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Endoscopic transpapillary gallbladder drainage (ETGBD) is an established procedure and is listed in the Tokyo guidelines 2018. Although there are many reports of ETGBD in normal anatomy cases, it is rarely performed for patients with a surgically altered anatomy. We herein report the case of a patient who underwent ETGBD with Billroth-II reconstruction. ETGBD could be an effective treatment option even for patients with a surgically altered anatomy.

Pulmonary veins carry oxygenated blood from lungs to the left atrium of the heart. The anatomy of the pulmonary veins is variable with some anatomic variants. In clinical practice the difference between the normal anatomy of pulmonary veins with its variants and abnormal anatomy is very important for clinicians. Variants of pulmonary veins may occur in number, diameter and normal venous return. We present a case report and a review of the literature with the pulmonary venous return that deviates from the usual anatomical configuration and ranges from normal variant drainage to anomalous pulmonary—systemic communication. Initially, it was considered as an anatomical variant of the pulmonary venous return associated with the persistence of the left superior vena cava. Upon detailed exploration it was established that it was an anomaly of the pulmonary venous return which led in time to the installation of its complications. Diagnosis can be difficult, sometimes missed, or only made late in adulthood when complications were installed. Knowledge of variant anatomy and anomalous pulmonary venous return play a crucial role in the diagnostically challenging patient.

The posterior trans-septal portal technique is an arthroscopic surgery of the knee providing surgeons with the ability to fully visualize the posterior compartment. With this procedure, portals are placed at the posteromedial and posterolateral aspect of the knee. Visualization of the medial and lateral posterior compartments then allows working space for the creation of the intra-articular portal that is made by dividing the posterior septum. We provide an imaging overview of the posterior septum, the trans-septal portal technique, possible indications, and introduce how surrounding anatomy may warrant unique imaging considerations.

Acute appendicitis is the most common disease of the appendix. However, the differential diagnosis for an abnormal appendix includes other conditions that often present with symptoms and imaging features that overlap with acute appendicitis. In this pictorial essay, we review the normal anatomy of the appendix and outline the pathogenesis, clinical manifestations, and imaging findings that are characteristic of acute appendicitis and other less common appendiceal abnormalities. Inflammatory/non-neoplastic processes including appendiceal diverticulitis, stump appendicitis, foreign body appendicitis, Crohn's appendicitis, and appendiceal hernias are discussed. Neoplastic considerations include appendiceal neuroendocrine tumors, mucinous and non-mucinous (colonic type) epithelial neoplasms, and lymphoma. It is important for the radiologist to be able to differentiate these alternative diagnoses for the purpose of directing appropriate patient management.

Popliteus is an integral component of the posterolateral corner of the knee. We review the anatomy and various pathologies affecting the popliteus.

The olfactory pathway is composed of peripheral sinonasal and central sensorineural components. The wide variety of different pathologies that can affect the olfactory pathway reflect this complex anatomical relationship. Localising olfactory pathology can present a challenge to the reporting radiologist. This imaging review will illustrate the normal anatomy of the olfactory system and describe a systematic approach to considering olfactory dysfunction. Key concepts in image interpretation will be demonstrated using examples of olfactory pathway pathologies.

The midface region is an area that contains important anatomical structures and there are many different radiographic modalities for the evaluation of normal anatomy, abnormality, and fractures in the region. US machine is portable compared to the other imaging methods, gives clinician immediate feedback, and allows making correct examination in a timely manner. In maxillofacial region traumas, the selection of the imaging technique is an important issue. USG is promising and can be considered successful in diagnosing the midfacial bone fracture, but its use is limited in evaluating bone-surrounded air spaces such as the paranasal sinuses.

The elbow is a common site for sports related injuries of the upper extremity. Ultrasonography (US) is a noninvasive imaging modality that offers several distinct advantages over its cross sectional counterparts. These include real time dynamic evaluation, direct patient feedback, ability to guide therapeutic interventions, and among many others. This chapter will review the normal anatomy of the elbow and its sonographic appearance, the approach to US imaging, the commonly encountered disease pathologies, and several fundamental therapeutic interventions for the elbow.

