The patient was a 21-year-old man, currently serving in the military, who was referred to a physical therapist for a chief complaint of left lateral ankle pain of 2 months in duration, after an inversion ankle injury sustained while hiking. At the time of the initial evaluation, the physical therapist reviewed computed tomography images and the radiologist’s report, which noted a cystic lesion in the anterior calcaneus, with a small area of communication with the subtalar joint, which was concerning for a pathologic fracture. The patient was diagnosed with a unicameral bone cyst of the calcaneus and subsequently underwent curettage and packing with a multipotential cellular bone matrix containing adult stem cells.

J Orthop Sports Phys Ther 2012;42(1):43. doi:10.2519/jospt.2012.0401

KEY WORDS: computed tomography, multi-potential cellular bone matrix, radiography, stem cells

The patient was a 53-year-old male with a chief complaint of right wrist pain of insidious onsent for the past month. The patient reported no recent trauma, but said he had multiple falls while skiing and mountain biking. Wrist radiographs and magnetic resonance imaging revealed ulnar variance and signs of osteonecrosis of the lunate, or Kienbock's disease. The patient underwent a radial shortening osteotomy in an effort to reduce compressive forces on the lunate and further fragmentation and collapse.

J Orthop Sports Phys Ther 2010;40(6):376. doi:10.2519/jospt.2010.0409

KEY WORDS: magnetic resonance imaging, radiography, wrist

The patient was a 24-year-old male with a 1-month history of right knee pain following a twisting injury. The patient was seen by his physician and radiographs of the right knee were taken and interpreted as normal. He was then referred to physical therapy. Magnetic resonance imaging of the right knee was ordered by the physical therapist because of concern over an anterior cruciate ligament (ACL) injury, and revealed a complete tear of the ACL, with the distal aspect of the ACL flipped anteriorly. It was hypothesized that the positioning of the distal segment of the ACL contributed to the loss of full knee extension in this patient. After recognition of the ACL tear, the patient was referred to an orthopaedic surgeon and underwent an ACL reconstruction 2 weeks later.

J Orthop Sports Phys Ther 2009;39(8):635. doi:10.2519/jospt.2009.0408

KEY WORDS: ACL, magnetic resonance imaging, radiographs

The patient was a 38-year-old female at 34 weeks' gestation, with a 3-week history of low back pain of insidious onset. Her physician referred her to physical therapy on the assumption that her pain was typical of normal pregnancy. However, the patient's significantly worsening condition prompted the physical therapist to contact the physician who ordered lumbar magnetic resonance imaging. MRI results led to a diagnosis of cauda equina syndrome, secondary to central spinal canal stenosis from a posterocentral disc extrusion at L4-5. The patient underwent an immediate surgical discectomy at L4-5.

J Orthop Sports Phys Ther. 2008; 38(11):721. doi:10.2519/jospt.2008.0411

KEY WORDS: low back pain, magnetic resonance imaging, pregnancy