CSF Leak After Diastematomyelia Operation

I’ll be frank, I don’t have all the details on this but the findings are clear on this animated gif.  If you watch carefully, you can see the pulsation artifact at the site of leak.  There is a rent in the dura and pseudomeningocele in the dorsal soft tissues.

 

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I’m guessing this was a laminectomy for a bony septum producing symptoms.  I have seen these on myelography where the dye pours out as soon as it’s injected.

Peroneus Quartus

This is one of my favorite accessory muscles.  I have no idea why.  Perhaps it’s because it rarely if ever causes trouble and you have to know what you’re looking at to actually find one.

In my experience, there is a spectrum of appearances, ranging from a distinct separate muscle to one like this one that blends with the adjacent PL.

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Florid Adhesive Capsulitis

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At at least one conference I’ve been to, this entity has been described as the most underdiagnosed malady of the shoulder. Here is a classic case with thickening of the axillary pouch and edema around the shoulder joint capsule. While there are not very many differential considerations,  inflammatory arthritis and recent trauma are the most likely mimics.

In my previous practice I most commonly saw this in obese women and came to believe that it was due to a restricted range of motion because of their body habitus in that population.

Discoid Lateral Meniscus with Tear

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Another classic: discoid meniscus with associated tears.  I often see normal (not torn) incomplete discoid menisci.  Full/True discoid menisci are more rare but more often have a tear associated with them.  This knee also had the courtesy to give rise to parameniscal cysts from the meniscal tear.

The most obvious tear is the radial component but there is almost certainly a horizontal component of the tear producing the parameniscal cysts and this patient will probably end up with a small remnant of the meniscal body and posterior horn following arthroscopic debridement.