Injury to the medial collateral ligament (MCL) and lateral collateral ligament (LCL), including the posterolateral corner (PLC), can occur independently but are also commonly found concomitant to other ligamentous injuries. Diagnosis of injury to these structures can be difficult and may be overlooked. Understanding the anatomy and biomechanics of the involved structures are critical in diagnosis and decision-making in treatment. This chapter includes description of normal anatomy and essential biomechanical features of each structure followed by an overview of injury pattern and biomechanics of the reconstructed knee.

It is critical to understand the details and complexity of injuries to the posterior cruciate ligament (PCL) and associated structures to best design a successful treatment plan. Most isolated PCL injuries can be treated non operatively but complete PCL injuries associated with other ligaments usually require surgical intervention. Successful surgery requires a detailed knowledge of the anatomy, pathophysiology and skilled surgical techniques that reproduce the normal anatomy.

Knowledge of the appearance of normal anatomy is critical before identifying abnormal pathology. This chapter reviews the definitions and appearance of general sonographic findings that correspond to commonly encountered rheumatologic pathologies, its associated conditions, and supporting literature. Once normal and pathologic sonoanatomy is recognized, learning how to incorporate your new skill set into your daily clinical practice in a safe and efficient way will expand your ability to help differentiate diagnoses for your patients.

It is customary, at the current time, to consider many, if not most, of the lesions involving the ventricular outflow tract in terms of conotruncal malformations. This reflects the introduction, in the early 1940s, of the terms conus and truncus to describe the components of the developing outflow tract. The definitive outflow tracts in the postnatal heart, however, possess three, rather than two, components. These are the intrapericardial arterial trunks, the arterial roots, and the subvalvar ventricular outflow tracts. Congenital lesions afflicting the arterial roots, however, are not currently considered to be conotruncal malformations. This suggests a lack of logic in the description of cardiac development and its use as a means of categorizing congenital malformations. It is our belief that the developing outflow tract, like the postnatal outflow tracts, can readily be described in tripartite fashion, with its distal, intermediate, and proximal components forming the primordiums of the postnatal parts. In this review, we present evidence obtained from developing mice and human hearts to substantiate this notion. We show that the outflow tract, initially with a common lumen, is divided into its aortic and pulmonary components by a combination of an aortopulmonary septum derived from the dorsal wall of the aortic sac and outflow tract cushions that spiral through its intermediate and proximal components. These embryonic septal structures, however, subsequently lose their septal functions as the outflow tracts develop their own discrete walls. We then compare the developmental findings with the anatomic arrangements seen postnatally in the normal human heart. We show how correlations with the embryologic findings permit logical analysis of the congenital lesions involving the outflow tracts.

This chapter provides an introductory overview of basic body surface ultrasonography, focused transthoracic echocardiographic examination (TTE), and focused assessment with sonography in trauma (FAST). The overall goal is to provide the reader with the tools to utilize ultrasonography to facilitate clinical decision-making and impact patient management and outcome. The goal of this chapter is to aid the reader in learning how to perform a basic exam and recognize normal anatomy. We will concentrate on two-dimensional (2D) imaging, targeted color flow Doppler (CFD) valve assessment, and continuous wave Doppler (CWD).

The elbow joint is contained within a capsule the medial and lateral thickenings of which comprise the radial and ulnar collateral ligaments; ligamentous injury may occur with or without injury to the adjacent flexor or extensor tendons. The ulnar collateral ligament (UCL) provides both static and dynamic stability to the elbow acting as the primary medial stabilizer in flexion. The anterior band of the UCL is the primary stabilizer of the elbow against valgus stress. In this chapter, the normal magnetic resonance imaging (MRI) anatomy of the UCL is discussed as are the most common injuries to the anterior and posterior bands of the UCL. MRI images of normal anatomy, ligamentous injuries to the professional pitching athlete and injuries to the amateur competitor, to include Little Leaguer’s elbow, are shown.

This chapter discusses the normal anatomy of our brains and how cerebrospinal fluid (CSF) is made and then reabsorbed into the large veins outside of the brain. We then discuss the veins of the brain and how the pressure of the blood within these veins affects the reabsorption of CSF. This chapter covers the basic anatomy and physiology of the brain that will serve as a foundation for the later chapters of the book when we discuss why IIH occurs and its different treatment options.

Understanding the physics of ultrasonography may seem like an unnecessary endeavor but having a solid understanding of what is behind the image can help you acquire the optimal image as well as correctly interpret the image. Ultrasound waves are mechanical waves which are at a frequency above the range of human hearing. They are sent into tissue and are returned through the transducer, allowing the machine to interpret what is returned. Doppler factors in frequency shifts to determine movement and direction. Adjusting the frequency affects the resolution and the penetration into the tissue, whereas adjusting the gain affects the amplitude of the signal returning to the transducer. There are numerous artifacts that are crucial to identifying pathology, recognizing normal anatomy and guiding image acquisition. Lastly, when performing a procedure, consider keeping probe marker and indicator on the same side to avoid confusion.

The relationship between the anterior vitreous interface and the posterior capsule has received increasing attention in the past decade. The advent of integrated intraoperative optical coherence tomography has allowed a real-time opportunity to grasp this dynamic understanding. Here we describe the normal anatomy of this interface in children and then demonstrate the variation in this interface with different forms of pediatric cataract, namely a posterior plaque and posterior capsular opacity due to abnormal adherence to the vitreous face. The authors describe these changes using meticulous annotation. An understanding of these differences will aid the surgeon in managing pediatric cataracts in a more confident and safe manner.

Medical imaging is the creation of technique and process for the visual representations of the interior of the body for clinical analysis and medical intervention, as well as the functions of certain organs or tissues (physiology). Medical imaging trying to reveal the internal structures hidden in the skin and bones, as well as to diagnose and treat diseases. Medical imaging also set up a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of excised organs and tissues can be performed for medical reasons, such procedures are generally considered to be part of pathology rather than medical imaging.

Infancy, childhood, and adolescence involve somatic growth as well as intellectual and psychological development. With the adequate progression of puberty and normal anatomy, male and female fertility is achieved, and the species can be propagated. A common manifestation of growth failure is short stature. This chapter explores the ontogeny of normal growth, definitions and assessment of short stature, causes of short stature, and provides a diagnostic algorithm for the evaluation of short stature.

The clinical examination of laboratory rodents and rabbits is a challenging task since these species instinctively conceal signs of sickness to avoid attracting the attention of its predators, as they would in the wild. However, in biomedical research, the need to understand the clinical signs evinced by these animals under experimentation is of paramount importance as it gives a prelude to the course of the experiment. In laboratory rodents, the clinical signs expressed are the sum of the changes in the normal anatomy and physiology of the animal under experimentation. Therefore, it becomes imperative for the investigator to understand the normal in these animals before classifying a change as abnormal. The various regulatory bodies have developed reommendations/guidelines suggesting ways to understand the clinical signs; however, there is no universal source that can clearly define the clinical signs in these animals because the clinical changes can depend on the strain or stock of the animal being used in the research. The chapter will provide a basic idea to the reader on the means to perform a clinical examination in the laboratory rodents employed in research.

The knee joint is commonly injured or becomes painful during childhood. This chapter discusses common injury patterns of the knee. The growing bones and tendons of the pediatric patient respond uniquely to forces during injury. Normal anatomy and anatomic variants throughout development alter the physiologic function, appearance, stability, and risk for injury. Understanding the baseline anatomy of the pediatric knee, factors that predispose to injury, mechanisms of injury, and specific injury patterns during development allows for proper diagnosis and timely management decisions to optimize treatment outcomes.

