Filip M Vanhoenacker

Algemeen ziekenhuis Sint-Maarten · Department of Radiology

Teaching point: Magnetic resonance imaging (MRI) and ultrasound may be useful to assess the extent of onychodystrophy associated with psoriatic dactylitis by showing nail bed thickening, matrix changes, and vascularity indicative of active inflammation.

This chapter deals with the general principles of posttreatment imaging of tumors of the osseous spine. Prerequisites for post-therapeutic imaging include clinical presentation and familiarity with the tumor histology, surgical technique, previous radio- or chemotherapy, and access to the preoperative imaging. The recommended time interval for loca...

Teaching point: Benign hyperostosis of the rib is a benign entity consisting of a stress phenomenon that should not be confused with Paget, fibrous dysplasia, or osteoblastic metastasis.

Vertebral hemangiomas and angiomatous neoplasms consist of a group of vascular tumors that arise from the abnormal proliferation of blood vessels within the bone. Vertebral hemangiomas are common, benign vascular tumors and are often discovered incidentally during routine imaging studies. These tumors are typically slow-growing and asymptomatic. Co...

Tuberculosis (TB) represents a major public health problem worldwide. Any tissue may be infected. Involvement of the musculoskeletal (MSK) system account for 1–3% of all tuberculous infections. MSK TB may manifest as tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue infections. Although TB spondylitis may present with distinctive i...

1. Dienst Radiologie, Chirec Delta 2. VUB, faculteit geneeskunde 3. Dienst Radiologie, UZ Brussel 4. Dienst Radiologie, AZ Sint-Maarten, Mechelen 5. Dienst Radiologie, UZ Antwerpen, Universiteit Antwerpen 6. Universiteit Gent Deze bijdrage beschrijft bilaterale cuboïdo-naviculaire coalitie bij een volwas-sen dame. Tarsale coalitie is een afwijking...

2. Faculté de médecine, VUB 3. Service de radiologie, UZ Brussel 4. Service de radiologie, AZ Sint-Maarten, Malines 5. Service de radiologie, UZ Antwerpen, Universiteit Antwerpen 6. Universiteit Gent Cet article décrit une coalition cuboïdo-naviculaire bilatérale chez une femme adulte. La coalition tarsienne est une anomalie dans laquelle une fusio...

Teaching Point: Palmar dislocation of the scaphoid and lunate is an extremely uncommon injury that warrants early diagnosis and treatment to avoid complications such as median nerve dysfunction, avascular necrosis, and premature osteoarthritis.

Objectives Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insigh...

Because of the increased life expectancy, the aging population can participate in recreational sports activities. The fact that activity is promoted as having a positive effect on mental and physical health is another factor that may contribute to a trend of increased participation in sports activities by middle-aged and older patients. Due to age-...

Bone islands (enostoses) are osteoblastic benign bony lesions. They consist of focal regions of mature bone cortex at the site of trabecular bone. Bone islands are thought to result from failure of bone resorption during endochondral ossification process or due to congenital etiology or failure of the development during childhood. The prevalence of...

Solitary plasmacytoma of bone is one of many existing types of bone tumors and is part of the plasma cell disorder spectrum. It is a local clonal plasma cell proliferation without evidence of symptomatic multiple myeloma. It occurs slightly more frequently in males with a median age at diagnosis of 55 years. The thoracic vertebrae are most frequent...

Our goal was to determine if “Nomenclature 2.0,” the classification of lumbar disk pathology consensus, should be updated. We conducted a social media and e-mail-based survey on preferences regarding the use of classification on magnetic resonance spine reporting. Members of the European Society of Neuroradiology, European Society of Musculoskeleta...

The craniocervical junction (CCJ) is a complex anatomical structure comprising the occiput, the atlas, and the axis. The CCJ plays an important role in maintaining stability, providing protection, and supporting neurovascular structures. The CCJ can be affected by a wide range of congenital variants and traumatic, degenerative, inflammatory, and tu...

