Unusual stress fracture in an adolescent baseball pitcher affecting the trochlear groove of the olecranon

Stress fractures of the proximal ulna are known to occur in throwing athletes. Most cases extend to involve the olecranon, and cases limited to the trochlear groove are rare. In this report we present a 17-year-old elite baseball pitcher with a stress fracture of the trochlear groove of the proximal ulna. Diagnosis was made by demonstration of characteristic signal changes on MRI of the elbow. The fracture occurred at the cortical notch, also known as the pseudodefect of the trochlear groove. This case suggests that the cortical notch serves as an area of weakness predisposing pitchers to development of a stress fracture.     

Speckle tracking as a method to measure hemidiaphragm excursion

Introduction: Diaphragm excursion measured via ultrasound may be an important imaging outcome measure of respiratory function. We developed a new method for measuring diaphragm movement and compared it to the more traditional M‐mode method. Methods: Ultrasound images of the right and left hemidiaphragms were collected to compare speckle tracking and M‐mode measurements of diaphragm excursion. Speckle tracking was performed using EchoInsight (Epsilon Imaging, Ann Arbor, Michigan). Results: Six healthy subjects without a history of pulmonary diseases were included in this proof‐of‐concept study. Speckle tracking of the diaphragm is technically possible. Unlike M‐mode, speckle tracking carries the advantage of reliable visualization and measurement of the left hemidiaphragm. Conclusions: Speckle tracking accounted for diaphragm movement simultaneously in the cephalocaudad and mediolateral directions, unlike M‐mode, which is 1‐dimensional. Diaphragm speckle tracking may represent a novel, more robust method for measuring diaphragm excursion, especially for the left hemidiaphragm. Muscle Nerve 55 : 125–127, 2017     

A case of secondary erythromelalgia with perivascular and intramural mucin

We present a 49‐year‐old man with type I erythromelalgia, demonstrating a newly reported histological feature of striking perivascular mucin. There is a single previously reported case in the literature describing these histological features. This patient had a comorbid history of primary myelofibrosis diagnosed 2 years prior to his presentation.     

Adrenocortical carcinoma: contrast washout characteristics on CT

OBJECTIVE: The purpose of this study was to characterize pathologically proven adrenocortical carcinoma by examination of washout attenuation characteristics on contrast-enhanced CT images. CONCLUSION: Adrenocortical carcinoma has relative contrast retention on delayed contrast-enhanced CT. All tumors in this series had a relative percentage washout less than 40%, a finding consistent with malignant disease.