Isolated sternal hypoplasia: a rare cause of kyphoscoliosis

In most cases, kyphoscoliosis is idiopathic. However, this is a diagnosis of exclusion and can be made only if no cause can be identified. Kyphoscoliosis can occur due to various causes. Isolated sternal anomalies may also cause kyphoscoliosis secondary to the bony deformity though this has not previously been reported in literature. We have reported a case of kyphoscoliosis secondary to isolated sternal hypoplasia with complete absence of bony and cartilaginous elements of the body and xiphoid process of the sternum without any associated deformities of mediastinal structures, lung parenchyma or soft tissues in a young male patient. Careful evaluation of patients with kyphoscoliosis can ensure timely diagnosis of unusual and potentially treatable causes for the same such as sternal anomalies. Addition of lateral chest radiographs to the imaging protocol for evaluation of kyphoscoliosis can play a major role in timely diagnosis of such cases.

Comparison of dynamic contrast-enhanced and diffusion weighted magnetic resonance image in staging and grading of carcinoma bladder with histopathological correlation

Bladder cancer is the second most common neoplasm of the urinary tract worldwide. Dynamic contrast-enhanced and diffusion-weighted MRI has been introduced in clinical MRI protocols of bladder cancer because of its accuracy in staging and grading. To evaluate and compare accuracy of Dynamic contrast enhanced [DCE] and Diffusion weighted [DW] MRI for preoperative T staging of urinary bladder cancer and find correlation between apparent diffusion coefficient [ADC] and maximum enhancement with histological grade. Sixty patients with bladder cancer were included in study. All patients underwent Magnetic Resonance Imaging [MRI] on a 1.5-T scanner with a phased-array pelvic coil. MR images were evaluated and assigned a stage which was compared with the histolopathological staging. ADC value and maximum enhancement curve were used based on previous studies. Subsequently histological grade was compared with MR characteristics. The extent of agreement between the radiologic staging and histopathological staging was relatively greater with the DW-MRI [?=0.669] than DCE-MRI [?=0.619]. The sensitivity, specificity, and accuracy are maximum and similar for stage T4 tumors in both DCEMRI [100.0, 96.2 and 96.7] and DW-MRI [100.0, 96.2 and 96.7] while minimum for stage T2 tumors - DCEMRI [83.3, 72.2, and 76.7] and DWI-MRI [91.7, 72.2, and 80]. MRI is an effective tool for determining T stage and histological grade of urinary bladder cancers. Stage T2a and T2b can be differentiated only by DCE-MRI. Results were more accurate when both ADC and DCE-MRI were used together and hence a combined approach is suggested