JuanMiranda
@themskarchive
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Musculoskeletal Radiologist. Husband. Obsessive reader. Investor. Grateful to share my daily MSK and Tanzanian activities #radiology #radtwitter #MSKRad
Madrid, Comunidad de Madrid
Joined December 2022
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21/2/2024. 🚨 Proximal Femur Alert! Female, 29yo. 🦴 A closer look at an AP
#Xray
unveils a medullary lesion. What’s the suspected diagnosis based on location and morphology?
1⃣- Fibrous Displasia
2⃣- Simple bone cyst
3⃣- Gyant cell tumor
4⃣- Litic metastasis
🧐
#Radiology
#MSK
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37
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9/5/2024. 🟢 Frozen shoulder often diagnosed clinically, but imaging can reveal telltale signs:
1⃣ Rotator interval edema
2⃣ Axillary recess thickening
3⃣ Pericapsular axillary recess edema
4⃣ Subentheseal GH edema
Imaging offers valuable insights!
#MSK
#diagnosis
#shoulder
9
46
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16/2/2024. Type V Habermeyer LHBT
#instability
: Intraarticular tendon dislocation. Tears of the medial and lateral limbs of the CH and SGHL with a full-thickness tear of the subscapularis allows medial dislocation of the LHBT into the joint.
#MRI
#shoulder
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46
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19/3/2024. 🟠 26F with chronic ankle pain aggravated over past year. XRAY hints at underlying pathology; confirmatory
#CT
/
#MRI
warranted for definitive diagnosis.
#MSK
#Radiology
#AnklePain
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31
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28/2/2024. 🔴53-year-old male presents with hip pain in the emergency department. Here is a more zoomed-in view of the hip X-ray. What could be the cause of his pain?
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31
134
7/2/2024. 🚨 Common Meniscal Tear Alert! 🚨 Do you know which type this is?
1️⃣ Radial Tear
2️⃣ Vertical Tear
3️⃣ Horizontal Flap Tear
4️⃣ Complex Tear
🤔💭 Drop your guesses below!
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17/7/2024. 🟩 What are rew arrows 📌 pointing at in this AP knee XRAY of a 14yo female with bilateral knee pain?
#MSK
#orthrotwitter
#XRAY
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10/7/2024. 🟧💁 Male 28 years-old with longstanding pain after trauma in his right wrist 🤚, years ago.
A
#MRI
is performed.
Some features are pointed with different arrows.
What´s your diagnosis?
The result is coming soon. Stay tunned.
#MSK
#wristpain
#traumatwitter
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19/2/2024. 🟠 Arrows point to a finding in this lateral non-standing
#radiograph
of the
#ankle
🦶 of a 22yo-male with recurrent sprains.
1⃣ Can you describe the finding?
2⃣Associated symptoms?
3⃣What kind of sports predispose to this lesion?
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23
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8/2/2024. 📸 One picture, two diagnoses. 🔴 and 🟡 arrows highlight two distinct pathologies. Can you identify them? Full MRI reveal coming soon. Stay tuned!
#MedicalMystery
#MRIChallenge
#MSK
#shoulder
#rotatorcuff
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24
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1/4/2024. 🟠🔍Awaiting MRI and lateral X-ray for a 17-year-old adolescent. Suspected diagnosis pending. Describe the finding and let's delve into differentials. 💡Stay tuned. 🧐
#MedTwitter
#MSKRadiology
#bonetumor
#radiology
#XRAY
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19
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2/7/2024. 9-year-old with knee pain—any guesses on the diagnosis? 🤔 Which knee do you think it is?
#Lateral
#XRay
and
#MRI
on the way! 🦵💡
#KneePain
#Pediatrics
#DiagnosisChallenge
#Health
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18
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11/1/2024. 💪Where is the abnormality in this shoulder? ⛷️Young male patient...
#msk
#XRAY
#shoulder
#traumatwitter
Would you recommend any other view or projection? 🧐
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8/4/2024. 🟢📷📷 45-year-old woman with knee pain post-trauma: lateral reveals a small fracture. What kind of fracture is it and where is it located?
#MSK
#radtwitter
#orthotwitter
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30/11/2023. Medial patellar plica syndrome, plica located in the articular interline (Type B Sakakibara). It leads to advanced femoropatellar arthritis with high-grade chondropathy and impingement of the medial infrapatellar fat.
