Avulsion Fracture and Myositis Ossificans in a Professional Teenage Dancer: A Case Report

Fractures of the transverse processes in the lumbar vertebrae occur as the result of major forces such as direct blunt trauma, violent lateral flexion-extension forces, avulsion of the psoas muscle, or Malgaigne fractures of the pelvis. Dancers make repeated and forceful hyperextension and flexions of the spine, which may cause fractures of the transverse processes of the lumbar vertebrae. Repeated trauma of muscles in dancers may cause avulsion fractures and myositis ossificans. Herein, we report MRI and CT findings of an avulsion from the right transverse process of the L2 and L3 vertebrae in a 16-year-old professional teenage dancer, who responded to conservative treatment.

Atypical mycobacterial tenosynovitis and bursitis of the wrist

Atypical mycobacterial tenosynovitis of the wrist can easily be misdiagnosed as synovial chondromatosis. Both sonography and magnetic resonance imaging plays an important role in depicting "rice bodies" within the distended tendon sheaths and bursae of atypical mycobacterial infection. An endemic place for Mycobacterium species and the occupation of the patient should raise the suspicion for the disease. Polymerase chain reaction of the distended tendon fluid is a sensitive, specific and rapid method in identification of the mycobacteria.

CT and MRI in the evaluation of craniospinal involvement with polyostotic fibrous dysplasia in McCune-Albright syndrome

In this study, the efficacy of computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of craniospinal involvement with polyostotic fibrous dysplasia (PFD) in McCune-Albright syndrome (MAS) and related complications were reviewed. In CT, ground-glass appearance with well-defined borders was seen, with medullary widening and cortical thinning. More rarely, cystic/necrotic areas were observed within involved bone. These lesions were seen as hypointense in T1-weighted sequences and as hyperintense in T2-weighted sequences of MRI. There was no heterogeneous contrast enhancement. Cystic/necrotic areas were seen as hyperintense images on T2-weighted sequences. While bone marrow involvement was shown more clearly with MRI, compression of cranial and spinal nerves was determined most effectively by evaluation of CT and MRI together. CT and MRI should be employed together in order to demonstrate the extent of disease, and complications of craniospinal involvement of PFD in patients with MAS.

Prolapsing ectopic ureterocele presenting as a vulval mass in a newborn girl

Prolapse of the ureterocele and its presentation as a vulval mass is an extremely rare condition. There are no detailed imaging findings of such cases in the literature. We present voiding cystourethrography and MRI findings of a newborn girl with a ureterocele extending through the urethra.

Neuro-otologic applications of MRI

Magnetic resonance imaging (MRI) has increasingly new applications in neuro-otology. The aim of this review was to summarize MRI applications in neuro- otology and make a correlation between neuro-otologic anatomy and MR images. Different MRI techniques have been described in the imaging of different neuro-otologic structures. In particular, we discuss the effectiveness, indications, and techniques of MRI in the demonstration of neuro-otologic tracts and their related pathologies. MRI should be the first choice imaging modality for the evaluation of retrocochlear pathologies.

Real time balanced turbo field echo Cine-MRI in the analysis of deglutition events and transit times

Investigation of swallowing is an important part of oral diagnosis. It usually plays a role in the aetiology of some orofacial deformities and open-bite as well as in the relapse of treated open-bite patients. In recent years, the movements of the anatomical structures that participate in deglutition have been investigated by several methods such as cineradiography, electromyography, electropalatography, electromagnetic articulography and ultrasonography. However, all these techniques have various disadvantages. Recently, dynamic magnetic resonance imaging has become available in the evaluation of swallowing function. In this study we intended to present this new technique to the dental literature and aimed to obtain dynamic images of the deglutition process. We also compared the timing of events in subjects with anterior open-bite and normal overbite during swallowing 10 mL water.

