Ankle impingement syndrome is a painful condition resulting from friction of joint tissues that is both cause and effect of an altered joint biomechanics. The leading causes of such condition are post-traumatic lesions, particularly the ligamentous ones, resulting in chronic ankle pain. From an anatomic and clinical point of view, these syndromes may be classified as anterolateral, anterior, anteromedial, posteromedial, and posterior. Magnetic resonance imaging is an excellent diagnostic method for demonstrating bone and soft tissue abnormalities resulting from different types of ankle impingement, providing useful data to confirm the diagnosis as well as to rule out other possible causes of joint pain. The present essay is aimed at illustrating the main magnetic resonance imaging findings in ankle impingement syndrome.

Keywords: Magnetic resonance imaging, Syndrome, Impingement, Ankle

OBJECTIVE: To assess the role of proton magnetic resonance spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in the differentiation between malignant and benign musculoskeletal tumors. MATERIALS AND METHODS: Fifty-five patients with musculoskeletal tumors (27 malignant and 28 benign) were studied. The examinations were performed in a 1.5 T magnetic resonance scanner with standard protocol, and single voxel proton magnetic resonance spectroscopy with 135 msec echo time. The dynamic contrast study was performed using T1-weighted gradient-echo sequence after intravenous gadolinium injection. Timesignal intensity curves and slope values were calculated. The statistical analysis was performed with the Levene's test, followed by a Student's t-test, besides the Pearson's chi-squared and Fischer's exact tests. RESULTS: Proton magnetic resonance spectroscopy sensitivity, specificity and accuracy were, respectively, 87.5%, 92.3% and 90.9% (p < 0.0001). Statistically significant difference was observed in the slope (%/min) between benign (mean, 27.5%/min) and malignant (mean, 110.9%/min) lesions (p < 0.0001). CONCLUSION: The time-intensity curve and slope values using dynamic-enhanced perfusion magnetic resonance imaging in association with the presence of choline peak demonstrated by single voxel magnetic resonance spectroscopy study are useful in the differentiation between malignant and benign musculoskeletal tumors.

Keywords: Proton magnetic resonance spectroscopy, Perfusion magnetic resonance imaging, Magnetic resonance imaging

We report a case of spontaneous healing of bucket-handle tear of the medial meniscus in a 32-year-old man. The patient twisted his left knee during a soccer game. At clinical examination, there was pain at mobilization and lock of extension at 45°. Magnetic resonance imaging showed a bucket-handle tear of medial meniscus and a detached fragment in the intercondylar notch. After conservative treatment there was spontaneous healing of the injury, seen on magnetic resonance imaging.

Keywords: Magnetic resonance imaging, Bucket-handle tear, Meniscal tear, Knee