#MSKRadiology
0
22
107
26/1/2024.🧐 What's the Likely Diagnosis? 🚨
1️⃣ Intraarticular Lipoma
2️⃣ Focal Pigmented Villonodular Sinovitis
3️⃣ Diffuse Pigmented Villonodular Sinovitis
4️⃣ Synovial Osteochondromatosis
5️⃣ Synovial Sarcoma
Best
#MRI
Sequence for Diagnosis? 🧠 Share your thoughts!
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4/1/2024. 🤔🦵 Can you identify what's going on in this X-ray? 🦴 No clinical data provided, just the image. Share your thoughts and let's discuss the main differential diagnoses! 💬🌍
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14/6/2024. 🟧 Painful bulk on the medial aspect of the knee in a 13 yo child. What´s your diagnosis? Why? 🦵
1⃣Osteochondroma
2⃣Osteosarcoma
3⃣Ewing sarcoma
4⃣Nora lesion
Stay tunnned for answers and MRI, coming soon.
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18/4/2024. 💪Young female with painful shoulder post-trauma! 🤕 History of injury raises concern.
🤔 Is anything alarming in the
#ShoulderXRAY
?
📸 Stay tuned for insights!
💡
#Rockwood
#MSK
#TraumaTwitter
🔍
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17/6/2024. Considering the following axial slice of a 24-yo right
#shoulder
arthrogram, which lesion would you suspect?
1⃣Bennet lesion
2⃣ALPSA
3⃣Perthes
4⃣Regular soft-tissue Bankart
#MSK
#arthroMRI
#contrast
#labrum
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20/4/2024. 🟢What´s the likely cause of omarthrosis in this patient? Why? 🫸
1⃣ CPPD.
2⃣ Rotator cuff arthropathy.
3⃣ Trauma.
Reply with your insights! 🧠
#Radiology
#MSKRad
#traumatwitter
#orthotwitter
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03/10/2023. Just got into a 1.5 T MRI scanner and got CT-like images of my wrist using a T1 spoiled GE and ultra-short TE MRI sequence. Acquisition time: 4 minutes. Here are the results.
#wrist
#MRI
#CT
#gradientecho
#insights
#MSK
#Innovation
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11/4/2024. 🟠 Can you spot the two crucial findings in this AP
#XRAY
of the right
#wrist
, months post-injury? 🤚 Stay tuned for the CT and MRI images!
#RadiologyInsights
#MSK
#traumatwitter
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5/7/2024. 🟩 The variety of treatments for postraumatic osteochondral lesions or defects around the knee. I highly recommend the following article 📙.
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8/5/2024. 🟠 Giant medial aponeurotic plane Morell- Lavallée hematoma around the knee in a 74 year-old male after trauma.
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20/3/2024. 🔴Interesting case: Male soccer player, 20, signs of posterior shoulder instability. 🤔 Is this merely a 1⃣ normal variant or 2⃣ pathology? Stay tuned for further insights from the study. What's your take on this?
#MSKRad
#ShoulderInstability
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5/6/2024. 👌 Thrilled to have improved MRI protocols with my teammate
@pepelermarx
! This
#shoulder
MRI clearly shows a preinsertional partial articular-sided mid-grade supraspinatus tear in three planes 💪.
#MRI
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15/2/2024. 🔍 DIAGNOSIS: Bifascicular Anatomy of the ACL 🏥
1️⃣ AM Bundle:
📍Distal Tibial Insertion: Medial
📍Femoral Insertion: Proximal
Fx: Anterior Translation Stability
2️⃣ PL Bundle:
📍Distal Tibial Insertion: Lateral
📍Femoral Insertion: Distal
Fx: Rotatory Instability
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17/1/2024. 🦵🦴🧐This is a knee XRAY to follow up surgical treatment of patellar fracture. Curious to hear your thoughts! 🤔 What stands out to you? Let's dive into the details!
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21/12/2023. 🔍✨ Dive into this X-ray challenge! What four abnormalities catch your eye? 👁️💡 Additionally, could these symptoms align with two specific syndromes? 🤔
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19/12/2023. 🚨Very subtle finding in a 33-year-old trauma patient's radiological exam. Stay tuned for details. What do you think?🤔 MRI will be posted later.
