ABSTRACT
<p><b>OBJECTIVE</b>To explore the manifestation of CT for excavated-type of rhomboid fossa of the clavicle.</p><p><b>METHODS</b>Nine cases with rhomboid fossaes of the clavicle of 8 patients accepted CT and 1 case added MRI together;all 8 patients were male who aged from 17 to 70 years old with mean age of 42.5 years old;three dimensional reconstruction of all CTs were made, the distance between focus and inside end of clavicle and the size of all focus were measured respectively, then the position, shape, margin of focus were analyzed.</p><p><b>RESULTS</b>All focuses located near the inside end of clavicle and the distances between focus and inside end of clavicle were lower than 2 cm and the mean value was 1.3 cm, the size of all focuses was from 1.05 to 3.45 cm and the mean value was 2.18 cm. All 9 focuses of 8 patients located in the posterior and nether edge of inside end of clavicle, 5 cases located in right and 4 cases located in left side(both right and left side occurred in 1 patient. Seven focuses showed "fishhook sign" and the rest 2 focuses were small and without fishhook shape;the cortex of clavicle of all 9 cases showed local minus and nearly marrow showed integrated sclerotic margin. Regular soft tissue as strip can be seen in 7 focuses and the rest small focuses without the symptom.</p><p><b>CONCLUSIONS</b>CT could show certain characteristics for excavated-type of rhomboid fossa of the clavicle and certain value for its diagnosis and identification.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To study the MSCT features and diagnosis of foot and ankle tendon injury and improve the recognition to avoid the missed.</p><p><b>METHODS</b>From January 2009 to December 2010, 32 patients suspected of foot and ankle tendon injury were enrolled and included 24 males and 8 females with an average age of 43 years ranging from 23 to 68 years. All patients had pain, tenderness, swelling or disfunction in the diseased foot and were finally confirmed with surgery, MRI, contralateral contrast and followed-up. The MSCT was performed with a multi-detector CT scanner (Emotion 6; Siemens) within 7 days after injury. Two experienced radiologists evaluated the tendon abnormalities before told the outcome.</p><p><b>RESULTS</b>With 5 patients lost, the final study included 27 patients. Thirty-one tendon injuries were finally confirmed in 23 cases. Thirty-five tendon abnormalities were diagnosed on CT images among all 243 tendons but 4 of them were misdiagnoses. The CT overall diagnostic sensitivity, specificity, and accuracy was 88.8% (31/35), 98.1% (208/212), and 98.4% (239/243). Eleven tendon dislocations showed as the tendon partially or completely off the tendon groove. Thirteen tendon entrapment showed no less than half section of the tendon embedded the fracture in the axial images, and 7 tendons located in the fracture gap or 6 tendons closely related with widened fracture in VR images (2 misdiagnosis). Four bone chip insertion showed the chip inserted in the tendons both in the axial images and VR images (1 misdiagnosis). Four tendon ruptures showed discontinuity and shortening of the tendon (1 misdiagnosis). Three tendon injuries showed thickening, density reduction and blurring of tendons, and misty surrounding fat space.</p><p><b>CONCLUSION</b>With comprehensive MSCT examination (thin-slice scanning and volume rendering) of foot and ankle, the tendon dislocation, tendon entrapment, bone chip intercalation, and tendon rupture/injury could be confidently diagnose.</p>