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Teaching point: The clues to the correct diagnosis of heterotopic ossification of the indirect head of the rectus femoris are its location above the acetabular rim and its (inverted) comma‑like morphology.

Teaching point: Extradigital glomus tumor should be considered in the differential diagnosis of a highly vascular solid lesion that is painful on palpation.

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.

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.

Abstract 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. Evolution and extrathoracic imaging findings are important clues toward the diagnosis.

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

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

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

Langerhans cell histiocytosis is a tumor-like condition characterized by idiopathic proliferation of Langerhans cells. The disease may involve the skeleton as well as other organs systems. Bone involvement may be solitary or multifocal. Unifocal osseous Langerhans cell histiocytosis may involve virtually any bone, with the calvarium being most frequently involved. Plain radiography, computed tomography and magnetic resonance imaging are the most used techniques for detection and characterization of the lesion. The use of ultrasound is less known, although it may be a valuable technique in detection and follow-up of superficially located lesions such as calvarial lesions. This case report describes an 8-year-old girl, in whom the lesion was initially detected by ultrasound. Furthermore, ultrasound was used to evaluate spontaneous resolution of the lesion. The knowledge of ultrasound characteristics may be important to avoid unnecessary radiation and gadolinium administration, particularly in a pediatric population.

We describe a case of an isolated periosteal avulsion fracture of the teres major tendon. A 29-year-old rugby player presented following a direct hit with his opponent followed by a fall on the ground. Clinical examination showed a limited and painful abduction of his left arm. MR-arthrography showed no capsulolabral lesions but revealed an extra-articular lesion at the origin of the teres major tendon. Follow-up radiography and CT showed progressive ossification of the lesion. To the best of our knowledge, this is the first case of a distal avulsion fracture of the teres major tendon reported in the imaging literature.

Ischiofemoral impingement is a rare cause of hip pain related to narrowing of the space between the ischial tuberosity and the lesser trochanter. It is usually seen in middle-aged women. We report a rare case of a young male patient presenting with ischiofemoral impingement due to a solitary exostosis at the lesser trochanter. Imaging, especially Magnetic Resonance Imaging (MRI), is an excellent tool to confirm the diagnosis by demonstrating narrowing of the ischiofemoral space and soft tissue edema in the muscle belly of the quadratus femoris muscle.

Osteochondral lesions (OCL) of the talus involve both articular cartilage and subchondral bone of the talar dome. This term refers to a wide spectrum of pathologies including mild bone marrow contusion as well as severe osteoarthritis resulting from long standing disease. Although Magnetic Resonance Imaging (MRI) at 1.5 Tesla is the leading cross-sectional modality for detection and staging of OCL, lack of spatial resolution hampers accurate assessment of thin articular cartilage. Cone Beam Computed Tomography (CBCT) arthrography is better suited for precise staging of cartilage lesions. The purpose of this pictorial review is to illustrate the strength of each imaging method.

The purpose of this pictorial review is to present an overview of the radioclinical features of osteomyelitis. The presentation of the disease may vary depending on the clinical stage (acute, subacute and chronic), the pathogenesis of the infection and the age of the patient. Thorough knowledge of the basic pathophysiological mechanisms is a prerequisite to understanding the variable imaging appearance of osteomyelitis. Special subtypes of osteomyelitis including CRMO and SAPHO will be discussed very shortly.

We present a case of an 80-year-old man with progressive pain for 5 days at the medial and plantar aspect of the left heel. Wearing shoes aggravated the pain. Ultrasound and magnetic resonance imaging (MRI) revealed thrombosis of the medial plantar veins. Plantar vein thrombosis is a rare condition. The clinical symptoms are non-specific and can be confused with plantar fasciitis. It has been associated with hypercoagulable conditions, foot trauma and recent surgery. The imaging modality of choice is ultrasound. MRI may add to the diagnosis in unclear cases.

Sarcoidosis is a multisystemic disease usually affecting the lungs and mediastinal lymph nodes. Other organs, such as the liver and the spleen, are less commonly involved. Patients usually present with mild nonspecific symptoms. On imaging, hepatosplenomegaly with or without multiple focal lesions within the spleen may be seen in the active disease stage. Rarely, the disease may evolve to cirrhosis and liver failure. We report such a rare case of hepatosplenic sarcoidosis complicated by acute esophageal bleeding due to portal hypertension.

We present a case of a surface aneurysmal bone cyst in a 19-year-old boy. Plain radiograph showed an osteolytic lesion with sclerotic margin and interrupted lamellar periosteal reaction at the posterolateral aspect of the diaphysis of the left proximal femur. MRI confirmed a bony lesion containing a fluid-fluid level (FFL) on T2-WI. Bone marrow oedema was seen within the femoral diaphysis and the soft tissue changes adjacent to the femoral cortex were enhancing. Because of the aggressive appearance on imaging, the patient underwent a biopsy and the final diagnosis of a subperiosteal aneurysmal bone cyst (ABC) was made. The patient was treated with curettage of the lesion.

Tuberculosis (TB) continues to be a public health problem in both developing and industrialized countries. TB can involve pulmonary as well as extrapulmonary sites. The musculoskeletal system is involved in 1-3% of patients with tuberculosis. Although musculoskeletal TB has become uncommon in the Western world, it remains a huge problem in Asia, Africa, and many developing countries. Tuberculous spondylitis is the most common form of musculoskeletal TB and accounts for approximately 50% of cases. Extraspinal musculoskeletal TB shows a predilection for large joints (hip and knee) and para-articular areas; isolated soft tissue TB is extremely rare. Early diagnosis and prompt treatment are mandatory to prevent serious destruction of joints and skeletal deformity. However, due to the nonspecific and often indolent clinical presentation, the diagnosis may be delayed. Radiological assessment is often the first step in the diagnostic workup of patients with musculoskeletal TB and further investigations are decided by the findings on radiography. Both the radiologist and the clinician should be aware of the possibility of this diagnosis. In this manuscript we review the imaging features of extraspinal bone, joint, and soft tissue TB.

A 42-year-old female known with osteogenesis imperfecta (OI) was referred to our department with complaints of deteriorating hearing loss. The medical history, besides some limb fractures, secondary to the OI, was negative. During clinical examination, a sensorineural hearing loss was confirmed bilaterally.