Figure 1
A 15‑year‑old male with a left L5 pedicle stress fracture. (A) Sagittal MR images demonstrate hypointense signal abnormality (arrow) on the T1‑weighted image, associated bone marrow edema (arrow) on the fat‑suppressed T2‑weighted image (B) with a linear hypointense fracture line in the left L5 pedicle (white arrow). (C) The sagittal ZTE image clearly depicts the cortical discontinuity (arrow), confirming the diagnosis of a stress fracture.
Figure 2
MRI of the pelvis in a 48‑year‑old female long‑distance runner demonstrating a stress injury (arrows). (A, B) Coronal T1 and proton‑density fat‑suppressed images demonstrate signal changes in the pubic symphysis with associated bone marrow edema (arrow). (C) The coronal ZTE image demonstrates a sclerotic line compatible with a stress injury.
Figure 3
A distal fibular fracture in a 45‑year‑old female patient following an ankle sprain. (A, B) Anteroposterior and lateral ankle radiographs show no definite fracture. (C, D) Coronal proton density and coronal fat‑suppressed T2‑weighted MR images demonstrate a subtle hypointense line in the distal fibula with associated bone marrow edema (white arrows). (E) The coronal ZTE image clearly depicts the cortical fracture line.
Figure 4
Osteoid osteoma of the right femoral diaphysis in a 23‑year‑old kickboxing male athlete. (A) Anteroposterior radiograph of the right femur demonstrates focal cortical thickening along the medial diaphysis (arrow). (B, C) Coronal T1‑weighted and fat‑suppressed T2‑weighted MR images show medial cortical thickening with periosteal reaction (arrows). (D) Axial fat‑suppressed T2‑weighted MR image reveals a subtle central hyperintensity suggestive of a nidus (arrow). (E, F) Axial and coronal ZTE images clearly depict a small cortical nidus within the thickened cortex (arrows), confirming the diagnosis of osteoid osteoma.
Figure 5
A 15‑year‑old female gymnast with pain in the elbow. (A) Sagittal T2 fat‑suppressed MRI demonstrates subchondral bone marrow edema (arrow) in the capitellum accompanied with thinning of the overlying articular cartilage. (B, C) Sagittal and coronal ZTE images provide enhanced visualization of the articular surface, depicting contour irregularity and a subtle bony fragment (arrows).
Figure 6
A 12‑year‑old male soccer player with an ankle injury. (A) Coronal proton density without and with fat suppression, (B) and (C) sagittal proton density fat‑suppressed image shows an osteochondral lesion centered in the talar dome (arrow), with associated subchondral bone marrow edema and articular cartilage involvement. (D, E) Coronal and sagittal ZTE images demonstrate the centrally cortical fragment with mild loss of height of the subchondral bone (arrow).
Figure 7
A 15‑year‑old male soccer player with right knee giving way. Sagittal MRI of the knee demonstrates a large osteochondral lesion (arrows). (A) Sagittal T1‑weighted and (B) fat‑suppressed proton density images show a focal osteochondral defect in the medial femoral condyle with associated cartilage involvement and subchondral bone marrow edema (arrows). (C) The ZTE image provides improved delineation of the subchondral bone, demonstrating a fragmented cortical fragment (arrow).
Figure 8
A 24‑year‑old high‑level football player presenting with anterior knee pain, consistent with jumper’s knee. (A) Sagittal proton density‑weighted and (B) T2 fat‑suppressed images demonstrate focal thickening of the proximal patellar tendon insertion with increased intratendinous signal intensity (arrows). (C) The sagittal ZTE image depicts a small calcification (arrow) that is not appreciable on conventional MRI sequences.
Figure 9
A 52‑year‑old active female presenting with left shoulder pain and calcific tendinitis. (A) The coronal proton density‑weighted image demonstrates an inhomogeneous signal at the supraspinatus tendon insertion and increased fluid in the subacromial bursa (arrow). (B) The coronal ZTE image clearly depicts the calcific deposits with sharp delineation of the mineralized component (arrow).
Figure 10
Coronal ZTE MRI of the pelvis and hips for assessment of osseous morphology in an athlete. (A) The coronal ZTE image demonstrates bilateral hip osseous anatomy with improved cortical definition. (B) Magnified view of the left hip demonstrates an osseous bump at the femoral head–neck junction in keeping with CAM morphology, an increased alpha angle of 71°, and an os acetabuli (arrow).
Figure 11
Coronal MRI of the pelvis in a 21‑year‑old male sub‑elite football player demonstrating pubic apophysitis. (A) The coronal T2 fat‑suppressed image demonstrates bilateral bone marrow edema at the pubic symphysis, more pronounced on the right (arrows). (B) The coronal ZTE image demonstrates widening of the pubic symphysis with adjacent sclerosis (arrow) and focal irregular delineation of the articular margins (bold arrow).
Figure 12
MRI of the pelvis in a 32‑year‑old male runner presenting with low back and buttock pain radiating to the right leg. (A) Oblique coronal T1‑weighted image demonstrates irregular and blurred articular margins of the right sacroiliac joint with subchondral low signal intensity (arrow). (B) Oblique coronal T2 fat‑suppressed image demonstrates extensive bone marrow edema adjacent to the right sacroiliac joint. (C, D) Oblique coronal and axial ZTE images show sclerosis (arrow) and erosions (bold arrow), orienting the diagnosis to inflammatory sacroiliitis, which was proven after rheumatologic investigation.