A Weight Loading Device as a Method for Assessment of Unilateral Knee Pain

OBJECTIVE: To identify the effectiveness of a weight loading device as a method for assessment of unilateral knee pain. METHOD: Twenty-five patients with unilateral knee pain and 25 pain-free controls participated in this study. Patients with a score of 2 or more on modified Kellgren-Lawrence scale based on the radiologic findings were diagnosed as degenerative arthritis. We constructed a device of segmental foot plates with strain gauge weight sensors to measure the weight load of each leg during self-selected walking speed. Using this device, we obtained the ratio of symptomatic side to asymptomatic side of weight load (RATIO) for each patient. The degree of pain according to visual analogue scale (VAS), abnormalities in radiologic findings, and weight load ratio were compared with each other. RESULTS: The RATIO was 1.00+/-0.03 in the control group, and 0.92+/-0.08 in the patient group (p<0.05). In the patient group, there was a significant correlation between RATIO and the VAS score (r=-0.44, p=0.03). In the patient group with degenerative arthritis, the RATIO (p=0.75) and VAS (p=0.94) were not different from those in patient group without degenerative arthritis. CONCLUSION: The foot plate weight loading device may be an effective tool for convenient measurements of knee pain.

Radiological Findings of Congenital Lipoid Adrenal Hyperplasia: A Case Report

Congenital lipoid adrenal hyperplasia (CLAH) is a rare autosomal recessive disorder characterized by the marked accumulation of lipids and cholesterol in the adrenal cortex, and the failure of adrenal steroids to synthesise. We report the ultrasound (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in a four-day- old female neonate with CLAH.

MR Findings of the Spinal Paraganglioma : Report of Three Cases

Extraadrenal paragangliomas involving the spine is less common and usually takes the form of intradural compression of the cauda equina. The authors report three cases of spinal paragangliomas resulting in extradural spinal cord compression and their MR findings. The MR imaging revealed a well-demarcated extradural mass with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-weighted images compared to paravertebral muscles. After Gd-DTPA administration, heterogeneous and intense enhancement was found. Multiple punctate and serpiginous structures of signal void due to high-velocity flow were noted around and within the tumors on all sequences. In one case, the signal void structures were well corresponded with feeding arteries on angiography. These may be the characteristic findings of the extraadrenal paraganglioma involving the spine.

Gadolinium-enhanced Fat-Suppression MR Imaging of the Female Pelvis

PURPOSE: To compare the value of Gd-DTPA enhanced, fat-suppression T1-weighted (Gd-FST1SE) MR images in thediagnosis of female pelvic disorders with that of fast spin-echo T1-weighted(T1FSE) and fast spin-echoT2-weighted(T2FSE) MR images. MATERIALS AND METHODS: Pelvic MR images of 42 women (24 ovarian disorders, 19uterine disorders) were reviewed by two radiologists. Discrimination of normal anatomic structures, identificationof pathologic lesions and recognition of internal structure of the lesions such as solid and cystic portion,papillary nodule, septa and wall were evaluated using a scoring system. The Friedman two-way ANOVA test was usedfor data analysis. RESULT: T2FSE was useful for evaluation of the uterine cervix(T1/T2/Gd, 2.5/3.9/2.8,respectively), junctional zone(1.6/3.1/2.5), endometrium (2.0/3.3/3.0), ovary(1.1/2.1/1.7) and uterine myoma(1.7/2.4/2.1)(P<0.001), but secondary degeneration was best visualized on Gd-FS T1SE. The Gd-FS T1SE ;lymphadenopathy(3.4/1.5/3.7) was better visualised on this modality than on eithor TIFSE or T2FSE. Gd-FS T1SEimages also clearly depicted papillary projection(2.4/3.1/3.8) and the solid component (2.9/3.1/3.5) of ovariancystic neoplasm(P<0.01). The confidence level in the identification of ovarian mass, internal septation andsurrounding wall of cystic neoplasm was not improved on Gd-FS T1SE. CONCLUSION: The Gd-FS T1SE images were usefulfor the evaluation of metastatic lymphadenopathy in uterine cervical malignancy and for identification of thesolid component and papillary projection of ovarian cystic neoplasm.