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17/2/2024. 🔎🟢 Another Case of Anterior
#Knee
Pain: Age: 14-year-old female 🧒
🚫 No extra imaging needed for the right diagnosis but it must be clinically correlated.
1️⃣ What are the main features?
2️⃣ What's the name of the disease?
Your insights? 💡
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8/5/2024. 🟢 After years of a prolonged stay in the ICU, here are the X-ray results for the left hip. ❌
What are the findings?
What´s your diagnosis?
Stay tuned for comments and diagnosis!
#MSK
#traumatwitter
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29/2/2024. 🟢🚨
#Knee
Diagnosis Alert! 🚨
1️⃣ X-Ray 🦴 reveals...
2️⃣ MRI 🔍 shows...
👀 Stay tuned for more insights!
#Radiology
#MSKRad
#KneeInsights
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3/7/2024. 🟧 Can anyone tell where is the abnormal finding in the following lateral
#knee
XRAY? 🦵
1⃣ Femoral tunnel of ACL graft.
2⃣ Tibial tunnel of ACL graft.
3⃣ Lemaire extraarticular tenodesis.
#msk
#orthotwitter
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15/4/2024.🟠Male 34 yo with radial-sided
#elbow
💪 pain, clinically characterised of epicondylitis. Is this a
1⃣ normal variant of anatomy or
2⃣pathology?
🦴What's the name of this finding?
Give your thoughts and stay tunned.
#MSK
#traumatwitter
#orthotwitter
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18/3/2024. 19yo skier down! 🎿 Which ligaments got hit? 🤔 Stay tuned for the diagnosis!
#skiing
#injury
#ligaments
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29/11/2023. 17yo basketball player + "jumper´s knee": Tendinopathy of the proximal deep fibers of the patellar tendon at its patellar insertion, with a small intrasubstance delaminating partial tear + adjacent Hoffa fat pad peritendinitis. 🩹🦵
#MSKRadiology
#SportsInjuries
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4/6/2024. 🟥 🚨70-year-old man goes out for a walk, feels a sudden "pedrada" (stone hit) in his leg, and falls. What happened in the posterior aspect of his leg? Check out the
#XRAY
and stay tunned.
#ankle
#Achylestendon
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8
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13/2/2024. 🚨 🟠Among other post-traumatic features in this
#WristXRay
, the yellow arrow points to a critical sign we should not ignore. 1⃣What's the name of this sign, and 2⃣what does it reveal? 🤔💡
#Radiology
#MedicalEducation
#XRayInsights
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9/4/2024.🦶 Thick walled apparently chronic distal intermetatarsal bursitis in the 3rd space. The main differential: Morton´s neuroma. XRAY, MRI and US correlation.
#MSKRadiology
#MRI
#Ultrasound
#Orthopedics
#MedTwitter
🟢
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24/7/2024. 🟧✋ Volar bump in the wirst of a 7 yo boy. AP
#XRAY
is performed.
What´s your suspected diagnosis?
Lateral XRAY and MRI coming soon. Stay tuned for the results of the additional imaging! 📸
#MSK
#MRI
#WristInjury
#PediatricHealth
#Orthopedics
#StayTuned
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11/12/2023. A common cause of extraarticular posterior ankle impingement: bilateral Haglund deformity + left Haglund syndrome. Female 46yo. Right deformity surgically removed.
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70
10/4/2024. Pellegrini-Stieda lesion in a 43 yo female. (avulsion injury of the superficial band of MCL at the medial femoral condyle). The main differential: calcifying periarthritis (HA deposition) of the
#knee
in the MCL here:
#MSK
0
13
69
5/4/2024. 🟠 23yo male presents to ED with left
#knee
🦵contusion.
#XRAY
reveals:
1⃣ Superolateral patellar fracture, two displaced fragments.
2⃣ Type III tripartite patella.
Let's dive into the diagnosis. MRI and rest of the findings incoming.
#MSKrad
#Trauma
#OrthoTwitter
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13
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4/12/2023. Exploring sonographic signs of tumors: a peripheral nerve sheath tumor emerging in the sensitive branch of the radial nerve, just beneath the distal fibers of the brachioradialis muscle. Dive into the videos for a closer look. 📽️
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15
67
22/04/2024. 🟠 With all these
#MRI
findings around the
#foot
and the
#hand
, what kind of diseases would you suggest to rule out in this patient?
