Limb amputation is one of the oldest known surgical procedures performed for a variety of indications. Little surgical technical improvements have been made since the first procedure, but perioperative and post-operative refinements have occurred over time. Post-amputation pain (PAP) of the stump is a common complication but is an extremely challenging condition to treat. Imaging allows early diagnosis of the underlying cause so that timely intervention is possible to minimize physical disability with its possible psychological and socioeconomic implications. A multidisciplinary approach should be taken involving the rehabilitation medicine team, surgeon, prosthetist, occupational therapist and social workers. Conventional radiographs demonstrate the osseous origin of PAP while high-resolution ultrasound is preferred to assess soft-tissue abnormalities. These are often the first-line investigations. MRI remains as a problemsolving tool when clinical and imaging findings are equivocal. This article aimed to raise a clear understanding of common pathologies expected in the assessment of PAP. A selection of multimodality images from our Specialist Mobility and Rehabilitation Unit are presented so that radiologists are aware of and recognize the spectrum of pathological conditions involving the amputation stump. These include but are not limited to aggressive bone spurs, heterotopic ossification, soft-tissue inflammation (stump bursitis), collection, nervosas, osteomyelitis etc. The role of the radiologist in reaching the diagnosis early is vital so that appropriate treatment can be instituted to limit long-term disability. The panel of authors hopes this article helps readers identify the spectrum of pathological conditions involving the post-amputation stump by recognizing the imaging features of the abnormalities in different imaging modalities.

Arthrodesis remains a sensible and safe treatment option maintaining independent mobility without multiple operations or significant bone loss for 20-30 years which subsequently can be successfully converted to an arthroplasty.

Arthrodesis remains a sensible and safe treatment option maintaining independent mobility without multiple operations or significant bone loss for 20-30 years which subsequently can be successfully converted to an arthroplasty.

Radiologists frequently interpret cross-sectional imaging of the spine in the setting of trauma. Mechanical stability of the traumatised spine is the single most important factor which guides further management. Several classification systems have been developed over the past to assist radiologists to judge the potentially unstable injuries. The radiologists are arguably most familiar with Denis system of classification which is based on injury morphology and mechanism. This system has been criticised for being too simple, not prognostically valuable and lack of consideration of patients' neurological status. AO (Arbeitsgemeinschaft für Osteosynthesefragen) and TLICS (Thoracolumbar Injury Classification and Severity Score ) classification systems are the next major evolutions which highlight the importance of the posterior ligamentous complex (PLC) and neurological status of the patients in predicting the potentially unstable fracture. The aim of this pictorial review is to familiarise radiologists with newer classification systems to improve their image interpretation skills and promote efficient communication with spinal surgeons. The pictorial examples are intended to illustrate the various injury types and how to classify them according to the aforementioned classification systems.

Background:Although subspecialist orthopaedic surgeons usually request Magnetic Resonance Arthrogram (MRA) examinations, some orthopaedic surgeons may request this examination for a body part that is different from their subspecialty. The purpose of the study is to compare the MRA and the clinical findings in the subspecialist and non-subspecialist groups.Method:Retrospective analysis of MRA examinations over a 6-month period. Findings were compared with the clinical information.Results:There were 144 examinations (69 shoulder, 42 wrist and 33 hip). 85% of these were subspecialist referrals; 60% of them showed findings compatible with the clinical diagnosis. 15% of the MRA examinations were non-subspecialist referrals; 52% of them correlated with the clinical findings.Overall, clinical information agreed with MRA findings for shoulder labral tears, hip labral tears and wrist triangular fibrocartilage complex tears in 63.3%, 64.5% and 61.5% respectively. The subspecialist group were more accurate than the non-subspecialist group in diagnosing hip labral tears (68% vs. 50%) and triangular fibrocartilage complex tears (62.5% vs. 50%). On the contrary, shoulder MRA and clinical findings correlated better in the non-subspecialist group (77.8%) compared to the subspecialist group (63.3%). However, the small number of requests generated by the non-subspecialist group may affect the results. Suspected scapholunate ligament injury showed low correlation with MRA at 26.7% (33.3% in the subspecialist group and 0% in the non-subspecialist group).Conclusion:Generally, the clinical findings are more accurate in the subspecialist referrals when compared to MRA findings and therefore a subspecialist referral is preferred. The low agreement between clinically suspected scapholunate ligament injuries and wrist MRA probably reflects the relative difficulty in establishing this diagnosis clinically.