MR findings of Dysembryoplastic Neuroepithelial Tumor

PURPOSE: Dysembryoplastic neuroepithelial tumor (DNET) is a newly described, pathologically benign tumor arising within the supratentorial cortex. We reviewed the MR appearance of five patients with DNET, emphasizing the clinical and radiologic features. MATERIALS AND METHODS: MR images in the five patients (three male and two female) with a history of epileptic seizure and pathologically-proven DNET were retrospectively reviewed. We analyzed the location, configuration, signal intensity, contrast enhancement, vasogenic edema and calcifications of these tomors. RESULTS: The tumors were located mainly in the cortical to subcortical area with very little perifocal mass effect on MR imaging. They were essentially hypointense on T1-weighted imaging, and showed a hyperintense well circumscribed mass on T2-weighted imaging and a thick gyrus-like configuration was retained within the lesions. On contrast enhanced study, focal nodular enhancement was seen in one patient, and multifocal nodular enhancement in two. CONCLUSION: DNET is rare benign tumor resulting in often medically intractable epileptic seizure and shows a characteristic gyriform configuration, well-described lobular tumor margins and sometimes multifocal nodular enhancement. These radiologic features may aid in differentiating DNET from ganglioglioma and other gliomas.

The Value of CT in detecting Pathologic Bowel Perforation

PURPOSE: To evaluate the usefulness of CT for assessing the location and cause of pathologic gastrointestinal perforation. MATERIALS AND METHODS: A retrospective analysis of abdominal CT was performed in 27 perforations of 26 patients with underlying gastrointestinal pathology. Fifteen benign and 12 malignant perforations consisted of five gastric cancers, one gastric ulcer, ten duodenal bulb ulcers, two bowel adhesions, one jejunal metastasis from lung cancer, one ileocolic Crohn's disease, one radiation colitis and six colon cancers. CT scans were evaluated for 1) diagnosis of bowel perforation, 2) assessment of the cause and site of perforation, and, in particular, differentiation between benignancy and malignancy, and 3) complications and their extent. RESULTS: CT easily detected varying amounts of free air or fluid collection, and infiltration or abscess formation adjacent to the main lesion, and the diagnosis of gastrointestinal perforation was therefore easy. In 11 of the 12 malignancies (92%), primary tumor was diagnosed, but detection of the site of perforation was possible in only seven cases (7/12, 58%). The 15 benign lesions revealed nonspecific CT findings, and the perforation site could be presumed in six (6/15, 40%). In one case of Crohn's disease, the primary cause was visualized. Among six colonic cancers, four pericolic abscesses and two fistulas to adjacent organs were found, but there was no evidence of diffuse peritonitis. CONCLUSION: CT was helpful to lead to optimal treatment of pathologic gastrointestinal On CT, the detectability of perforation, primary benign or malignant lesion, perforation site and extent of complication was high, and this modality was therefore a useful indicator of the optimal treatment for pathologic gastrointestinal perforations.

Pelvic Actinomycosis

PURPOSE: To demonstrate the radiologic characteristics of the pelvic actinomycosis. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of seven patients with pathologically proven pelvic actinomycosis and analyzed the anatomical location, characteristics of the lesion and alteration of surrounding structures. RESULTS: The location of the lesions were the ovary and adnexa(n=4), rectum(n=1), cecum and terminalileum(n=1), and bladder(n=1). Three of the seven patients had a past history of intrauterine devices.Post-contrast enhanced CT showed an ill-defined mass with inhomogeneous enhancement and a tendency to invade th esurrounding normal tissue plane. CONCLUSION: Pelvic actinomycosis should be included in differential diagnosis when an unusually aggressive infiltrative mass is located in the pelvic cavity, especially in a patient with long-term use of intrauterine contraceptive devices.