#rheumatology
#activeinflammation
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10
66
27/12/2023. What´s happenned in this knee? Can you guess previous lesions, surgery, and post-op features and complications?
#xraychallenge
#XRAY
#knee
Lateral view CXR, CT and MRI will be coming soon.
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7
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18/1/2024. 🚨 60yo male dealing with instep pain! 🦶💔
#Foot
Got his AP
#XRAY
revealing a diagnosis that's easy to miss! Confirmed in lateral oblique. Any guesses? 🤔 Drop your thoughts below! 👇
#traumatwitter
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15
66
21/9/2023. Male-21yo. Posterior glenohumeral instability and pain. Bennet lesion: Consolidated posteroinferior periosteal capsulolabral avulsion (Bennet enthesophite) + condrolabral tear + bone edema. Check out another example we published 2 years ago. .
0
26
66
1/7/2024. 💪 A rare, but possible cause of axillary nerve entrapment 🟥: inferior ganglion cyst / paralabral glenohumeral cyst contacting with the axillary nerve in the cuadrangular space. No physical or MR signs of denervation.
#MRI
#shoulder
#nerveentrapment
#axillary
0
12
64
12/4/2024. 🟢 What´s the cause of the advanced radiocarpal osteoarthritis in this patient in this
#hand
#XRAY
?
#MSK
#radtwitter
#orthotwitter
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24/10/2024. Lateral plantar vein thrombosis. An uncommon cause of plantar tenderness. Male, 54yo, "painfull, tubular shaped soft tissue tumor exhibiting a fibrous consistency".
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16/4/2024. 🟢 Up to 50% of this anatomical variant is bilateral as it is happening in this 46yo female
#knee
s.
🦵What´s it´s name?
#MSK
#orthotwitter
#MRI
#meniscus
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16/7/2024. 🔍📷 Trouble in the
#shoulder
!
#XRAY
anteroposterior view:
1⃣Subscapular tendon bony avulsion.
2⃣HS + bony Bankart.
3⃣Supraspinatus tendon bony avulsion.
4⃣Infraspinatus tendon type II calcifying tendinopathy.
5⃣Trochiter fracture.
#traumatwitter
#orthotwitter
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27/10/2023. Thick, coarse enthesophytes around the MSK structures, in this patient in the patellar ligament and gluteal complex: a common finding in patients with DISH. I recommend the following article:
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13
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23/4/2024. 🔴 93 yo female, foot
#XRAY
reveals a bunch of findings. Reason for performing: malleolar pressure ulcers. 🦶
Describe the findings. What´s your diagnosis?
1⃣ Diabetic foot?
2⃣ Charcot?
3⃣ ...? Help me please.
Stay tunned and let´s discuss.
#MSK
#traumatweeter
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12
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2/4/2024. 🦿Question for MSk world. ✅ A very common type of traumatic meniscal tear. What type is it? 🦵
1⃣ Radial tear.
2⃣ Horizontal tear.
3⃣ Vertical tear.
For trauma/ortho world: What kind of tx would you perform? 👨🔧 Stay tunned for the rest of MRI findings.
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7/2/2024. 🔍 The arrow points to a lesion in the proximal phalanx's marrow. What’s your diagnosis? Describe the features and choose:🔢
1️⃣ Intraosseous ganglion
2️⃣ Lytic metastasis
3️⃣ Enchondroma
4️⃣ Low-grade chondrosarcoma
🎓 Reply with your answer & why. Let’s discuss!
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11
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26/9/2023. 55yo woman, chronic pelvic pain syndrome. Cortico-anesthetic injection of the left pudendal nerve in Alcock's canal (internal obturator fascia), with prior addition of iodinated contrast for precise treatment location.
#pelvis
#pain
#woman
#CT
#intervention
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27/2/2024.🔍 Spotting the cause of erosion in the volar aspect of the proximal phalanx of the 1st finger on this
#hands
#xray
. 🧐 70 yo male. What's your pick? 🤔
1️⃣ Tophus
2️⃣ TGCT
3️⃣ Ganglion cyst
4️⃣ Sarcoma
Stay tuned for the
#mri
follow-up. 📸
#radiology
#mskradiology
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1
16
58
9/11/2023. Müller-Weiss syndrome: sclerosis and collapse with "comma-shaped" deformity of the lateral aspect of the navicular bone on X-Ray + severe Chopart and subtalar OA.