Imaging plays an important role in assessing acute and chronic spinal cord injuries or lesions. The use of appropriate imaging technology is an important part of the diagnosis and management of spinal cord injuries. For an effective imaging study, the normal anatomy and characteristics of each imaging modality are relevant as a basis for understanding pathologic alteration. If a patient is seriously injured, damage to the spinal column or spinal cord should be suspected. The trauma of the spine or spinal cord should be considered with the expected injury mechanism. The treating physician should perform appropriate imaging as soon as it is done safely. As in other areas of medicine, imaging is based on history and physical examination. For the purposes of clinical imaging, the choice of the imaging method and the value of the information provided is highly dependent on the clinical stage of care. For example, in the acute stage, immediately after hospitalization, the most urgent information is to determine whether or not there has been damaged to the spine and spinal cord, and X-ray and CT are widely used. However, depending on the type or mechanism of the suspected injury, MRI can also be of great value. Because of the information that can provide for the neural tissue of the spinal cord itself, MRI may be of considerable value during recovery and evaluation of the effects of injuries or for the planning of surgical interventions or rehabilitation strategies.

Introduction In the upper there are different neural entrapment sites that can be associated with neighboring structures which in turn can mimic other neural entrapments syndromes. The objective of this study was to review the literature concerning neuromusculoskeletal anatomical variations in the upper limb and their possible clinical correlations with certain pathologies or syndromes. Methods A systematic literature search over different databases was used to examine the relationship between anatomical variations of neuromusculoskeletal structures and pathologies in the upper limb, using the search strategy proposed by the Cochrane Handbook for Systematic Reviews of Interventions. Results Analysis of the full text studies after the exclusion criteria had been applied showed that anatomical variations in the upper limb correlated in one third of the studies to nerve entrapment, such compressions frequently being attributable to some type of accessory muscle or variation in its insertion site. This demonstrates the importance of knowing the normal anatomy in order to investigate these structures and their possible variations, thus avoiding a non-specific differential diagnosis. Conclusions This literature review does not address a single type of anatomical variation but gives guidelines for considering different structures of the upper limb with anatomical variations that could predispose to some type of upper limb neural entrapment.

Temporal bone trauma is a frequently encountered clinical issue that requires careful evaluation and precise description in order to exclude serious complications and guide surgical interventions when necessary. This chapter discusses the appropriate trauma imaging strategy based on various clinical settings, reviews the normal anatomy that could potentially mimic fractures, i.e. pseudo-fractures and elaborates on the different types of temporal bone fractures and complications. Quick reference checklists for potential complications, ossicular chain disruptions and important surgical descriptors are provided as well.

Ultrasound for the airway can be used for diagnosing pathology and as a tool for the prediction of a difficult airway. Recognizing some basic structures within the neck and being able to differentiate between normal anatomy and associated pathology can improve clinical decision-making. Unlike other imaging modalities ultrasound can provide real-time dynamic information of the airway. The hyoid bone, larynx, vocal cords, cricothyroidmembrane, trachea and thyroid can be identified with some practice. It is recommended to gain experience scanning these areas in non-emergent situations so when the skills are needed at a critical time they have been well rehearsed. The most important skill is arguably proper identification of the cricothyroid membrane in case of a “cannot intubate, cannot ventilate” situation.

The evolution towards more anatomical procedures to restore normal joint mechanics increases the need for detailed knowledge of normal anatomy, possible variations and the position of the ligamentous attachments related to local landmarks. In this chapter we describe the position of the normal anatomical footprints of the ATFL and CFL. Guidelines are offered to locate these points during surgery. The possible tunnels used for reconstruction of ATFL and CFL are presented. Recommendations are given to choose the optimal tunnel position with respect to biomechanics and safety.

The virtual computed tomography hysterosalpingography (CT-VHSG) technique allows a complete evaluation of the female reproductive system. Knowledge of normal anatomy and typical imaging findings in normal patients are essential for a correct diagnosis.

