E2183. Painful Musculoskeletal Variants: When Normal Becomes Abnormal
  1. Oluwadamilola Teniola; University of Virginia
  2. Anthony Balzer; University of Virginia
  3. Michael Perry; University of Virginia
Developmental anatomic variants of the musculoskeletal system pose a diagnostic dilemma to clinicians and radiologists. Recognizing normal variations on imaging is important to avoid misdiagnosis. However, in some cases the “normal” musculoskeletal variant can be the source of symptoms. Many musculoskeletal anatomic variants have been associated with clinical symptoms despite being considered a spectrum of normal variation. Most notably, accessory ossicles of the hands and feet have been well documented to cause pain. Identification of the imaging presentation of these symptomatic musculoskeletal variants will aid in appropriate radiologic and clinical correlation.

Educational Goals / Teaching Points
The purpose of this presentation is to provide a case-based review of clinical symptoms and imaging findings that may help differentiate painful from asymptomatic normal variants.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
A variety of cases will be provided illustrating commonly encountered variants of the axial and appendicular musculoskeletal system. Correlation with common clinical presentation and symptoms will be linked to imaging, particularly MRI, focusing on how these imaging features can help distinguish painful from asymptomatic normal variants. Treatment options, including image-guided injections, will be discussed.

The recognition of anatomic variants and their associated pathologic conditions is important in avoiding common pitfalls in musculoskeletal imaging. MRI is a powerful tool in the recognition and accurate diagnosis of painful normal variants.