#foot
#MRI
#Xray
#osteonecrosis
2
17
56
25/3/2024. 🔴 Following US-guided arthroCT and MRI assessment in a 45-year-old male with
#wrist
trauma 🤚. What's your differential diagnosis? Stay tunnned and wait for more images.
#PALMER
#classification
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12
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@pepelermarx
@drwillyjara
@JM_Zulueta_O
@SermeMsk
@ESSRmsk
DIAGNOSIS - Mucoid degeneration of ACL + proximal intrasubstance ganglion (🟢)+ bony spread into tibial plateau (🔴) and intercondilar notch (🟡) insertions and abutting the posterior capsular with laminar extension beyond the capsule (🍑).
0
12
54
7/3/2024. 🚀 Quick
#Radiology
Quiz! 📸 A different femoral neck lesion:
1️⃣ How do you describe on
#Xray
?
2️⃣ Are additional imaging techniques needed?
3️⃣ What are the top differential diagnoses?
🔍 MRI insights coming! 🧐
#MSKRadiology
#hip
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12
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3/10/2023. Proximal high grade injury of MCL involving both superficial and deep (meniscofemoral fascicle avulsion) layers. Check out the BM edema + floppy and the retracted fascicle.
#knee
#orthotwitter
#trauma
#ligament
#pain
1
9
53
4/3/2024. 🔍 Spotting osteochondroma in a child's knee via X-ray & MRI:
1️⃣ Key X-ray sign?
2️⃣ MRI cartilage cap appearance?
3️⃣ Implications for a growing child?
Reply with your insights! 🧠👀
#Osteochondroma
#PediatricRadiology
#MSKRad
5
11
48
@pepelermarx
🩺 DIAGNOSIS: SNAC
#wrist
Stage II. MRI: 🟢Complete proximal waist scaphoid fracture non-union 🟡 Radiocarpal & 🔴incipient midcarpal OA 🟠 Radioscaphoid capsular tear/synovitis 🤎 Viegas Type II lunate with lunohamate impingement signs
#MedicalUpdate
#Orthopedics
@dr_alfon
0
15
52
8/7/2024. 🟥 Female 67 yo suddenly falls and breaks her leg ⚡️🦵. Describe the fracture.
#XRAY
#MSK
#fracture
#traumatwitter
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9
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17/4/2024. 👋🟢 HA calcium deposits can also appear in capsular planes, not only in tendons or bursae, as in this example:
Volar radiocarpal calcific periarthritis.
#XRAY
and
#Ultrasound
correlation.
#MSK
#traumatwitter
#orthotwitter
2
10
50
3/6/2024. 🟩🖖 Ghosty opacity in volar aspect of the following wrist: main diagnosis? No trauma.
Few more examples of the same disease in other locations coming soon in the post.
Stay tunned and feel free to comment!!!
#mskcomeback
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10
50
@pepelermarx
@JM_Zulueta_O
@drwillyjara
@SermeMsk
@ESSRmsk
DIAGNOSIS -
#XRAY
"C sign" suggests middle talocalcaneal non-osseous tarsal coalition.
#MRI
confirms the disease and assesses degenerative changes in both signs of the synchondrosis. Thank you all
@northwoods1980
@faisalcaptures
@Strauniedoc
@DrizzyBoadi
@DrAnantaSaikia1
!
1
6
51
@pepelermarx
@ESSRmsk
@SermeMsk
DIAGNOSIS - Proximal diaphyseal medullary lesion featuring ground-glass attenuation & sclerotic rim, intermediate T1 & high (no fluid) PDFS signal, + subtle diffusion restriction. Location & imaging suggest fibrous dysplasia. A classic "no touch" lesion.
#MSKRadiology
3
7
50
20/2/2024. 🚨 Don't Miss This! 🚨
1️⃣ Critical
#Fracture
Alert in AP
#WristXray
! 👀 Name?
2️⃣ Two More Key Findings Near the Distal Ulna. 📍🔍
✅ Quick recognition is crucial!
#Radiology
#MedEd
#Ortho
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