Skeletal radiology
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Case Reports
Anaerobic osteomyelitis of femoral head with intraosseous, intra-articular, bursal and muscle pneumatosis.
A case is presented of anaerobic osteomyelitis with intraosseous pneumatosis resulting in extension of gas in soft tissue structures and femur in a patient with mitral valve vegetation and bacteremia. The finding of intraosseous pneumatosis and its extension into the hip joint, iliopsoas bursa and subgluteus medius bursa is depicted. Intraosseous pneumatosis is a rare but concerning finding for osteomyelitis in the absence of a penetrating wound, recent surgery, biopsy or fracture.
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Case Reports
Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine: fatal course in a 65-year-old woman.
A case of Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine in a 65-year-old woman is described. The patient presented with progressive neurologic symptoms, pain, and deformities of the cervico-thoracic spine as well as of her left shoulder following a traumatic shoulder luxation. ⋯ The results of the clinical, radiological and histopathologic examination leading to the diagnosis of Gorham-Stout disease are described. Neither attempted surgery nor radiotherapy produced clinical improvement and the patient died 1 year after the first clinical evaluation.
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To evaluate the frequency and location and to determine the long-term MR changes in patients with edema-like bone marrow abnormalities after acute knee trauma. ⋯ The majority of acute post-traumatic marrow signal changes are found in the lateral compartment and do not show additional osseous or chondral alterations. After a minimum of 2 years acute post-traumatic bone marrow edema-like signal alterations vanish in the majority of patients. Even more severe articular surface injuries such as subchondral bone impaction or chondral/osteochondral fractures will heal without obvious osseous long-term sequelae. Post-traumatic osteonecrosis, as reported in the literature, must be a rare event after acute knee trauma.
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We report a case of intra-articular intracortical chondroblastoma of the femoral condyle which radiologically appeared to be osteoid osteoma. A 19-year-old woman presented with a 3-year history of gradually increasing pain in the right knee and had been on nonsteroidal anti-inflammatory drugs for pain relief. Laboratory data were within normal limits. ⋯ The lesion was excised en bloc and the histological diagnosis of chondroblastoma was made. A mild inflammatory reaction was observed in the bone marrow and synovium around the tumor. The chondroblastoma cells were shown to express cyclooxygenase-2 with immunohistochemistry.
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Fluctuating equilibrium magnetic resonance (FEMR) is a rapid three-dimensional (3D) imaging sequence with high signal-to-noise ratio (SNR). FEMR may be useful for detecting cartilage defects in the knee. At 1.5 T, FEMR uses a TR with odd multiples of 2.2 ms for fat/water separation. With a TR of 6.6 ms, high-resolution 3D imaging of cartilage is possible. ⋯ FEMR obtains high-resolution 3D images of the entire knee in 2 min with excellent cartilage/fluid contrast. FEMR is sensitive to field inhomogeneity and requires shimming. Surface defects are outlined by bright synovial fluid, and cartilage has higher signal-to-noise efficiency compared with PD-FSE, T2-FSE, and 3D-SPGR techniques.