[RECIST classifications : our experience at a university hospital]

Since the WHO [World Health Organization]'s criteria published in 1981, many organizations and research teams worked on revising and defining criteria for response monitoring of solid tumors. The RECIST criteria in 2000 and its revised version in 2009 introduced major changes in selecting lesions to be assessed and measuring them, and determining treatment response. While treatments are becoming more specific with the emergence of targeted therapies, response criteria are becoming more diversified and specialized with a type of tumor or/and treatment. This review describes the evolution of response criteria methods and sketches our experience in this field in Lebanon

[Ultrasound-guided interventional procedures of the shoulder: the practical aspect]

Objectives : Musculoskeletal ultrasound has evolved throughout the last decade. This procedure allows accurate corticosteroid injections guidance. Precision is much higher than the infiltration performed blindly or under fluoroscopy. The purpose of our approach is to describe our technique in ultrasound-guided infiltration of the shoulder with an overview of the results

Material and method: 123 cases of ultrasound-guided infiltration of the shoulder were selected in our institution from July 2011 to June 2012. They are divided into sub-acromial sub-deltoid bursitis, biceps tenosynovitis, acromioclavicular osteoarthritis, adhesive capsulitis and calcific tendinosis lavage and aspiration

Results: The infiltration technique and the sonographic appearance in each condition are described. The rate of improvement is estimated between 70 and 80%

Conclusion: The ultrasound-guided infiltration provides an accurate and minimally invasive therapeutic option before any surgery. Recovery and socio-professional integration prove to be optimal and fast

Focus on the immediate hypersensitivity reactions products contrast iodinated [PCI]

The use of iodinated contrast agents [IC] has become common practice nowadays in the daily diagnostic and therapeutic procedures in radiology. Immediate hypersensitivity reactions occurring up to the first hour after injection of IC, can be of serious consequences, occasionally leading to death. This justifies the establishment of a prevention algorithm, including a sharp identification of those at risk and the implementation of premedication with corticosteroids. A history of previous reaction to IC is the major risk factor of a new reaction. Other risk factors include asthma, atopy and cardiomyopathy. The factors that influence the severity of the hypersensitivity allergic reactions are female gender, age, and taking beta blockers or ACE inhibitor drugs

multiple ultrasound patterns of ectopic pregnancy

Ectopic pregnancy [EP] has a variable and misleading clinical presentation contributing to the confusion with medical or other gynecological disorders. The rapid recourse to diagnostic methods, human chorionic gonadotropin [beta-hCG] titers and transvaginal ultrasonography, represents the best approach not only in the early diagnosis but also in the management and monitoring of patients with diagnosed EP. The purpose of this article is to provide a pictorial essay about EP and its multiple ultrasound [US] patterns. We present a large spectrum of EP aspects diagnosed on US and confirmed by pathology. We also review miscellaneous gynecologic diseases that may mimic EP on US. Although endovaginal US combined with quantitative [beta-hCG] analysis is an excellent tool for identifying EP, it may be normal sometimes in early pregnancies. Knowledge of all these patterns is helpful in establishing an early correct diagnosis, therefore leading to elective and conservative management in stable patients and preventing tubal rupture or substantial hemorrhage

[Application of ultrasound in musculo skeletal pathologies in pediatrics]

Osteoarticular ultrasound, a well established technique in adults, appears to be very useful also in children because of the non ossification of cartilaginous structures, the possibility to avoid sedation and irradiation, and hence the use of scanner and MRI will be reduced. This is a review of the clinical applications of musculoskeletal ultrasound in the pediatric population. Pictorial examples of cases collected between January 2003 and December 2006 of different pathologies encountered in Lebanon are displayed with a discussion of congenital malformations, traumatic lesions, inflammatory and infectious lesions, bone dystrophy and dysplasia, metabolic and tumoral lesions