Imaging of Turf Toe.

During the advent of artificial turf and flexible footwear in football, turf toe was initially coined and described as a 1st metatarsophalangeal joint sprain injury. In the classic setting of hyperextension of the 1st metatarsophalangeal joint, turf toe is an injury to its plantar capsuloligamentous complex. Advances in MR imaging and knowledge of the complex 1st metatarsophalangeal joint help pinpoint the injured plantar structures as well as assess severity and chronicity of the injury. Detailed analysis of turf toe should highlight the best conservative and surgical options for injured athletes to reach optimal recovery.

Snapping hip: imaging and treatment.

Snapping hip, or coxa saltans, presents as an audible or palpable snapping that occurs around the hip during movement and can be associated with or without pain. The prevalence of snapping hip is estimated to occur in up to 10% of the general population, but it is especially seen in athletes such as dancers, soccer players, weight lifters, and runners. Although the snapping sound can be readily heard, the diagnostic cause may be a clinical challenge. The causes of snapping hip have been divided into two distinct categories: extra-articular and intra-articular. Extra-articular snapping hip can be further subdivided into external and internal causes. Advances in imaging techniques have improved the diagnostic accuracy of the various causes of snapping hip, mainly by providing real-time imaging evaluation of moving structures during the snapping phase. Image-guided treatments have also been useful in the diagnostic work-up of snapping hip given the complexity and multitude of causes of hip pain. We discuss the common and uncommon causes of snapping hip, the advanced imaging techniques that now give us a better understanding of the underlying mechanism, and an image-guided diagnostic and therapeutic algorithm that helps to identify surgical candidates.

MR imaging of turf toe.

MR imaging provides soft tissue detail unparalleled by any other modality for the assessment of turf toe injuries and has become standard in certain populations of athletic patients. Principal knowledge of the anatomy and appropriate imaging techniques is central for accurate imaging evaluation. The precise determination of the structures involved and the severity of the injury by MR imaging provides the basis for treatment.

Sonography of postexcision specimens of nonpalpable breast lesions: value, limitations, and description of a method.

OBJECTIVE: The objective of our study was to retrospectively review our experience regarding the value of sonography in identifying a nonpalpable mass within a surgically excised specimen and in assessing the surgical margins in cases of malignancy. MATERIALS AND METHODS: One hundred four lumpectomies were performed in 99 consecutive patients with 131 nonpalpable breast lesions after sonographically guided needle localization. All 104 surgical specimens were scanned on sonography, and 86 specimen radiographs were obtained. Visualization of the lesion on sonography was compared with specimen radiographs and histologic findings. Sonographic margin status was classified as negative (shortest distance between tumor and specimen margin, > 0.2 cm) or positive (shortest distance between tumor and specimen margin, 0.2 cm) and was compared with pathology results. RESULTS: Specimen sonography showed 95.4% (125/131) of the excised abnormalities; nonfatty background and a lesion size of greater than 0.5 cm contributed significantly to the success of specimen sonography. Four of six lesions missed on sonography were identified on specimen radiography. Among 81 malignant specimens, sonography identified 38 specimens with positive margins and 43 with negative margins. Pathologic examination revealed eight false-positive and 10 false-negative results (21% false-positive rate and 23.2% false-negative rate). CONCLUSION: Specimen sonography is an effective procedure for identifying the presence of the lesion within the specimen; however, it is of limited value in cases of small hypoechoic lesions against a fatty background. Assessment of margins is limited by both false-positive and false-negative results.