Generalized Tetanus in a Canadian Farmer Following Orthopedic Surgery.

Tetanus is extremely rare in developed countries. We report the first documented case of tetanus in the province of Alberta since 2016: a farmer that developed trismus, shoulder stiffness, and fevers eight days following orthopedic surgery. Tetanus immunoglobulin elicited rapid recovery. We highlight risk factors, pathogenesis, epidemiology, and diagnostic challenges.

Plantar plate tear diagnosis using dual-energy computed tomography collagen material decomposition application.

Computed tomography (CT) scans of the feet are often obtained in the context of trauma or suspected stress fracture mainly for assessment of osseous pathology. However, compared with magnetic resonance imaging (MRI), soft-tissue assessment on CT is typically limited. Plantar plate injury is a common cause of metatarsalgia and, along with other soft-tissue injuries, is typically diagnosed with MRI. We present a case of plantar plate tear detected on dual-energy CT scan using a collagen material decomposition algorithm confirmed on subsequent MRI.

Driven around the bend: novel use of a curved steerable needle.

PURPOSE: This technical note describes the novel use of a curved, steerable needle to access symptomatic osseous lesions in the pelvis and sacrum for palliative percutaneous treatment that would otherwise be difficult to treat using conventional straight needles. MATERIALS AND METHODS: Seven patients with lytic bone lesions were treated. One patient had multiple myeloma; the remaining had metastatic disease: breast carcinoma (n = 2), colorectal carcinoma (n = 1), renal cell carcinoma (n = 1), squamous cell carcinoma (n = 1), and leiomyosarcoma (n = 1). Five of the seven patients had lesions in the posterior acetabulum, and the two other patients had lesions in the sacrum. Four of the seven patients received radiofrequency ablation followed by cementoplasty; three patients received cementation alone. We used a novel needle designed for vertebroplasty, which has an articulating tip allowing it to be guided into lytic bone lesions located in difficult-to-access regions of the pelvis and sacrum. RESULTS: All patients were successfully treated with cementoplasty either with or without thermal ablation. No serious adverse events were reported. The needle was difficult to withdraw in two patients. CONCLUSION: Steerable curved needles can be successfully used to treat lytic osseous metastases with cementoplasty when lesions are located in sites that may be difficult to reach using conventional straight needles.

In vivo magnetic resonance imaging of the human cervical spinal cord at 3 Tesla.

PURPOSE: To demonstrate the feasibility of obtaining high-quality magnetic resonance (MR) images of the human cervical spinal cord in vivo at a magnetic field strength of 3 T and to optimize the signal contrast between gray matter, white matter, and cerebrospinal fluid (CSF) on 2D gradient recalled echo (GRE) images of the cervical spinal cord. MATERIALS AND METHODS: Using a custom-built, anatomically molded radio frequency (RF) surface coil, the repetition time and flip angle of a 2D GRE sequence were systematically varied in five volunteers to assess tissue contrast in the cervical spinal cord. RESULTS: The 2D GRE parameters for an optimal balance between gray-white matter and CSF-white matter contrast at 3 T were determined to be a time-to-repetition (TR) of 2000 msec and a flip angle of 45 degrees, with the constant short time-to-echo (TE) of 12 msec used in this study. Excellent tissue contrast and visualization of the internal anatomy of the spinal cord was demonstrated reproducibly in eight subjects using these optimal parameters. CONCLUSION: This study demonstrates that imaging the cervical spinal cord and delineating internal spinal cord structures such as gray and white matter is feasible at 3 T.