The throwing shoulder requires a complex coordination of neuromuscular activity. Over time, this extreme repetitive motion results in changes in the shoulder. Some changes are considered adaptive and provide a biomechanical advantage in throwing performance. Other changes are pathologic and require specific injury treatment to return to play. In this chapter, we review the biomechanics of throwing and the complex kinetic chain involved in this task. We will also discuss adaptive changes seen in this population and highlight the pathophysiology seen in throwing injuries. Finally, we will discuss treatment of these injuries with an emphasis on how restoring normal anatomy may compromise the adaptive changes that allowed for a high level of play.

This chapter provides a summary of the histology and pathology of parathyroid glands and provides a succinct review of the developmental aspects, normal anatomy, and histology of parathyroids followed by a discussion of the histopathology of the main disease entities affecting these glands. This edition contains new information about recently described molecular alterations in some of these conditions and aims to provide a practical approach for clinicians to understand the pathologic basis of parathyroid diseases and assist them in better appreciating the recent advances in the molecular pathology of parathyroid disorders. Multiple illustrative examples accompany the discussions.

Background Novel technologies for management and reconstruction of complex bony defects regarding both function and facial appearance are interestingly used in maxillofacial surgery. In the current study, we demonstrated reconstruction of a bilateral ramus-condyle unit (RCU) defect while preserving both condyles by a novel designed titanium prosthesis using virtual surgical planning (VSP), computer-aided design and manufacturing (CAD/CAM), and Selective Laser Melting (SLM) technologies. Materials and methods A 3D customized titanium prosthesis was designed for a 49 -year-old patient with bilateral mandibular aggressive central giant cell granuloma (CGCG) according to mandibular normal anatomy and structure while preserving bilateral intact condyles. Finite element study was performed to investigate the effects of new design strength and the stress shielding phenomenon. The design of macro-pores inside the body of prosthesis allowed it to act as a scaffold for bone tissue engineering under load bearing conditions. Results Analysis of the strength and stress shielding phenomenon demonstrated favorable outcomes regarding the novel design. For instance, there was no stress shielding in any of the preserved condyles with regard to the size and distribution of stresses. Also, the stress distribution around the pores showed that these pores had no effect on the strength of the prosthesis. Thirty month follow-ups after reconstruction of bilateral RCU defect showed normal jaw function with a favorable facial appearance and mandibular contour. Conclusion We design a novel patient-specific prosthesis with desirable biomechanical features for reconstruction of bilateral RCU defect after resection of the benign tumor with preservation of bilateral intact condyles.

Alveolar Bone Grafting is a clinical procedure which is performed to maintain the integrity of the alveolar arch in cleft patients. This clinical procedure helps in facilitating eruption of canine and lateral incisors. This chapter discusses the normal anatomy of alveolus, significance of cleft alveolus, surgical steps to ensure separation of a well-defined oral and nasal layer, donor sites for bone grafting, harvesting techniques and final closure of the alveolar cleft. In addition, this chapter further highlights the recent developments in the field of bone regeneration.

The (para-)sellar region is anatomically complex with a number of neoplastic, infectious, inflammatory, developmental, and vascular pathologies challenging image-based diagnosis. Differentiation among various etiologies may not always be easy, since many of these lesions may mimic the clinical, endocrinological, and radiological presentations of pituitary adenomas. The diagnosis of sellar lesions involves a multidisciplinary effort, and detailed endocrinological, ophthalmological, and neurological testing is essential. MRI is the key imaging modality characterizing normal anatomy and the majority of pathologic processes in this region.

A good knowledge of the normal anatomy of the temporal bone is key to the accurate interpretation of temporal bone imaging. Correlation with clinical history and physical examination is essential to provide a correct diagnosis or appropriate differential.

Imaging of paranasal sinuses forms an essential part of management of patients with disease of nose and sinuses, and over the last decade with availability of multiplanar CT scans and advances in imaging, it has become imperative for ENT surgeons to have the knowledge of imaging for diagnosis and preoperative planning. In this chapter, we have discussed about the normal anatomy and imaging characteristics of common paranasal sinus pathologies.

