Final Pr. ID: Paper #: 050
Cartilage imaging in adults has been a rich area of research in which MR T2 and T1rho mapping provide complementary information regarding the extracellular matrix, including collagen fibers and glycosaminoglycans, respectively. However, in the pediatric population, there remains a need to obtain normative data for these variables during skeletal maturation.
The purpose of this study is to provide complementary information regarding cartilage during skeletal maturation with T2 and T1rho maps. Read More
Final Pr. ID: Paper #: 051
Mensicocapsular injury (ramp lesion) occurs in 9-17% of ACL tears. These injuries are a risk factor for instability and failure following ACL reconstruction. The far peripheral location has contributed to under-diagnosis during routine anterior-approach arthroscopy. While there has been increasing interest in the identification and treatment of these lesions in adults, there is a paucity of published data on children and the proposed MRI features lack specificity. Therefore, the purpose of this study was to investigate the performance of MRI criteria for identifying ramp lesions in children. Read More
Final Pr. ID: Poster #: SCI-027
The prevalence, imaging features, and etiologies of pediatric intra-articular soft tissue masses are not well described in the literature. Therefore, intra-articular masses can present diagnostic dilemmas for pediatric radiologists. The purpose of this study was to further evaluate pediatric intra-articular soft tissue masses. Our hypothesis was that intra-articular masses have a limited differential diagnosis and are mostly benign. Read More
Final Pr. ID: Poster #: SCI-062
Depending on the age of the patient, knee MRI may be a daunting exam. Physicians may have a higher threshold to order MRI in the pediatric setting compared to the adult setting. Few if any studies are available which attempt to predict the prevalence of MRI findings based on the patient’s presenting history in the sports medicine setting. Our objective was to determine the prevalence of knee pathology using MRI in two groups of pediatric patients: those with an acute event, and those with knee pain without history of acute event. Read More
Final Pr. ID: Paper #: 114
Underlying causes for loss of knee flexion in a child are myriad. Once an intrinsic cause has been excluded and a physical block to flexion has been confirmed, pathology within the extensor component must be sought. Idiopathic contractures, congenital contractures, and fibrosis of multiple components of the quadriceps muscle as causes of limitation to flexion of the knee have been reported in the orthopedic literature.
More recently, additional structures within the quadriceps muscle have been described, leading to the new designation of a ‘quinticeps femoris’ muscle. This has been termed both an accessory quadriceps femoris and a tensor vastus intermedius (TVI). The latter has been described as a previously unrecognised common variant of anatomy, whereas the former presents as a pathological entity, resulting in progressive fixed flexion of the knee.
Two such cases of 'quinticeps femoris' have presented to our institution. Both patients were reviewed by multiple health professionals and had a significant delay in diagnosis (of two and five years respectively), with marked progression of fixed knee flexion during this period. Both diagnoses were ultimately made on MRI, with the causative abnormality appearing as a fusiform structure of low signal intensity arising from the anterolateral proximal femur and blending with the common quadriceps tendon distally. This highlights the importance of radiologists being aware of this anatomical entity as they will often be first to suggest the diagnosis. Both patients underwent surgical release of the anomalous quadriceps band with significant functional improvement.
Here we discuss the presentation, underlying pathology, and treatment of this uncommon cause of restricted knee flexion, to our knowledge unreported in the pediatric imaging literature, as well as the need for its recognition and inclusion in the differential diagnosis of progressive loss of knee flexion. Read More