We present a short overview of the most common causes and imaging findings of a rigid spine including long-standing spondylarthritis, diffuse idiopathic skeletal hyperostosis, and the less common ossification of the posterior longitudinal ligament. The article also focuses on the pathogenesis and imaging findings of acute complications of the rigid...

This history page in the series “Leaders in Musculoskeletal Radiology” is dedicated to the memory and achievements of French radiologist Maxime Ménard, whose name is associated with the Shenton-Ménard line that Ménard described independently with the British radiologist Edward Shenton. This landmark line describes the relationship of the proximal f...

Teaching Point: Calcified intervertebral disc herniation in children is rare, and spontaneous resolution is the rule.

Dupuytren's disease (DD) is a chronic benign fibroproliferative disorder of the palmar and digital fasciae. It is characterized by formation of nodules and fibrous cords that may eventually lead to contractures with permanent flexion of the finger joints. Correction of the flexion contractures in advanced disease is still performed by open limited...

Lunotriquetral (LT) coalition is the most common carpal coalition. Four morphological types of LT coalition have been described. LT coalition is usually asymptomatic, but rarely a fibrocartilaginous type may cause ulnar wrist pain. We report a case of bilateral asymptomatic LT coalition that was seen incidentally on conventional radiography taken a...

This history page in the series “Leaders in MSK Radiology” is dedicated to the memory and achievements of the Italian surgeon Augusto Pellegrini, whose name is partially associated with the medical eponym Pellegrini-Stieda disease.

Case-report about 65-year-old female with chronic abdominal pain and intermittent flare-ups. CT abdomen reveals a colo-colonic invagination in the transverse colon with a large submucosal lipomateous tumor as leading point. Our patient was treated with partial colectomy, and anatomo-pathological examination revealed a benign lipoma.

Teaching Point: Myxopapillary ependymoma presenting as a highly destructive lesion in the sacrum is rare but should be included in the differential diagnosis.

Due to its unparalleled soft tissue resolution and multiplanar imaging capability, MRI is the modality of choice for imaging synovial tumor and tumorlike lesions. The minimal hardware requirements, imaging protocol, and either basic or advanced MR sequences are described. For lesion characterization, four major groups can be distinguished based on...

In this chapter, a diagnostic algorithm and essential key points for the imaging workup of synovial tumors and tumor-like conditions are provided.It should be emphasized that imaging findings should be interpreted in conjunction with relevant clinical and laboratory examination. The imaging algorithm of a joint lesion should start with a convention...

Teaching Point: Spontaneous rupture of the anterior tibial tendon at the ankle joint may mimic a tumor.

Case-report describing a 32-year old female with right-sided thoracic pain. CT-thorax reveals multiple thick-walled cysts in the upper lung segments with a solitary eosinophilic granuloma on a rib. Immunohistochemical diagnosis of Langerhans’ Cell Histiocytosis was made after a surgical lung biopsy.

This chapter focuses on the classification and imaging of synovial cyst, ganglion cyst, and bursae. These lesions clinically present as a soft tissue mass and are often referred to the radiologist for further workup of a “soft tissue tumor.” They are however of nonneoplastic origin and have in most scenarios characteristic imaging features.Keywords...

Traumatic and inflammatory joint alterations suspicious of synovial tumor form an extensive and inhomogeneous group. Located either intra-articularly or around the joint within bursae, these disorders are challenging to diagnose on clinical examination and often require further imaging. Acute or chronic synovial disease in a patient with a history...

Primary synovial chondromatosis (PSC) is a rare, benign neoplastic disorder affecting otherwise healthy joints. It is characterized by formation of cartilaginous nodules in the synovial lining. These nodules can detach from the synovium and evolve to numerous intra-articular loose bodies, which may be calcified or not. On conventional radiography,...

This history page in the series “Leaders in MSK Radiology” is dedicated to the achievements of the Polish radiologist Kazimierz Kozlowski, whose name is associated with the Kozlowski type of spondylometaphyseal dysplasia.

