Intra-cardiac extension of hepatocellular carcinoma (HCC) is an uncommon but serious condition related to poor prognosis. We report a 57-year-old male diagnosed with HCC with intra-cardiac extension into the right atrium at presentation. There were no symptoms related to cardiac involvement and intra-cardiac extension was incidentally noted on radiological imaging. He was offered palliative treatment and succumbed to his disease within 50 days of first diagnosis.
Carcinoma, Hepatocellular ; Liver Neoplasms

A 47-year-old woman who underwent resection of known spinal meningioma at the T1 level returned for postoperative magnetic resonance imaging of the cervical spine. Incidentally, thin-walled structures with signal intensities that are similar to those of cerebrospinal fluid were found to be present in the left neural exit canal at the C7-T1 level and bilateral neural exit canals at the C6-7 level. Imaging findings were in keeping with perineural cysts. Cervical spine perineural cysts are likely underreported, as most of them are asymptomatic. The imaging features and differential diagnoses of perineural cysts are discussed in this article.

A 53-year-old man presented with acute cervical myelopathy following a fall. Cervical radiography and computed tomography showed ossification of the posterior longitudinal ligament (OPLL) from C2 to C6 level, with severe cervical canal stenosis and cord compression. Magnetic resonance imaging further showed increased T2-weighted signal in the spinal cord at the level of greatest central spinal canal stenosis. OPLL is a significant cause of myelopathy in Asian populations and is found in up to 25% of patients presenting with cervical compression myelopathy. The clinical presentation, radiological evaluation and management of OPLL are discussed.
Cervical Vertebrae ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament ; diagnostic imaging ; Spinal Cord ; diagnostic imaging ; Spinal Cord Compression ; diagnostic imaging ; Spinal Cord Diseases ; pathology ; Tomography, X-Ray Computed

A 30-year-old woman presented with a six-month history of left posterior heel pain. Physical examination revealed a tender, inflamed and indurated posterior heel with a visible bony prominence of the posterosuperior aspect of the calcaneus. Lateral ankle radiography showed a prominent left posterosuperior calcaneal tuberosity and thickening of the distal Achilles tendon outline. Magnetic resonance imaging demonstrated high-signal inflammatory fluid in the retrocalcaneal bursa, increased signal intensity and thickening of the Achilles tendon, and prominence of the posterior calcaneus tuberosity with reactive marrow oedema. The findings are consistent with Haglund's deformity. The patient underwent hind foot surgery after failing a six-month course of conservative therapy. There was no further recurrence of symptoms after surgery. The clinical and radiological features of Haglund's deformity are described, including a short discussion of other causes of hind foot pain.
Achilles Tendon ; diagnostic imaging ; surgery ; Adult ; Bone and Bones ; surgery ; Calcaneus ; diagnostic imaging ; surgery ; Female ; Foot ; diagnostic imaging ; Foot Deformities ; surgery ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Pain ; etiology ; Treatment Outcome

A 54-year-old woman presented with a large mass on her right hand that was progressively enlarging over a period of a few years. She had cosmetic concerns about the enlarging mass and experienced interference with routine activity. Physical examination revealed a soft, mobile, non-tender, lobulated mass with well-defined margins. Magnetic resonance imaging showed the soft lump to be a lipomatous mass in the deep palmar space of the hand, which was subsequently surgically resected. The imaging features of deep palmar lipomas of the hand and other common benign lesions at this location are discussed.
Arteriovenous Malformations ; diagnostic imaging ; Female ; Hand ; diagnostic imaging ; pathology ; Hemangioma ; diagnostic imaging ; Humans ; Lipoma ; diagnosis ; diagnostic imaging ; Magnetic Resonance Imaging ; Middle Aged ; Soft Tissue Neoplasms ; diagnosis ; diagnostic imaging ; Tenosynovitis ; diagnostic imaging

A 31-year-old male motorcyclist presented with prepatellar swelling of the left knee after a collision with a car. Magnetic resonance imaging of the knee showed no bony or ligamentous injury to the knee. Instead, a well-defined, thin-walled, T2-weighted hyperintense fluid collection with internal septations was identified in a prefascial location overlying the left patella and patellar tendon. The findings were in keeping with those of a Morel-Lavallée lesion, a closed internal degloving injury. Morel-Lavallée lesions are occasionally encountered after a blunt soft-tissue trauma. The presentation and imaging features are discussed.
Adult ; Compression Bandages ; Humans ; Knee Injuries ; diagnosis ; therapy ; Magnetic Resonance Imaging ; methods ; Male ; Physical Therapy Modalities ; Soft Tissue Injuries ; diagnosis ; therapy ; Trauma Severity Indices

An 82-year-old woman presented with neck pain and bilateral upper limb paraesthesia after sustaining an unwitnessed fall at home the day before. Physical examination revealed tenderness over the C4-6 region but no evidence of step deformity or neurological deficit. Magnetic resonance imaging of the cervical spine revealed multiple small fractures at the anteroinferior endplate corners of the C3, C5 and C6 vertebrae with focal kyphosis and marrow oedema at these levels, as well as associated disruption of the anterior longitudinal ligament and central spinal canal stenosis. The diagnosis of multiple flexion teardrop fractures was made based on these imaging findings, and the patient subsequently received conservative management. This paper illustrates the radiological features of flexion teardrop fractures and highlights the importance of prompt diagnosis and management of such cases.
Accidental Falls ; Aged, 80 and over ; Cervical Vertebrae ; diagnostic imaging ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; diagnostic imaging ; Humans ; Neck Pain ; Radiography ; Range of Motion, Articular ; Spinal Fractures ; diagnostic imaging ; Treatment Outcome

Accessory ossicles are normal variants that are frequently seen but often overlooked or misdiagnosed. Commonly seen at the foot and ankle, they may be mistaken for fracture fragments or loose bodies, or not be recognised as a cause of the patient's symptoms. This pictorial essay aimed to review commonly encountered accessory ossicles of the foot and ankle by highlighting anatomic landmarks and associated pathologic processes through the use of both basic and advanced imaging modalities, in an effort to increase awareness of these clinical entities.
Adult ; Aged, 80 and over ; Ankle Joint ; diagnostic imaging ; Female ; Foot ; diagnostic imaging ; Fractures, Bone ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Male ; Sesamoid Bones ; diagnostic imaging ; Tomography, X-Ray Computed

A 39-year-old man presented with acute left knee pain and swelling. There was limitation of movement of the knee joint. His past medical history was significant for gout. Computed radiography showed bony erosions that were not typical of chronic tophaceous gout. Magnetic resonance (MR) imaging showed focal deposits within the knee joint, which demonstrated isointense signal to muscle on T1-weighted sequence and intermediate signal on proton density (PD) and PD fat-saturated sequences. There was extensive, similar signal abnormality in the cruciate ligaments, popliteus tendon and lateral meniscus. These findings were in keeping with an intra-articular manifestation of chronic tophaceous gout. The clinical presentation and imaging features are herein discussed, with an emphasis on MR imaging.