Rapid chondrolysis after an intra-articular leak of bone cement in treatment of a benign acetabular subchondral cyst: an unusual complication of percutaneous injection of acrylic cement.

Percutaneous injection of methylmethacrylate is now increasingly employed to treat bone lesions, both malignant and benign. However, the risks of this procedure are still to be fully established. In this report, we describe a case of rapid chondrolysis appearing after the intra-articular leakage of cement during injection of an acetabular subchondral cyst, resulting in hip replacement. Although the mechanism of such chondrolysis is unknown, this event suggests a chondrolytic effect of the acrylic cement. Thus, it is essential to systematically search for the presence of an intra-articular passage before injecting bone cement into a peri-articular cyst. This unusual complication highlights the need for rigorous evaluation of the benefits and risks of percutaneous injection of acrylic cement in the treatment of benign lesions, especially close to an articulation.

[The value of 3-dimensional computed tomography in the preoperative evaluation of mandibular condyle fractures]. / Intérêt de la tomodensitométrie tridimensionnelle dans le bilan pré-opératoire des fractures du condyle mandibulaire.

The recent expansion of surgical treatment for displaced condylar neck fractures should rely on a precise and careful preoperative radiological assessment. Two goals must be achieved. First the diagnosis must be confirmed by usually sufficient conventional imaging. Secondly, all the features of the fracture have to be analysed to come to the surgical decision and to choose the best osteosynthesis technique. Compared to traditional imaging, three dimensional computed tomography offers the possibility of a direct viewing. The extend of the fracture, the aspect and degree of displacement of the condylar fragment in relation to the ramus or the fossa are easily assessed. The examination and the integration of multiple axial or coronal bidimensional CT scan sections are no more necessary. The clearer perception of both the spacial relationships and delineation of these condylar fractures results in a better choice for surgical planning.

[Contribution of magnetic resonance imaging in the neonatal diagnosis of congenital cardiopathies. Apropos of 10 cases]. / Apport de l'imagerie par résonance magnétique dans le diagnostic néonatal des cardiopathies congénitales. A propos de 10 cas.

The aim of this study was to evaluate potential indications of Magnetic Resonance Imaging (MRI) in the diagnostic workup of congenital heart disease in the newborn in comparison with two other means of investigation: Doppler-echocardiography and angiography. The imaging permitted to make the diagnosis in the 10 cases. MRI was superior than echocardiography in one newborn with a double aortic arch. MRI detected small muscular ventricular septum defects in two newborns with transposition of the great vessels. There was good agreement between MRI and angiographic images. Neither age nor prematurity proved to pose a limit on the diagnosis of MRI. MRI proved to be a good investigative tool which should be used after echocardiography, eventually making it possible to avoid angiography.