This history page in the series “Leaders in MSK Radiology” is dedicated to the achievements of Dr. John Caffey, whose name is associated with infantile cortical hyperostosis, also known as Caffey's disease.

In deze bijdrage bespreken we een casus van een 17-jarige jongen die zich presenteert met een periostaal avulsieletsel aan de aanhechting van de pees van de m. teres major. Dit is zeldzaam en dient op standaardradiografie gedifferentieerd te wor¬den van een avulsieletsel van de pezen van de latissimus dorsi en pectoralis major. Standaardradiografie...

This history page in the series “Leaders in MSK Radiology” is dedicated to the memory and achievements of the French physician Jacques Calvé, whose name is partially associated with the medical eponym Legg-Calvé-Perthes disease.

Introduction Ultrasound is a powerful technique in musculoskeletal (MSK) imaging, and it can replace MR imaging in many specific clinical scenarios. This article will feature some common and less common spot diagnoses in musculoskeletal ultrasound. Spot diagnosis Cases were collected by members of the Educational Committee of the ESSR ( European So...

Teaching Point: A thrombosed calcified aneurysm of the splenic vein is a rare complication of pancreatitis.

Tenosynovial giant cell tumour (TGCT) is a rare, locally aggressive, mesenchymal tumor arising from the joints, bursa and tendon sheaths. TGCT comprises a nodular- and a diffuse-type, with the former exhibiting mostly indolent course and the latter a locally aggressive behavior. Although usually not life-threatening, TGCT may cause chronic pain and...

Teaching point: A linear flake of bone at the posterolateral aspect of the distal fibula indicates avulsion of the superior peroneal retinaculum and warrants further investigation by dynamic ultrasound.

Automated breast ultrasound is a three-dimensional ultrasonographic technique allowing the evaluation of women with dense glandular breast tissue. In this group of patients, mammography has a low sensitivity because dense breasts can obscure breast cancer on mammogram. On the other hand, women with dense breast tissue, types C and D on the BI-RADS...

Objectives: The aim of this study was to evaluate the residual value of Conventional Radiography in children with arthralgia clinically suspected of Juvenile Idiopathic Arthritis (JIA). Materials and methods: Three hundred seventy-two patients aged 1-18 years suspected of JIA were retrospectively reviewed. All patients had foot and ankle plain f...

Teaching Point: A posterior tibial lip fracture is a rare avulsion fracture at the tibial insertion of the posterior tibiofibular ligament that causes significant ankle instability and often requires surgical intervention.

Teaching point: Eosinophilic fasciitis (EF) is a rare sclerodermiform disease characterized by upper- and lower-limbs oedema and hardness, which should be confirmed by skin biopsy and MRI in case of clinical suspicion.

Teaching Point: A chondroid lipoma is a rare benign adipocytic neoplasm, containing a chondromyxoid matrix, that may mimic a myxoid liposarcoma and myxoid chondrosarcoma.

Teaching point: The coffee bean sign, the whirl sign, and the bird’s beak sign are the key findings on abdominal CT of cecal volvulus.

In deze casus bespreken we een minder bekende anatomische variant bij een man van middelbare leeftijd met schouderpijn. Glenoïdale hypoplasie is een ossificatie-stoornis die vaak bilateraal voorkomt. Initieel zijn er vaak geen klachten. Op latere leeftijd kan vroegtijdig artrose optreden. Behandeling is vaak conservatief. Heelkunde wordt uitgevoerd...

Teaching Point: Torsion of a segment of the small bowel and its mesentery, together with closed loop obstruction and absent enhancement of paper-thin small bowel walls, is an alarm sign for small bowel volvulus complicated by acute bowel infarction.

A splenic lesion often represents a diagnostic challenge due to relative scarcity and the broad differential diagnosis. Sclerosing Angiomatoid Nodular Transformation (SANT) of the spleen is usually encountered only incidentally. Although benign, patients with SANT often receive splenectomy, due to its rarity, diagnostic uncertainty and sometimes in...

