Background/Objectives: Intraneural tumors (INTs) pose a diagnostic challenge, owing to their varied origins within nerve fascicles and their wide spectrum, which includes both benign and malignant forms. Accurate diagnosis and management of these tumors depends upon the skills of the radiologist in identifying key imaging features and correlating them with the patient’s clinical symptoms and examination findings. Methods: This comprehensive review systematically analyzes the various imaging features in the diagnosis of intraneural tumors, ranging from basic MR to advanced MR imaging techniques such as MR neurography (MRN), diffusion tensor imaging (DTI), and dynamic contrast-enhanced (DCE) MRI. Results: The article emphasizes the differentiation of benign from malignant lesions using characteristic MRI features, such as the “target sign” and “split-fat sign” for tumor characterization. The role of advanced multiparametric MRI in improving biopsy planning, guiding surgical mapping, and enhancing post-treatment monitoring is also highlighted. The review also underlines the importance of common diagnostic pitfalls and highlights the need for a multi-disciplinary approach to achieve an accurate diagnosis, appropriate treatment strategy, and post-therapy surveillance planning. Conclusions: In this review, we illustrate the main imaging findings of intraneural tumors, focusing on specific MR imaging features that are crucial for an accurate diagnosis and the differentiation between benign and malignant lesions.

Guyon’s canal, or the ulnar tunnel, is a critical anatomical structure at the wrist that houses the ulnar nerve and artery, making it susceptible to various pathological conditions. Pathologies affecting this canal include traumatic injuries, compressive neuropathies like ulnar tunnel syndrome, and space-occupying lesions such as ganglion cysts. Ulnar tunnel syndrome, characterised by numbness, tingling, and weakness in the ulnar nerve distribution, is a prevalent condition that can severely impair hand function. The canal’s intricate anatomy is defined by surrounding ligaments and bones, divided into three zones, each containing distinct neural structures. Variations, including aberrant muscles and vascular anomalies, can complicate diagnosis and treatment. Imaging techniques are essential for evaluating these conditions; ultrasound provides real-time, dynamic assessments, while magnetic resonance imaging (MRI) offers detailed visualisation of soft tissues and bony structures, aiding in pre-surgical documentation and pathology evaluation. This review article explores the anatomy, pathologies, and imaging modalities associated with Guyon’s canal and underscores the necessity of understanding Guyon’s canal’s anatomy and associated pathologies to improve diagnostic accuracy and management strategies. By integrating anatomical insights with advanced imaging techniques, clinicians can enhance patient outcomes and preserve hand function, emphasising the need for increased awareness and research in this often-neglected area of hand anatomy.

Fluid-sensitive sequences on MRI [Magnetic Resonance Imaging] have widely been used to assess soft tissue oedema. Windowing techniques play a significant role in adjusting the contrast to highlight the pathology. The purpose of this study is to establish the impact of modified MRI window parameters, with a narrower window width than window level, in assessing soft tissue oedema in a plethora of musculoskeletal pathologies. Fifty randomly selected patients with a range of musculoskeletal pathologies resulting in soft tissue oedema on MRI were included in the study. Two separate images of each MRI study were taken on a PD fat suppressed sequence, one with default windowing range and another with window width lower than that of window level. Both images were reviewed by two radiologists and were assessed for diagnostic effectiveness in terms of image resolution and depiction of pathology. Assessment was semi-quantitatively compared and graded on the Likert scale, from 1 to 5, with 1 indicating poor quality and 5 indicating excellent quality. Friedman’s test was then conducted to compare the scores of both images. In most of the cases, the image with the modified window/level setting was significantly better in terms of depicting pathology and having better resolution, though some cases showed no clear preference. Friedman’s test showed that the score for images with modified window settings was significantly higher. Images with modified windowing in conjunction with standard imaging protocols help to assess soft tissue oedema.