focus on the clinical features, workup and complex imaging of the "anatomic" cubital tunnel and relevant pathological entities.

Imaging modalities for non-acute pathologies of the foot and ankle.

Chronic foot and ankle pain, in contrast to acute traumatic injuries, presents a diagnostic challenge due to its diverse underlying causes. Accurate diagnosis often necessitates the utilization of various imaging modalities, emphasizing the importance of selecting the most appropriate one. The intricate structure of the foot, composed of multiple bones and supported by soft tissues like ligaments and plantar fascia, gives rise to a spectrum of mechanical disorders, including stress fractures, plantar fasciitis, Morton's neuroma, and more. In addition to mechanical issues, non-acute abnormalities encompass inflammatory diseases affecting tendons and joints, benign tumors, tumor-like lesions, vascular abnormalities, and others. This article reviews the indispensable role of imaging in the assessment of these conditions, with a focus on plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine studies, tailored to the specific clinical presentation. By providing insights into the selection and interpretation of imaging modalities, this article aims to assist clinicians in achieving accurate diagnoses and optimizing patient care for nonacute foot and ankle pathologies.

The Human Botfly "Bubbling Sign": Ultrasound Features of Cutaneous Furuncular Myiasis.

Dermatobia hominis , the human botfly, is native to South and Central America with cases of infestation seen in travelers to these areas. Myiasis is the cutaneous manifestation of larvae between two periods of molting (instar) and presents as a firm furuncular mass with a central pore that can be easily clinically overlooked. Ultrasound is useful in the diagnostic workup and has specific features and techniques to demonstrate live larva. We present a patient who acquired cutaneous furuncular myiasis caused by D. hominis , the human botfly, during her jungle trek in the Amazon forests in South America. Over 5 weeks, she developed a firm furuncular lesion with a central pore. Ultrasound revealed a hypoechoic mass with a hyperechoic oblong-shaped core that showed a fluid circulation, confirming the presence of a viable larva. Surgery was performed and a second-instar D. hominis larva was confirmed. We discuss the key ultrasound findings and management of cutaneous furuncular myiasis with the aim of raising awareness of this condition, adding to the growing body of literature likely associated with the re-opening of global travel routes.

Hydroxyapatite deposition disease (HADD) of the spring ligament: an unusual cause of medial foot pain.

Foot pain is one of the most common presenting complaints in orthopaedic clinical practice and can be attributed to a multitude of pathologies in the various osseous structures, ligaments, and tendons of the foot. The spring ligament complex (SLC) between the calcaneum and navicular supports the talus and plays a major role in the static stability of the medial longitudinal arch of the foot. Although calcific ligamentous enthesopathy around the ankle has been described in the literature, we report the first case of its kind affecting the SLC in a 51-year-old male with medial foot pain and no history of trauma. We highlight the role of radiological interventions in the diagnosis and effective management using ultrasound (US)-guided barbotage.