Radiographic Features of Tuberculous Osteitis in Greater Trochanter and Ischium

PURPOSE: To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. MATERIALS AND METHODS: We retrospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involvingthe greater trochanter and ischium. In each case, the following were analyzed : morphology of bone destruction, including cortical erosion; periosteal reaction ; presence or abscence of calcific shadows in adjacent softtissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. RESULTS: Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. Inaddition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. CONCLUSION: Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that the selesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

Comparison of Benign and Malignant Microcalcifications

PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.

Is CT Effective in Diagnosing the Acute Appendicitis?: Focus on Comparison of Unenhanced CT with Barium Enema

PURPOSE:To evaluate the role of unenhanced CT in diagnosing the acute appendicitis. METHOD AND MATERIALS: We retrospectively analyzed conventional contrast-enhanced abdominal CT scans of 197 normal patients and barium enemas of 26 out of the 197 patients. Additional unenhanced CT scans of right lower abdomen were performed on 30 patients who were suspected of having acute appendicitis;barium enema was performed in 26 patients. RESULTS: in the analysis of the conventional CT scans, we could detect 132(67%) normal appendicies. On barium enema of 26 out of 197 patients, abruptly narrowed appendix was visualized in 5 cases and luminal irregularity in 4 cases but all 26 cases showed normal appendix on CT. In the 30 cases of unenhanced CT, all appendicies were visualized. Among 12 Cases which were proved as acute appendicitis, barium enenma was done in 10 case;abruptly narrowed appendix was shown in 3 and luminal irregularity in 1. Among 18 cases which were diagnosed as normal appendix, nonvisualization of appendix' was in 1 case, abruptly narrowed lumen in 3, and luminal irregularity in 9. CONCLUSION:Unenhanced CT in the area of the cecum may be an effective and safe diagnostic tool for acute appendicitis.