Initial effects of the tongue crib on tongue movements during deglutition: a Cine-Magnetic resonance imaging study

The objective of this study was to investigate the initial effects of a tongue crib on tongue movements during deglutition by using real time balanced turbo field echo (B-TFE) Cine-MR imaging. A total of 21 patients were evaluated in this study. The open-bite group (OBG) consisted of 11 patients (seven girls, four boys) who had a mean age of 11.09 +/- 2.02 years and a mean overbite of -5.14 +/- 1.83 mm. These patients were evaluated initially (T1) and while wearing a tongue crib (T2). A total of 10 patients (five girls, five boys) with a mean age of 14.5 +/- 2.6 years and with a mean overbite of 1.6 +/- 0.5 mm served as controls (CG), and only initial records were obtained from these patients. T2 was compared with T1 and CG. T1 was also compared with CG. We evaluated deglutition during three stages matching oral (1), pharyngeal (2), and esophageal (3) stages. Our results indicated that the tongue's tip positioned more posteriorly when the crib was in place (T2) compared with both T1 and CG; the anterior portion of the tongue's dorsum was at a lower position in T2 compared with both T1 and CG at stage 3; the midportion of the tongue's dorsum was at a lower position in T2 than in T1 and CG at stages 1 and 2. To compensate for the posterior position of the tongue's tip (caused by the tongue crib), adaptive changes occurred in the anterior and midportions of the dorsum of the tongue.

Real-time balanced turbo field echo cine-magnetic resonance imaging evaluation of tongue movements during deglutition in subjects with anterior open bite

INTRODUCTION

The aim of this study was to evaluate tongue movements in subjects with anterior dental open bites during deglutition by using real-time balanced turbo field echo cine-magnetic resonance imaging.

METHODS

The study included 28 subjects. Two groups were formed according to the presence of anterior open bite (at least 2 mm). The open-bite group (OBG) consisted of 18 patients (14 girls, 4 boys) with a mean age of 14.5 +/- 2.7 years. The control group (CG) consisted of 10 patients (5 girls, 5 boys) with a mean age of 14.5 +/- 2.6 years. We evaluated deglutition during 3 stages: oral (stage 1), pharyngeal (stage 2), and esophageal stage (3).

RESULTS

Results indicated that (1) in the OBG, from stage 2 to stage 3, the anterior portion of the tongue dorsum was elevated [corrected] whereas its midportion was lowered [corrected]; (2) in the CG, its posterior portion was lowered [corrected] from stage 2 to stage 3; (3) in the CG, the tongue tip was positioned more posteriorly [corrected] at stage 2 than at stage 1; (4) in the OBG, the tongue tip moved more anteriorly in all stages of deglutition than in the CG.

CONCLUSIONS

Compensatory tongue functions occur in patients with anterior dental open bites. Dynamic MRI is a promising tool for evaluating swallowing patterns in these patients.

MR cholangiopancreatography of a case with a biliary tract variation and postoperative biliary duct injury

Because of the increasing frequency of surgical procedures such as hepatic resection, partial liver transplantation, and laparoscopic cholecystectomy, the number of patients requiring biliary imaging has increased. In this report, magnetic resonance cholangiopancreatography findings of a case with an aberrant right posterior hepatic duct draining directly into the gallbladder, which was overlooked prior to laparoscopic cholecystectomy, is presented and the importance of magnetic resonance cholangiopancreatography in the evaluation of congenital biliary anomalies and iatrogenic bile duct injury is discussed.

MR urography in pediatric uropathies with dilated urinary tracts

PURPOSE

To determine the diagnostic value of magnetic resonance (MR) urography in children with urinary tract dilatation.

MATERIALS AND METHODS

Twenty-five children between the ages of 4 months and 13 years (19 males and 6 females, mean age 6.5 years) were evaluated with T2 weighted and contrast-enhanced T1 weighted MR sequences. Results were compared with findings obtained with ultrasonography (n=25), intravenous urography (n=18), Tc99m- DTPA scintigraphy (n=16), and/or micturating cystouretrography (n=13).

RESULTS

MR urography provided a superior imaging of urinary system dilatation, the site and the etiology of obstruction, and both regular and complicated kidney duplication than did conventional imaging methods. MR urography that used T2 weighted sequences was able to demonstrate 29 of 32 (90.6%) abnormal renal collecting systems. Fourteen of 21 (66.7%) normal systems were revealed by heavily T2 weighted images. Forty-six of 51 (90.2%) renal collecting systems could be shown by T1 weighted sequences. With this sequence, however, five collecting systems (9.8%) could not be shown secondary to poor renal function and/or dilution of contrast agent within the dilated urinary tract.

CONCLUSION

In children, MR urography may replace conventional uroradiological methods.

