Skeletal radiology
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A case of median nerve entrapment at the elbow between the supracondylar process and an anomalous insertion of Struthers' ligament is presented. The diagnosis of anomalous insertion of the ligament was made by MRI and confirmed at operation. ⋯ It produced symptoms identical to supracondylar process syndrome. Excision of the supracondylar process of the humerus and Struthers' ligament relieved symptoms in this athlete.
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The purpose of this study was to clarify the nature of Osgood-Schlatter disease (OSD) using MR images. ⋯ We clarified the progress of OSD with MRI. The process of OSD started from the apophyseal stage and a tear appeared in the secondary ossification center, widening to an opened shell-like shape. This damage progressed to an ossicle in some cases. In short, the ossicle was formed from an avulsed portion. It was very difficult to show the course of OSD with radiography. MR images were especially useful for revealing early and progressive lesions of OSD.
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Case Reports Comparative Study
Distinction of well-differentiated liposarcoma from lipoma in two patients with multiple well-differentiated fatty masses.
This case report describes the features of gadolinium-enhanced MRI in well-differentiated liposarcoma with histologic correlation and addresses the usefulness of this imaging technique in distinguishing well-differentiated liposarcoma from lipoma. Gadolinium-enhanced MRI revealed significantly enhanced signal in well-differentiated liposarcoma in a background of multiple well-differentiated benign fatty masses by showing the increased vascularity in the septa of well-differentiated liposarcoma. Although such signal enhancement can be seen in some types of benign lipomatous tumors with increased blood vessels, this technique is helpful in selection of biopsy site, especially in a clinical setting of multiple fatty masses.
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Comparative Study
Acute paediatric ankle trauma: MRI versus plain radiography.
To evaluate the diagnosis of acute physeal ankle fractures on plain radiographs using MRI as the gold standard. ⋯ The incidence of false negative ankle fractures in plain radiographs was small and no complex ankle fractures were missed on radiographs. The total extent of complex fractures was, however, not always obvious on radiographs. In an unselected series of relatively mild ankle injuries, we were unable to show a single case where the treatment or prognosis based on plain radiography should have been significantly altered after having done a routine MRI examination. Plain radiography is still the diagnostic cornerstone of paediatric ankle injuries.
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We report on a 4-year-old boy adopted from Paraguay who presented with an acute onset of thigh pain. Initial clinical, imaging, and histopathologic findings suggested florid osteomyelitis. However, the development of pancytopenia on intravenous antibiotics prompted further investigation and the ultimate diagnosis of Gaucher disease. In retrospect, characteristic changes on conventional radiographic and MR images, as well as growth of a contaminant organism, pointed to the diagnosis of pseudo-osteomyelitis rather than osteomyelitis.