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The objective of this study is to examine the anatomy of the atlanto-axial interspace using magnetic resonance (MR) imaging. Two hundred and forty MR images of living subjects were examined for the presence of a posterior dural prominence and oblique hypointense fibers between the first and second cervical neural arches. Of the 240 images analyzed, 64% revealed a posterior concavity of the cervical dura mater. Of this, 24% also revealed oblique, linear hypointense fibers that appeared to be in direct contact with the dura mater. Twenty-three percent of the 240 images revealed oblique, linear hypointense fibers. Of the 23% that exhibited these fibers, 76% had an associated posterior thecal concavity of the cervical dura mater. A posterior dural prominence and oblique hypointense fibers were present in the atlanto-axial interspace in a significant number of randomly selected magnetic resonance images. These findings may represent normal, nonpathological anatomy found on MR images and may be related to a recently reported anatomical structure.

Objective: The purpose of this case series is to describe the use of diagnostic ultrasound (US) in the detection of occult rib and costal cartilage fractures presenting as chest wall pain to a chiropractic clinic. Clinical features: Three patients presented with chest wall pain and tenderness. Two of the patients presented with acute chest wall injury and 1 carried a previous diagnosis of rib fracture after trivial trauma 2 months earlier.Intervention and outcomes: Diagnostic US was selected as a non-ionizing imaging tool for these patients after negative digital radiography studies. All fractures were considered isolated as there was no associated injury, such as pneumothorax. Both of the acute cases were followed up to complete healing (evidence of osseous union) using US. All patients eventually achieved pain-free status. Conclusion: In these cases, US was more sensitive than radiography for diagnosing these cases of acute rib and costal cartilage fractures. Early recognition of rib injury could avoid potential complications from local manipulative therapy.

Objective: The purpose of this case study is to describe the role of sonographic examination in the initial evaluation of an angioleiomyoma and to discuss the characteristic findings associated with this soft tissue mass. Clinical Features: A 52-year-old woman presented with a large, tender, erythematous mass on the anterolateral aspect of her right knee. Sonographic examination revealed a highly vascular mass within the subcutaneous tissues. Differential considerations included benign soft tissues masses such as angioleiomyoma and hemangioma. Intervention and Outcomes: Surgical consultation was recommended. Excisional biopsy was performed. Histopathological examination confirmed the diagnosis of angioleiomyoma. Conclusion: Although ultrasonographic findings of a superficial soft tissue mass may be nonspecific, when a highly vascular, well-defined, slow-growing mass is present, angioleiomyoma should be included in the differential diagnosis.

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