Duodenal intramural hematoma due to blunt abdominal trauma

A 14-year-old boy was admitted to the hospital with the complaints of epigastric pain and vomiting for three days following epigastric trauma. Physical examination revealed a palpable mass in the epigastrium without any signs of peritoneal irritation. Vital signs, biochemical analysis, chest and abdominal x-rays were normal. Abdominal US, CT and upper gastrointestinal endoscopy showed that there was a well-defined duodenal intramural mass suggesting hematoma. Intraabdominal solid organs were normal and we did not observe free air or extravasation of contrast media. Therefore, we followed up the patient by US. The hematoma completely resolved 48 days after the trauma.

Testicular microlithiasis in pediatric age group: ultrasonography findings and literature review

PURPOSE

To evaluate the occurrence of testicular microlithiasis in pediatric age group by means of ultrasonography (US) examinations and to review the literature for pediatric testicular microlithiasis cases accompanied by testicular and extratesticular tumors.

MATERIALS AND METHODS

Nine children aged 3-16 years (mean age, 9.2 years) with testicular microlithiasis had been evaluated with US in a period ranging from 6 months to 6 years. In addition to the testicular ultrasonographic evaluation, liver US and abdominopelvic US were performed in all patients.

RESULTS

Typical testicular microlithiasis findings were seen in a total of 17 testicles. In one patient, testis did not exist in either the scrotum or the inguinal canal or the abdomen unilaterally. None of the patients displayed a focal lesion during the evaluation. The abdominal ultrasonographic findings were normal in all patients.

CONCLUSION

Although no tumoral lesion accompanying testicular microlithiasis or occurring in the course of evaluation was detected in this study, larger population and longer control periods are required, considering the co-existence of benign and malign lesions with testicular microlithiasis in the literature.

True aneurysm formation in axillofemoral bypass with a reinforced ePTFE graft-a case report

Since improvement in reinforced expanded polytetrafluoroethylene (ePTFE) grafts, true aneurysm and pseudoaneurysm formation have become relatively rare complications after axillofemoral reconstruction. This is a case report of a true aneurysm of an axillofemoral graft. The true aneurysm occurred 29 months after insertion of a reinforced ePTFE graft for aortoiliac occlusive disease. A mid-graft true aneurysm was identified during examinations without any trauma history. Continuous long-term follow-up is recommended for these reinforced ePTFE grafts because of rare aneurysm formation, preferably using duplex ultrasonography.

Massive lower gastrointestinal hemorrhage from the surgical anastomosis in patients with multiorgan trauma: treatment by subselective embolization with polyvinyl alcohol particles

PURPOSE

To evaluate the efficacy and safety of subselective arterial embolization with polyvinyl alcohol (PVA) particles with or without microcoil augmentation to control postoperative lower gastrointestinal (GI) bleeding.

METHODS

Ten patients with clinical, scintigraphic, and angiographic evidence of postoperative lower GI bleeding were considered for subselective embolization. Subselective embolizations were performed through coaxial microcatheters with 355-500 micron PVA particles with or without additional coil embolization.

RESULTS

Embolization was technically successful in 9 of 10 (90%) patients. In one patient, subselective embolization was not possible; consequently no embolization was performed. Clinical success was achieved after a single embolization in 6 of 10 (60%) patients and after a second embolization in an additional 3 of the 10 (30%) patients. While there was no rebleeding in patients with normal coagulation parameters, all three patients (100%) with coagulopathy rebled, two of them from another source. Although no acute ischemic effects developed, no long-term sequela such as ischemic stricture were specifically looked for. Seven patients developed abdominal discomfort and/or fever within 24-48 hr. Four of 10 patients died of complications other than hemorrhage or ischemia.

CONCLUSION

Subselective PVA embolization with or without a microcoil embolization is an effective and safe means of managing postoperative lower GI hemorrhage in patients with multiorgan trauma.

Percutaneous treatment of hepatic hydatid cyst in pregnancy

A 20 cm hepatic hydatid cyst with daughter cysts, was diagnosed in a primigravida in the fifteenth week of pregnancy and was managed percutaneously. No complications occurred and the patient subsequently gave birth to a healthy baby.

TRUS, CT and MRI findings of hydatid disease of seminal vesicles

Hydatid disease of the urogenital system, especially seminal vesicles and prostate, or retroperitoneum is a very rare condition. Secondary dissemination of seminal vesicles has not been described before. We describe the transrectal ultrasonography (TRUS), CT and MRI findings of a secondary solitary hydatid cyst of the left seminal vesicle, in a patient with disseminated hydatid disease involving all abdominal organs except for right kidney. We obtained typical findings of hydatid cyst at all modalities.