Teaching point: Plantar vein thrombosis is a rare condition that should be considered in the differential diagnosis of ankle pain, particularly in patients with a high clinical index of suspicion for venous thrombosis.

Case report of malignant pleural mesothelioma with an ALK gene rearrangement, detected by FISH and confirmed by RNA-based next-generation sequencing. The co-occurrence of ALK gene fusions with the more common genetic alterations in CDKN2A, NF2 and BAP1 has, to our best knowledge, not yet been described in malignant mesothelioma. Furthermore, this u...

Teaching point: Idiopathic granulomatous mastitis is a rare disease that may present as breast abscesses and may mimic other inflammatory, infectious, or neoplastic disorders on imaging.

Objective: It is well recognized that nitrous oxide abuse can lead to vitamin B12 deficiency presenting with neurological complications. Nevertheless, establishing this diagnosis can be challenging, and treatment guidelines are lacking. Methods: In this paper, we present a case series of eight patients and discuss the diagnostic challenges and trea...

Pleural lesions form a diagnostic challenge for the radiologist. Whereas lesions can be initially detected on chest radiographs, CT and MRI imaging are the imaging modalities of choice for further characterization. In a number of cases, imaging findings can be relatively specific. In general unfortunately, imaging findings are rather aspecific. Evo...

Teaching Point: In the absence of a clear history of trauma, avulsion of the lesser trochanter should raise a high index of suspicion of an underlying malignancy.

Teaching Point: Persistent metacarpophalangeal joint pain after clenched-fist trauma with an unremarkable conventional radiography justifies further examination with dynamic ultrasound for detecting extensor hood injuries.

Teaching Point: Humeral splints or brachialis insertion avulsion syndrome is a distinct type of stress injury at the insertion of the brachialis muscle on the lateral surface of the humeral diaphysis.

Teaching Point: An os supranaviculare is a variant of the anatomy which however may predispose to symptoms.

Clinical History: A 47-year-old Caucasian male presented with progressive increasing abdominal pain since one day. The pain was predominantly located in the right iliac fossa. Abdominal wall muscle resistance and rebound tenderness was noted in the right lower quadrant. There was no fever. Blood analysis revealed leucocytosis and elevated CRP. Imag...

Teaching point: A space-occupying lesion should be considered in the differential diagnosis of progressive unilateral carpal tunnel syndrome.

Teaching point: Defective development of the anterior portion of the vertebral body at the thoracolumbar junction may be an important imaging clue in the diagnosis of mucopolysaccharidosis.

Teaching point: Meticulous anamnesis and a high index of suspicion is needed for the diagnosis of Lyme arthritis.

This history page in the series “Leaders in MSK Radiology” is dedicated to the memory and achievements of the French physician Jacques Forestier, whose name is connected with the medical eponym Forestier's disease, later referred to as diffuse idiopathic skeletal hyperostosis.

Teaching point: Unexplained bone marrow edema on MRI warrants further investigation with CT to demonstrate a nidus which is pathognomonic for an osteoid osteoma.

Spinal infection may occur due to iatrogenic causes. Its pathogenesis, clinical presentation, management, various imaging techniques, and its application in instrumented and noninstrumented spines are discussed. We provide an overview of the typical infection locations and its imaging correlates, such as spondylodiscitis, epidural and paravertebral...

Paraneoplastic dermatomyositis in rectal cancer: importance of rapid diagnosis and therapy, but uncertainty about the best approach A 55-year-old woman, recently diagnosed with peritoneal metastasized rectal adenocarcinoma, developed a rash on her face, hands and torso, shortly after starting chemotherapy, as well as progressive proximal myalgia. B...

Teaching point: Granular cell tumors are rare soft tissue tumors that may occur in the breast. While almost always benign, they may mimic a malignant tumor both clinically and on imaging.

Teaching Point: Snowball-like and icicle-like lesions in the corpus callosum suggest Susac Syndrome.