HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Anderson, S. E. Articles by Steinbach, L. S. Search for Related Content PubMed PubMed Citation Articles by Anderson, S. E. Articles by Steinbach, L. S. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Latissimus Dorsi Tendinosis and Tear: Imaging Features of a Pseudotumor of the Upper Limb in Five Patients

¹ Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, Inselspital, Freiburgstrasse, CH-3010 Bern, Switzerland.
² Department of Orthopedics, University Hospital of Bern, Inselspital, Bern, Switzerland.
³ Orthopedic Oncology, The Permanent Medical Group, South San Francisco, CA.
⁴ Department of Pathology, University Hospital of Bern, Inselspital, Bern, Switzerland.
⁵ Department of Radiology, University of California, San Francisco, San Francisco, CA.

View larger version (103K): [in a new window]   Fig. 1A —42-year-old woman referred from orthopedic oncology with concern for sarcoma with typical imaging appearances of latissimus dorsi tendon injury pseudotumor. Patient had experienced intermittent low-grade pain over upper third of humeral shaft for several years. Oblique frontal radiograph shows evidence of cortical erosion (arrowhead) and calcification (arrow).

View larger version (147K): [in a new window]   Fig. 1B —42-year-old woman referred from orthopedic oncology with concern for sarcoma with typical imaging appearances of latissimus dorsi tendon injury pseudotumor. Patient had experienced intermittent low-grade pain over upper third of humeral shaft for several years. Oblique image from bone scan shows focal radionuclide uptake in proximal humerus (arrow).

View larger version (126K): [in a new window]   Fig. 1C —42-year-old woman referred from orthopedic oncology with concern for sarcoma with typical imaging appearances of latissimus dorsi tendon injury pseudotumor. Patient had experienced intermittent low-grade pain over upper third of humeral shaft for several years. Axial T1-weighted MR image shows low-signal-intensity periosteal, cortical, and intramedullary reactions at site of origin of latissimus dorsi tendon (solid arrow) and evidence of fatty atrophy within latissimus dorsi muscle (open arrow).

View larger version (132K): [in a new window]   Fig. 1D —42-year-old woman referred from orthopedic oncology with concern for sarcoma with typical imaging appearances of latissimus dorsi tendon injury pseudotumor. Patient had experienced intermittent low-grade pain over upper third of humeral shaft for several years. Axial contrast-enhanced T1-weighted MR image shows enhancement within latissimus dorsi tendon (arrow) at its insertion site and within cortex and adjacent bone marrow.

View larger version (138K): [in a new window]   Fig. 1E —42-year-old woman referred from orthopedic oncology with concern for sarcoma with typical imaging appearances of latissimus dorsi tendon injury pseudotumor. Patient had experienced intermittent low-grade pain over upper third of humeral shaft for several years. Oblique sagittal STIR image shows radiographic correlate with cortical reaction (arrow) and bone marrow reaction (arrowhead).

View larger version (153K): [in a new window]   Fig. 1F —42-year-old woman referred from orthopedic oncology with concern for sarcoma with typical imaging appearances of latissimus dorsi tendon injury pseudotumor. Patient had experienced intermittent low-grade pain over upper third of humeral shaft for several years. Photomicrograph shows dense reactive connective tissue (arrow) at tendon insertion site consistent with tendinosis. There is evidence of bone remodeling (arrowheads). (H and E, x10)

View larger version (86K): [in a new window]   Fig. 2A —15-year-old male basketball player with acute onset of pain and mass formation after slam-dunking who was referred by his sports medicine doctor for sarcoma review. Axial T1-weighted MR image shows extensive increased signal intensity within latissimus dorsi muscle (arrows), which is consistent with recent hemorrhage.

View larger version (84K): [in a new window]   Fig. 2B —15-year-old male basketball player with acute onset of pain and mass formation after slam-dunking who was referred by his sports medicine doctor for sarcoma review. Corresponding axial T2-weighted MR image shows extensive partial tear of latissimus dorsi and teres major tendons (black arrows) and muscle with hemorrhage (white arrow) more posteriorly.

View larger version (88K): [in a new window]   Fig. 3 —17-year-old male amateur volleyball player and rollerblade enthusiast with upper limb discomfort. Sagittal STIR image shows typical appearance of associated altered bone marrow signal intensity (arrow).

View larger version (93K): [in a new window]   Fig. 4A —Diagrams and images illustrate anatomy of latissimus dorsi tendon and muscle. Diagram from anterior aspect shows insertions of pectoralis major (1), latissimus dorsi (2), and teres major (3) tendons. Bone landmarks include crista tuberculi majoris (arrow), crista tuberculi minoris (arrowhead), and sulcus intertubercularis (asterisk).

View larger version (103K): [in a new window]   Fig. 4B —Diagrams and images illustrate anatomy of latissimus dorsi tendon and muscle. Diagram of posterior aspect shows latissimus dorsi muscle fibers (m), aponeurosis (a), and tendon insertion (2) with adjacent teres major muscle and tendon insertion (3). Tendons of latissimus dorsi and teres major pass posteriorly onto anteromedial aspect of humerus. Components of large spanning latissimus dorsi muscle are evident. Transitional fibers (Tr) pass toward L1 and L2 levels and supraspinous ligaments. Raphe fibers (R) attach to lateral raphae of thoracolumbar fascia (Tf). Iliac fibers (IL) attach to iliac crest (Ic).

View larger version (107K): [in a new window]   Fig. 4C —Diagrams and images illustrate anatomy of latissimus dorsi tendon and muscle. Coronal localizer image with axial slice of 41-year-old healthy female volunteer defines level of axial image for D.

View larger version (98K): [in a new window]   Fig. 4D —Diagrams and images illustrate anatomy of latissimus dorsi tendon and muscle. Axial T1-weighted image of 41-year-old healthy female volunteer depicts axial anatomy corresponding to line drawing of A with tendon insertions of pectoralis major (1), latissimus dorsi (2), and teres major (3).

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati