ACL Anterior cruciate ligament tear

ACL tears usually occur in athletes and can be non-cantact tears or ruptures and are the most common injury of related to the ACL. to the left is an image which shows a tear in an ACL ligament on this MRI T1 wieghted image.

ACL injuries most commonly occur when athletes stop rapidly, and change direction during atheltic events. ACL injuries have been linked to landing stifflegged and or as some would desribe as stovepiping a straight unbent limb; while twisting or turning the knee as the same time.
Women in sports tend to be more likely to damage the ACL than men. It is believed that menstrual cycle hormone-induced changes in muscle tension may be an imprtant contributing factor.

The landing flat on ones heels is a major contributor of ACL injuries in athletes. The forward slide of the tibia against the femur is restrained primarily by the ACL which is strained in this position and subject to injury at this point.

Hearing a sudden popping sound as well as swelling, weakness and instability of the knee is a symptom of an ACL injury. It is highly recomended that you not continue to use and or punish an already injured ACL as it can cause extensive cartilage damage and arthritis later in life.

The funtion of the ACL is to stabalize the knee in the extended positon while muscles are relaxed. If you are lucky and have extra strong muscles you may get by without your ACL.

Surgery comes in the form of using a graft from a cadaver extracted at a tisssue bank. Not a pleasent thought to have a part inserted from a dead person.

Rotator Cuff Tear

In the images on the left you can see examples of rotator cuff tears. In the image on the right, the red arrow is pointing to the tear in this MRI image. The white area is the actuall tear in the tendon.

Rotator cuff tears in volve one or more of the four tendons of the rotator cuff muscles. The tear will likely occur at the point of attachment to the tubercle of the humerus bone.

Rotator cuff tears are the most common of shoulder injuries, the supraspinatus muscle being the on the giving the most trouble.

Often rotator cuff tears will present with little or no pain, and have no symtoms at all. The most obvious cause of these tears are aging and degeneration related to age.

Diagnosing may be difficult as symtoms may be intermittent or only present when active. Pain may be mild to severe with some possible weakness. An MRI would be the modality of choice to prove the rotator cuff tear, with surgical resection to follow.

Ovarian Cyst

An ovarian cyst is a fluid filled sac found on the ovaries, these cysts can be anywhere from the size of a pea, to the size of a basketball as seen in the image on the left middle with the Dr's hands on it. Most ovarian cysts are benign in nature and basically harmless.

The picture on the top left is a diagram of the fallopian tubes and ovaries with
a cyst on the left ovary. The cyst can be seen as the enlarged white sphere on the left ovary.

Below is a CT scan of an ovarian cyst. There are actually 2 cysts marked by arrows. The cysts ore a little darker and on either side of the uterus which is lighter in color and larger in diameter.

Ovarian cysts can cause some problems, and need to be removed if larger than 5 centimeters.

Some of the symtoms ovarian cysts may cause are, lower abdomen pain in the form of a dull aching pain, sudden severe pain that may be intermittent or canstant in nature. A woman may feel bloated and full, have tender breast, weight gain, tired all the time, nausea, vomitting, and trouble with bowel movements.

Treatment can range from nothing for small ovarian cysts that cause little or no problem, to surgical removal if large enough to cause problems. Sometimes the ovary can be salvaged and other times it may need to be removed with the cyst. A ruptured cyst may cause infection and a whole other array of problems.

Acute Appendicitis

An appendicitis is basically an appendix that is inflamed, and or infected. It is always a medical emergency. An inflamed appendix has a very high mortality rate if not promptly treated. The image on the left shows the large intestine or colon with the appendix marked and labeled at the cecal portion of the colon where the illeum or terminating end of the small intestine and colon come together. It is the small diameter structure hanging down from the colon.

While the image just below shows a CT

study with oral and IV contrast used to highlite structures within the abdomen. On the left side of the image, which is the right side of the patient, you can see an arrow pointing to a white circle with a dark center which in fact is the inflamed appendix.

Symptoms of an appendicitis are, pain in the right lower abdomen, fever as well as a loss of appetite accompanied by nausea, vomiting, diarrhea, and an elevated white blood count..

Palpating the area can cause intense pain, and upon releasing pressure applied during palpation can also cause intense pain. Removal of the inflamed appenix is always the treatment of choice.

Pulmonary Embolism

Pulmonary embolism or PE, is a partial or total occlusion of one of the pulmonary arteries or one of its branches by a deep vein thrombus, or blood clot from a vein that becomes dislodged and travels to the pulmonary arteries and slows or stops the blood flow the lungs resulting possibly in death.

The top left image shows a CT image of a PE in the right pulmonary artery. The slightly darker area the red arrows point to is the blood clot while the lighter area on either side is the contrast enhaced blood. A contrast dye is used which shows up bright on x-rays allows doctors to trace the flow of blood through the body and detect any occlusion or blockage of blood. The image on the right is a model drawing intended to give you a more clear idea of what takes place during a PE. The grey area would be blood, the black area is a blood clot, and the white area is a lack of blood which would lead to necrosis or death of tissues in that area.

Common symtoms include chest pain, shortness of breath and palpations, rapid breaths, rapid heart rate while the body starves for oxygen.

Treatment for a PE is some type of anticoagulant such as heparin and or warfarin. In more severe cases, tPA or tissue plasminogen activator may be used or surgery may be required to remove the embloism via pulmonary thromboectomy.