Coronary artery anomalies are an important cause of sudden cardiac death in a young individual. These anomalies are difficult to diagnose without radiological tests. CT coronary angiography alerts radiologists and cardiologists to variations of the anatomy of the coronary arteries. Electrocardiographically (ECG)-gated multi-detector row computed tomography (CT) allows the accurate and noninvasive depiction of the origin, course, and termination of coronary artery anomalies and is superior to conventional angiography in delineating the ostial origin and proximal path of an anomalous coronary artery. In this chapter, we review the normal anatomy as well as various variants and anomalies of the coronary arteries.

This chapter reviews the normal anatomy of the lower paediatric airway below the level of the cricoid.

Anatomy of the head and neck is of crucial importance in many types of surgery pertaining to many subspecialties. Vascular surgeons perform carotid endarterectomies. Surgical oncologists perform radical neck dissections. Endocrine specialists perform total or subtotal thyroidectomies. General and trauma surgeons perform tracheostomies. Plastic surgeons perform free flaps to the face. Even in non-surgical specialties, those who perform endoscopy will benefit from this chapter because anatomy of the vessels below is crucial to understanding and quickly diagnosing complications. In each section, we will discuss the normal anatomy of the vessel and subsequently the common variations described in our literature to this point as well as their clinical significance. We hope this chapter and the following on soft tissue anomalies of the head and neck are helpful to all medical professionals working in this delicate area. Although we will never know all the twists and turns of the road ahead, this chapter may be a rudimentary map of what to expect when faced with a challenging journey.

For rhinoplasty surgeons, surgery of the dorsum has never been so dynamic or as easily learned. Reproducible techniques offer excellent results that can be difficult to achieve in certain patients using component reduction. An expanding repertoire of dorsal preservation (DP) techniques is evolving. Each DP operation builds on the others. To understand DP requires a new appreciation of the cartilaginous septum, the perpendicular plate of ethmoid, nasal osteotomies, and anatomy of the nose where surgeons do not operate with traditional component reduction. The result is more beautiful noses where the normal anatomy is preserved.

Background: Prior ECG standards in children have largely been defined without echo confirmation of normal anatomy. The Pediatric Heart Network Normal Echocardiogram Z-score Project provides a racially diverse age/sex classified group of healthy children with normal echos that included 2170 matched contemporaneous digitally acquired ECGs. We hypothesized that ECG measures and z-scores of left ventricular (LV) dimensions are correlated in healthy children. Methods: This was a secondary analysis of the previously described cohort. Six ECG measures historically associated with LV size (R V5, R V6, S V1, Q III, axis, R V6+S V1), and 13 paired echo measures were identified a-priori with LV Mass (LVMass-z) and left ventricular end diastolic volume (LVEDV-z) z-scores serving as primary echo measurement predictors. Pearson or Spearman correlations were calculated for each of the 78 ECG- echo pairs. Regression analyses were performed to assess how much variance in ECG measures was explained by variation in LV dimensions and by demographic variables (age, sex, race). Results: ECG and echo measurement correlations were significant and concordant in 41/78 (53%), though many were significant and discordant in 13, (17%) or not correlated in 24 (31%). Of the 6 ECG measures of LV size, 5 correlated in the clinically predicted direction for LV Mass-z and LVEDV-z. While many of the correlations were statistically significant, the correlations were weak (0.05-0.25). R 2 was higher for demographic variables than for echo measures in all pairs, but even with demographic variables included, the overall R 2 was < 0.17. Conclusions: In a large, diverse cohort of healthy children, there was a positive association between echo measures of LV dimension and mass and the most commonly used ECG measures of LVH. However, these correlations were weak and most of the variability in ECG measures was explained by factors other than echo derived mass or volume or measured patient demographic variables. These data question the utility of traditional ECG measurements of LV size as standalone indications for further cardiac evaluation in healthy children.

Introduction: In-vitro fertilization (IVF) is associated with a higher incidence of congenital heart disease (CHD), resulting in universal screening fetal echocardiograms (F-echo) even when obstetric scan (OB-scan), including cardiac structures is normal. Recent studies suggest that when OB-scan is normal, F-echo may add little benefit and increases cost and anxiety. We aim to determine the utility of screening F-echo in IVF pregnancies with normal cardiac anatomy on prior OB-scan. Methods: We conducted a retrospective chart review of IVF pregnancies referred for F-echo at the Seattle Children’s Hospital between 2014 and 2020. OB-scan results and subspecialty of interpreting physician (Obstetrics=OB; Maternal Fetal Medicine=MFM; Radiology=Rads), F-echos, and postnatal outcomes were reviewed. Cardiac anatomy on OB-scans was classified as complete if 4-chamber and outflow-tract views were obtained. Supplemental views (three-vessel and sagittal aortic arch views) on OB-scan were also documented. Results: Of 525 IVF referrals, 450 had normal F-echo. OB-scan reports were available for review in 411; 304 (74%) demonstrated normal cardiac anatomy and were interpreted by OB (42%), MFM (61%) and Rads (31%). F-echo was normal in 270 (88%). Of the 34 abnormal F-echo, none required intervention (16 muscular and 5 perimembranous ventricular septal defects, 9 minor valve abnormalities, 2 mild ventricular hypertrophy, 2 arrhythmia). There was no difference in OB-scan accuracy for identifying normal cardiac anatomy when comparing 4-chamber and outflow-tract views vs. addition of supplemental views (88% vs 90% normal F-echo; p>0.1). Evaluation of OB-scan accuracy by interpreting physician subspecialty demonstrated normal F-echo in 93%, 80%, 91% read by OB, MFM and Rads, respectively. Conclusions: A majority of IVF referrals with normal cardiac anatomy visualized on OB-scan using 4-chamber and outflow-tract views resulted in normal F-echo, regardless of interpreting physician subspecialty or addition of supplemental views. Of the minority with abnormal F-echo, none required intervention. Consideration should be given to the cost/benefit of screening F-echo for the indication of IVF if normal cardiac anatomy is diagnosed on OB-scan.

Over the past years, magnetic resonance imaging (MRI) has become a cornerstone in evaluating anal canal and adjacent tissues due to its safeness, the three-dimensional and comprehensive approach, and the high soft-tissue resolution. Several diseases arising in the anal canal can be assessed through MRI performance, including congenital conditions, benign pathologies, and malignancies. Good knowledge of the normal anatomy and MRI technical protocols is, therefore, mandatory for appropriate anal pathology evaluation. Radiologists and clinicians should be familiar with the different clinical scenarios and the anatomy of the structures involved. This pictorial review presents an overview of the diseases affecting the anal canal and the surrounding structures evaluated with dedicated MRI protocol.

The most common traumatic orthopaedic injuries of the hindfoot and midfoot are calcaneus fractures and tarsometatarsal (TMT) fracture-dislocations (Lisfranc injury), respectively. These injuries can result in significant long-term morbidity primarily due to the development of posttraumatic osteoarthritis secondary to acute articular damage at the time of initial injury and chronic malalignment and abnormal force distribution across the foot resulting in progressive degeneration. This chapter will describe the normal anatomy and biomechanics of the hindfoot and midfoot, provide an outline for clinical evaluation, and describe both nonoperative and operative management strategies for treating symptomatic posttraumatic osteoarthritis of the hindfoot and midfoot.

The Fontan operation or the total cavopulmonary connection is a palliative surgery for single ventricle congenital heart disease where the systemic venous return circumvents a pumping chamber and flows directly into the pulmonary circuit. With surgical and medical advances, there has been improvement in life expectancy of these patients, however, it has also resulted in unique complications from the physiology that requires diligent surveillance. A critical component relies on optimal imaging for diagnosis and treatment of these complications. This article describes the normal anatomy of the Fontan circulation, current imaging modalities and techniques, and frequently encountered complications seen when imaging the patients who have undergone Fontan palliation.