Osteochondral lesions of the talus (OLT) represent an abnormality of the articular cartilage and sub-chondral bone. The abnormality is typically associated with trauma though the exact aetiology remains unknown. Multiple staging systems have been developed to classify the abnormality and management can vary from conservative treatment to different surgical options. Early diagnosis is essential for optimal outcome and all imaging modalities have a role to play in patient management. The aim of this article is to review the pathology, classification, multimodality imaging appearances of OLT, and how the imaging affects patient management.

The sinus tarsi is a funnel-shaped region at the junction of mid-foot and hind-foot which contains fat, vessels, nerves and ligaments. The ligaments help stabilise the subtalar joint and maintain the longitudinal arch of the foot. The nerve endings contain proprioceptive fibres indicating a role for the sinus tarsi in movement of the foot. Sinus tarsi syndrome is a clinical entity characterised by lateral hind-foot pain with worsening on palpation and weight-bearing, and perceived instability. It is associated with both traumatic and non-traumatic causes. Magnetic resonance imaging is the imaging modality of choice for assessment of the sinus tarsi and sinus tarsi syndrome. In this review article, we review the anatomy and various aetiologies of sinus tarsi syndrome, along with the imaging appearances.

Primary bone tumours are uncommon, with sarcomas accounting for < 0.2% of all malignancies. The survival rate of primary bone sarcomas has significantly improved due to (neo)adjuvant therapy, while improved surgical techniques and development of new prostheses have shifted the surgical focus from amputation to limb preservation in the vast majority of patients. A wide variety of surgical options are available for the treatment of primary bone tumours which depend upon histological diagnosis, their appearance at the time of presentation and response to any (neo)adjuvant therapy as required. This review is intended to help radiologists familiarise themselves with the management of primary appendicular bone tumours and expected normal postoperative appearances for the various surgical techniques, and to recognise potential complications.

The knee is a complex joint with its function dependent on a combination of osseous and soft tissue structures. Alteration in the relationship of these tissues, due to either acute or chronic repetitive injury with possible underlying congenital predisposing factors, can result in impingement between the structures resulting in pain, particularly on activity. The purpose of this article is to provide a comprehensive review of the MRI features of various impingement syndromes around the knee.

Poster: ESSR 2019 / P-0106 / Wrist MR arthrography technique and common pathologies by: L. A. Mohamed1, M. Yadegarfar1, A. M. Syed2, I. Khan1, S. Naqvi 1; 1Leicester/UK, 2Leicester /UK

Following treatment 40% of soft tissue sarcoma (STS) patients suffer disease recurrence. In certain cancers circulating cell free DNA (cfDNA) and circulating tumour-derived DNA (ctDNA) characteristics correlate closely with disease burden, making them exciting potential sources of biomarkers. Despite this, the circulating nucleic acid characteristics of only 2 STS patients have been reported to date. To address this we used an Ion AmpliSeq™ panel custom specifically designed for STS patients to conduct a genetic characterisation of plasma cfDNA, buffy coat (germline) DNA and where available Formalin-Fixed Paraffin-Embedded (FFPE) primary STS tissue DNA in a cohort of 11 metastatic STS patients. We found that total cfDNA levels were significantly elevated in the STS patients analysed, and weakly correlated with disease burden. Using our Ion AmpliSeq™ panel we also successfully detected ctDNA in 4/11 (36%) patients analysed with a wide variety of STS subtypes and disease burdens. This evidence included the presence of cancer associated TP53 / PIK3CA mutations in 2 patients’ plasma and matched primary STS tumour tissue, and in the plasma alone for 2 patients. We also identified 2 potential examples of allelic loss of heterozygosity in an additional patient's STS DNA and cfDNA. This is the largest study performed characterising STS patient cfDNA/ctDNA and confirms that the field remains an attractive potential source of novel STS biomarkers. Further work is required to investigate the circulating nucleic acid characteristics of individual STS subtypes, and the potential prognostic or therapeutic roles that cfDNA/ctDNA may hold for patients with these complex tumours.

Extracranial metastasis from meningiomas is a rare occurrence. Previous papers describing meningioma metastases have included disease from haemangiopericytomas, which are a distinct entity. We present our case of a patient with a history of malignant meningioma with subsequent separate and distant bone metastasis. We have also identified true cases of osseous meningioma metastases. To our knowledge, this is the first time an attempt has been made to look at true cases of osseous meningioma metastases, their distribution, and the imaging appearances.

The high intensity zone (HIZ) was first described by Aprill and Bogduk on lumbar spine magnetic resonance imaging (MRI) studies in 1992. Correlation with lumbar computed tomography (CT) discography showed that the HIZ represents a deep radial tear of the annulus fibrosus, which may be a cause of chronic low back pain. Initial studies comparing the finding of a HIZ on MRI with discography suggested that it may be a highly specific marker of a painful lumbar disc, but later investigators demonstrated that it is also present in asymptomatic individuals. The purpose of this article is to review the literature regarding the lumbar HIZ 20 years after its initial description.

Calcification of the lateral collateral ligament is a rare phenomenon, which can cause acute knee pain. The management is usually conservative and there is subsequent resolution of the calcification seen on initial radiographs. It is important to exclude more sinister pathology such as septic arthritis as a cause of pain. We report the case of an elderly lady who presented with acute knee pain. Initial radiographs showed calcification at the lateral aspect of the knee joint. The pain settled with conservative management. Resorption of calcification was demonstrated on subsequent radiographs.

Objectives: To determine the functional outcome of one stage posteromedial release in congenital clubfoot in terms offunctional and radiological assessment. Methodology: Forty five patients having clubfoot deformity were included in the study. Fifteen patientshad bilateral deformities. The outcome was evaluated by functionally assessing the foot in the last review visit (at the end of 14thweek ofsurgery) using the rating system of McKay, which has ten categories and has a maximum score of 180 points. It rates the outcome as excellent,good, fair, poor and failure (Fig-1). Radiological assessment is made by measuring various angles on anteroposterior and lateral radiograph ofthe foot with gonometer at 3,6,10 and 14 weeks after release (Table-II). . The values of talocalcaneal angle (measured during every visit) on APand lateral views will be summated to yield talocalcaneal index, and an index of >40 degree was taken as normal. Results: Forty five patientsincluded in the study with clubfoot deformity. Out of these patients, 33 (73.33%) were males and 12 (26.66%) were females (table-I). They weregraded according to the McKay rating system. In this short term follow up of one year, the following results were observed. Thirty-nine (65%)patients had excellent results, 11 (18.33%) patients had good results, 3 (5%) patients had fair results and 7 (11.66%) patients had poor results(Fig-1). No case can be labeled as failure. Conclusions: Mild to moderated clubfoot deformities can be successfully treated in children up tofive years of age by one stage postero-medial release.