1
|
Williams MA, Naffaa L. Ischial Tuberosity Avulsion Fracture Mimicking Calcified Mass on Plain Films: A Case Report. Cureus 2024; 16:e53165. [PMID: 38420073 PMCID: PMC10901254 DOI: 10.7759/cureus.53165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Ischial tuberosity avulsion fractures are overall uncommon but are known injuries in the adolescent population. They are the result of sudden, forceful contraction of the hamstring muscle groups. The characteristic radiographic appearance of an ischial tuberosity avulsion fracture is of an irregular ischial margin and a nearby avulsed bone fragment. Callous formation may ensue and appears as a calcific density in the region of injury. Awareness of the spectrum of radiographic presentations can help ensure correct diagnosis and minimize concern for alternative underlying diagnoses. This case report describes a 14-year-old boy with a chronic ischial tuberosity avulsion fracture which demonstrated an unusual presentation on radiographs and required MRI to confirm the diagnosis and rule out other potentially ominous pathology.
Collapse
Affiliation(s)
- Mason A Williams
- Radiology, University of Central Florida College of Medicine, Orlando, USA
- Radiology, Nemours Children's Health, Orlando, USA
| | - Lena Naffaa
- Radiology, Nemours Children's Health, Orlando, USA
| |
Collapse
|
2
|
Li C, Chen W, Jin Y, Xu H, Luo H. Ultrasound performance in pediatric deep soft-tissue tumor characterization. Sci Rep 2023; 13:22107. [PMID: 38092843 PMCID: PMC10719244 DOI: 10.1038/s41598-023-48931-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
This study investigated the performance of ultrasonography in diagnosing deep soft-tissue tumors and tumor-like lesions in children with histological results. Demographic information and ultrasound characteristics of benign and malignant masses were statistically analyzed. Three radiologists (Radiologists 1, 2, and 3) independently reviewed the ultrasonography studies while being blinded to the medical history and other imaging findings. The 82 lesions included in the study were histopathologically classified as malignant (n = 25) or benign (n = 57). No statistically significant differences were observed between the benign and malignant subgroups regarding age (p = 0.059), sex (p = 1.0), disease course (p = 0.812), presence or absence of symptoms (p = 0.534), maximum diameter (p = 0.359), margin (p = 1.0), calcification (p = 0.057), or blood Adler type (p = 0.563). However, statistically significant differences were observed between the benign and malignant subgroups in terms of isolated or Multiple occurrences (p < 0.001), history of malignancy (p < 0.001), shape (p < 0.001), and echogenicity (p < 0.001). Parameters such as tumor shape (p = 0.042, OR = 6.222), single or multiple occurrences (p = 0.008, OR = 17.000), and history of malignancy (p = 0.038, OR = 13.962) were identified as independent predictors of benign and malignant tumors. The diagnostic sensitivities evaluated by the three radiologists were 68.0%, 72.0%, 96.0%, respectively, while the specificities were 77.2%, 82.5%, 77.2%, respectively. Ultrasound demonstrates good performance in the diagnosis of benign deep lesions such as hemangiomas/venous malformation and adipocytic tumors. Multiple irregular morphologies and a history of malignancy were identified as independent risk factors for malignant masses. The experience of radiologists in recognizing specific tumors is important. Careful attention should be paid to masses with ambiguous ultrasound features, as well as small lesions.
Collapse
Affiliation(s)
- Cong Li
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610000, Sichuan, China
- Department Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital, Sichuan University, Chengdu, China
| | - Wenyi Chen
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610000, Sichuan, China
- Department Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital, Sichuan University, Chengdu, China
| | - Ya Jin
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610000, Sichuan, China
- Department Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital, Sichuan University, Chengdu, China
| | - Hong Xu
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610000, Sichuan, China
- Department Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital, Sichuan University, Chengdu, China
| | - Hong Luo
- Department of Ultrasonography, West China Second University Hospital, Sichuan University, Chengdu, 610000, Sichuan, China.
- Department Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
3
|
Llanos D, de la Pedraja I, Campos L, Armijo J, Ávila LF. Imaging palpable tumors in pediatrics: Part 2. RADIOLOGIA 2023; 65:43-54. [PMID: 36842785 DOI: 10.1016/j.rxeng.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/03/2022] [Indexed: 02/28/2023]
Abstract
Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology books do not cover some of them. This series of two articles aims to review the clinical and radiological characteristics of a selection of palpable tumors in children that radiologists need to be familiar with.
Collapse
Affiliation(s)
- D Llanos
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - I de la Pedraja
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L Campos
- Servicio de Dermatología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - J Armijo
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L F Ávila
- Servicio de Cirugía Pediátrica, Hospital Universitario Clínico San Carlos, Madrid, Spain
| |
Collapse
|
4
|
Llanos D, de la Pedraja I, Campos L, Armijo J, Ávila L. Radiología de las tumoraciones palpables en el paciente pediátrico. Parte 2. RADIOLOGIA 2023. [DOI: 10.1016/j.rx.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
5
|
Prenatal diagnosis of rhabdoid tumor: Ultrasound, magnetic resonance imaging, 3D reconstruction and review of the literature. J Gynecol Obstet Hum Reprod 2022; 51:102479. [DOI: 10.1016/j.jogoh.2022.102479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022]
|